Predictive factors, microbiology and outcome of patients with parapneumonic effusion

Falguera, Miquel; Carratalà, Jordi; Bielsa, Silvia; García-Vidal, Carolina; Ruiz-González, Agustı́n; Chica, I; Gudiol, Francesc; Porcel, José M.

doi:10.1183/09031936.00000211

Cited by 103 publications

(97 citation statements)

References 35 publications

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“…Interestingly, pleuritic chest pain is more commonly reported in younger patients with pneumococcal CAP than in older patients [34], and has previously been associated with the development of PPE [15]. The observed increased incidence of PPE and infection with PPE-related serotypes in younger patients provides a potential explanation for this finding, although the underlying mechanisms are unclear.…”

Section: Discussioncontrasting

confidence: 40%

“…Tachycardia was unexpectedly found to be negatively associated with PPE in the cohort with pneumococcal CAP, although it was not associated with all-cause PPE. In contrast, FALGUERA et al [15] reported an independent association of tachycardia .100 beats?min -1 with all-cause empyema and complicated PPE.…”

Section: Discussionmentioning

confidence: 91%

“…Although no previous publications have identified risk factors for pneumococcal PPE, we inferred potential risk factors from studies identifying risk factors for complicated PPE and complicated CAP (defined as multilobar CAP or CAP with PPE or empyema) [13][14][15] and alcohol abuse, although identified as potential risk factors for complicated PPE, were not recorded in all patients and therefore not included in the analysis.) Analyses were also performed to adjust for severity of CAP using PSI risk group [3].…”

Section: Discussionmentioning

confidence: 99%

“…Although no risk factors have been specifically identified for the development of pneumococcal PPE, factors associated with the development of complicated pneumococcal CAP (defined as multilobar CAP, PPE or empyema) include chronic liver disease, high C-reactive protein (CRP) levels on admission and creatinine level, with chronic obstructive pulmonary disease (COPD) a negative risk factor [13]. Risk factors for all-cause complicated PPE include age o60 years, alcoholism, pleuritic chest pain, tachycardia, leukocytosis, low albumin, low plasma sodium and high platelet count [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Serotypes associated with the development of pneumococcal para-pneumonic effusion in adults

et al. 2012

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Serotypes 1, 3, 7F and 19A are implicated in childhood pneumococcal para-pneumonic effusion (PPE). It is not known whether the same is true for adult PPE.A prospective cohort study was conducted over a 2-year period. Consecutive adults admitted with community-acquired pneumonia (CAP) were studied. Pneumococcal serotype was identified from urine samples using a multiplex immunoassay.Of 920 patients recruited, 366 had pneumococcal CAP; 100 of these had PPE and a serotype was determined in 73 patients. Factors associated with PPE were age, pneumonia severity index score and serotype. Serotypes most associated with PPE were 1 (18 (45%) out of 40), 19A (9 (45%) out of 20) and 3 (8 (40%) out of 20). Serotypes common in childhood PPE were independently associated with adult PPE (adjusted OR 2.3; p50.003). Serotypes not included in the 7-valent pneumococcal conjugate vaccine (PCV) were more likely to be associated with PPE (OR 2.1; p50.024) compared with those in the vaccine. Serotypes included in PCV-13 were as likely to be associated with PPE as those that are not (OR 0.8; p50.301).Serotypes 1, 3, 7F and 19A are independently associated with adult PPE, a similar finding to childhood PPE. Serotype replacement following pneumococcal vaccine implementation may influence the spectrum of clinical disease. @ERSpublications Serotypes associated with pneumococcal para-pneumonic effusion in adults are similar to those in childhood disease

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Section: Discussioncontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serotypes associated with the development of pneumococcal para-pneumonic effusion in adults

et al. 2012

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“…The microbe was known in 72 % of the patients. None of them were infected with N. meningitidis (15).…”

Section: Discussionmentioning

confidence: 99%

En ung mann med luftveisinfeksjon og ansiktsutslett

Riis¹,

Berg²

2017

Tidsskriftet

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Berg (born 1957) PhD, is a specialist in infectious diseases and internal medicine and senior consultant. The author has completed the ICMJE form and reports no conflicts of interest.A young man was hospitalised with left-side respiration-dependent chest pain. He had a slightly reduced general condition and fever. It was to be a lengthy stay in hospital, with diagnosis of an unusual cause of pulmonary involvement.A previously healthy man in his late teens was admitted to hospital via the Accident and Emergency Department after twenty-four hours of left-side, respiration-dependent pain. Could the rash developed by the patient after the first penicillin dose be a sign of a disseminated meningococcal disease rather than an allergic reaction? It was not petechial, looked like a drug-induced exanthem, and vanished when the antibiotic was changed. In three studies of a total of 862 patients with meningococcal infection, 37-49 % developed meningitis without shock, 10-18 % shock without meningitis, 7-12 % shock and meningitis and 18-33 % mild meningococcaemia with neither shock nor meningitis (1).The patient was still clinically well, with no neck stiffness or mental deficit, but he had

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Prognostic Role of Incidental Pleural Effusion Diagnosed During Echocardiographic Evaluation

Ercan

Davutoğlu

Altunbaş

et al. 2014

Clinical Cardiology

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Background: The purpose of this study was to determine the long-term prognostic implications of incidental pleural effusion (PE) detected during echocardiographic examination and its relationship with concomitant diseases. Hypothesis: The study hypothesis is to test whether incidental pleural PE detected during echocardiographic examination be used as a prognostic marker. Methods: The study was performed by evaluating patient records (N = 251) in whom PE was incidentally detected during echocardiographic examination in a tertiary hospital between 1999 and 2012. The patients were classified into 4 major groups according to the concomitant primary disease: malignancy, and cardiovascular, renal, and pulmonary diseases. The total survival time was obtained from hospital records for patients who died during the hospital stay and social security institution records for patients with out-of-hospital death. Results: One-year and 5-year life expectancies of PE cases concomitant with different disorders were as follows; heart failure (n = 151), 81% and 70%; malignancies (n = 45), 53% and 44%; pulmonary diseases (n = 37), 89% and 78%; renal diseases (n = 18), 100% and 83%; respectively. PE associated with heart failure, renal disease, and pulmonary disease had similar (P > 0.05 for all) and favorable outcomes compared to PE associated with malignancies (P < 0.001). Conclusions:The prognosis of incidental PE was the worst in patients with concomitant malignancies; however, PE associated with nonmalignant diseases including heart failure, pulmonary disease, and renal disease have similar and favorable outcomes.

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Predictive factors, microbiology and outcome of patients with parapneumonic effusion

Cited by 103 publications

References 35 publications

Serotypes associated with the development of pneumococcal para-pneumonic effusion in adults

Serotypes associated with the development of pneumococcal para-pneumonic effusion in adults

En ung mann med luftveisinfeksjon og ansiktsutslett

Prognostic Role of Incidental Pleural Effusion Diagnosed During Echocardiographic Evaluation

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