Phasic characteristics of inspiratory crackles of bacterial and atypical pneumonia

Norisue, Yasuhiro; Tokuda, Yasuharu; Koizumi, Masahiro; Kishaba, Tomoo; Miyagi, Seishirou

doi:10.1136/pgmj.2007.067389

Cited by 11 publications

(11 citation statements)

References 22 publications

(18 reference statements)

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“…SP-P was associated with a shorter length of respiratory symptoms before ICU admission (3 days [2-7] vs. 6 days [4][5][6][7][8][9], p = 0.0008). At ICU admission SAPS II score was higher for SP-P (42 [30-55] vs. 32 [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41], p = 0.005), shock was more frequent (32% vs. 8%; p = 0.0004), creatinine level was higher (101 [69.5-168.8] μmol/L vs. 77 [57.5-108] μmol/L, p = 0.008), and lactate level was high (2.3 [1.8-3.4] mmol/l vs. 1 [0.07-2.7] mmol/l; p = 0.003).…”

Section: Outcomes Of Atypical Pneumonia (Ap)mentioning

confidence: 99%

Severe atypical pneumonia in critically ill patients: a retrospective multicenter study

Valade

Biard

Lemiale

et al. 2018

Ann. Intensive Care

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BackgroundChlamydophila pneumoniae (CP) and Mycoplasma pneumoniae (MP) patients could require intensive care unit (ICU) admission for acute respiratory failure. MethodsAdults admitted between 2000 and 2015 to 20 French ICUs with proven atypical pneumonia were retrospectively described. Patients with MP were compared to Streptococcus pneumoniae (SP) pneumonia patients admitted to ICUs. ResultsA total of 104 patients were included, 71 men and 33 women, with a median age of 56 [44–67] years. MP was the causative agent for 76 (73%) patients and CP for 28 (27%) patients. Co-infection was documented for 18 patients (viruses for 8 [47%] patients). Median number of involved quadrants on chest X-ray was 2 [1–4], with alveolar opacities (n = 61, 75%), interstitial opacities (n = 32, 40%). Extra-pulmonary manifestations were present in 34 (33%) patients. Mechanical ventilation was required for 75 (72%) patients and vasopressors for 41 (39%) patients. ICU length of stay was 16.5 [9.5–30.5] days, and 11 (11%) patients died in the ICU. Compared with SP patients, MP patients had more extensive interstitial pneumonia, fewer pleural effusion, and a lower mortality rate [6 (8%) vs. 17 (22%), p = 0.013]. According MCA analysis, some characteristics at admission could discriminate MP and SP. MP was more often associated with hemolytic anemia, abdominal manifestations, and extensive chest radiograph abnormalities. SP-P was associated with shock, confusion, focal crackles, and focal consolidation.ConclusionIn this descriptive study of atypical bacterial pneumonia requiring ICU admission, mortality was 11%. The comparison with SP pneumonia identified clinical, laboratory, and radiographic features that may suggest MP or CP pneumonia.Electronic supplementary materialThe online version of this article (10.1186/s13613-018-0429-z) contains supplementary material, which is available to authorized users.

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Section: Outcomes Of Atypical Pneumonia (Ap)mentioning

confidence: 99%

Severe atypical pneumonia in critically ill patients: a retrospective multicenter study

Valade

Biard

Lemiale

et al. 2018

Ann. Intensive Care

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“…On physical examination, more than half of the patients with Mp pneumonia had no audible crackles and were likely to have late inspiratory crackles . Therefore, primary care physicians should be aware of these six factors that help discriminate Mp pneumonia from other causes of CAP using the JRS “diagnostic tests” (Table ).…”

Section: Mp Pneumoniamentioning

confidence: 99%

Mycoplasma pneumoniae infection: Basics

Saraya

2017

J of Gen and Family Med

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Mycoplasma pneumoniae (Mp) is one of the leading causes of community‐acquired pneumonia and can cause a number of extrapulmonary manifestations in the absence of pneumonia. In this regard, primary care physicians should know how to suspect, diagnose, and manage patients with Mp infection. This review gives a general overview of the basic clinical aspects of Mp infection with special reference to pneumonia, which will help further understanding of the disease.

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“…Goto (2011) reported that the mean body temperature in adult Japanese patients with Mp pneumonia was 37.7 ± 1.0°C and that 29.2% of patients had a temperature no greater than 37.0°C. Analysis of physical examination data revealed that more than half of patients with Mp pneumonia had no audible crackles and were likely to have late-inspiratory crackles as compared with those infected with typical pathogens (Norisue et al, 2008). On laboratory examination, Mp pneumonia patients had relatively lower leukocyte counts than did those having pneumonia from other causes (Von Baum et al, 2009).…”

Section: Clinical Featuresmentioning

confidence: 99%

Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications

et al. 2014

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Mycoplasma pneumoniae (Mp) is a leading cause of community acquired pneumonia. Knowledge regarding Mp pneumonia obtained from animal models or human subjects has been discussed in many different reports. Accumulated expertise concerning this critical issue has been hard to apply clinically, and potential problems may remain undiscovered. Therefore, our multidisciplinary team extensively reviewed the literature regarding Mp pneumonia, and compared findings from animal models with those from human subjects. In human beings, the characteristic pathological features of Mp pneumonia have been reported as alveolar infiltration with neutrophils and lymphocytes and lymphocyte/plasma cell infiltrates in the peri-bronchovascular area. Herein, we demonstrated the novel aspects of Mp pneumonia that the severity of the Mp pneumonia seemed to depend on the host innate immunity to the Mp, which might be accelerated by antecedent Mp exposure (re-exposure or latent respiratory infection) through up-regulation of Toll-like receptor 2 expression on bronchial epithelial cells and alveolar macrophages. The macrolides therapy might be beneficial for the patients with macrolide-resistant Mp pneumonia via not bacteriological but immunomodulative effects. This exhaustive review focuses on pathogenesis and extends to some therapeutic implications such as clarithromycin, and discusses the various diverse aspects of Mp pneumonia. It is our hope that this might lead to new insights into this common respiratory disease.

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Phasic characteristics of inspiratory crackles of bacterial and atypical pneumonia

Abstract: In patients with CAP and audible crackles, phasic characteristics of inspiratory crackles may be used to distinguish AP from BP. Prospective studies are needed to confirm these findings.

Cited by 11 publications

References 22 publications

Severe atypical pneumonia in critically ill patients: a retrospective multicenter study

Severe atypical pneumonia in critically ill patients: a retrospective multicenter study

Mycoplasma pneumoniae infection: Basics

Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications

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