Rhinovirus is associated with severe adult community-acquired pneumonia in China

Wang, Keqiang; Xi, Wen; Yang, Donghong; Zheng, Yali; Zhang, Yaqiong; Chen, Yu‐Sheng; Yan, Chunliang; Tian, Guizhen; An, Shuchang; Li, Xiangxin; An, Fucheng; Du, Juan; Ke, Hu; Cao, Jie; Ren, Lili; Huang, Fang; Gao, Zhancheng

doi:10.21037/jtd.2017.10.107

Cited by 24 publications

(30 citation statements)

References 34 publications

(43 reference statements)

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“…Their findings were consistent to ours. Wang et al (15) reported that HRV was associated with severe adult CAP in Chinese; Yu et al (16) reported that human adenovirus 7 type caused higher fatality rate (28.6%) of Chinese child acute respiratory infectious disease than other types. However, their conclusions were almost drew from univariate analyses, and some confounding factors, such as underlying disease, should be excluded.…”

Section: Discussionmentioning

confidence: 99%

Distribution of the atypical pathogens of community-acquired pneumonia to disease severity

Cheng¹,

Zhang²,

Luo³

et al. 2018

J. Thorac. Dis

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Section: Discussionmentioning

confidence: 99%

Distribution of the atypical pathogens of community-acquired pneumonia to disease severity

Cheng¹,

Zhang²,

Luo³

et al. 2018

J. Thorac. Dis

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“…The opacities are often patchy in distribution. 80,[84][85][86][87] Bilateral involvement is fairly common, and some series in influenza pneumonia show that bilateral involvement is slightly more common than unilateral involvement. 84 On the other hand, other series in respiratory syncytial virus or coronavirus pneumonia show that unilateral involvement is more common.…”

Section: Radiological Manifestationsmentioning

confidence: 99%

“…80,85 Pleural effusions are not usual but have been reported. 87 On computed tomography of the chest, the most common pattern, ground-glass opacity, becomes even more noticeable, often in a patchy and bilateral distribution. Other patterns, such as consolidation, nodular opacities, and interlobular thickening, also can be present 86 (Figs.…”

Section: Radiological Manifestationsmentioning

confidence: 99%

Influenza and Viral Pneumonia

Cavallazzi

Ramirez

2018

Clinics in Chest Medicine

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“…Laboratory Studies on Initial Presentation ALT, and alkaline phosphatase to microkatals per liter, multiply by 0.0167; creatinine to micromoles per liter, multiply by 76.25; CRP to milligrams per liter, multiply by 10; total bilirubin to micromoles per liter, multiply by 17.104; and white blood cell count to ×10 9 /μL, multiply by 0.001. , Bronchoscopic, and Imaging Findings of EVALI prolonged course, with a hospital stay of 21 days, including 14 days in the ICU receiving oxygen via high flow nasal cannula. Two patients (8%) had rhinovirus on PCR testing of BAL fluid 28,29,31. Three samples (13%) had positive PCR assays for Pneumocystis jirovecii that were considered false-positives because Pneumocystis direct fluorescence antibodies were negative and the patients recovered without treatment for Pneumocystis.…”

mentioning

confidence: 99%

Clinical, Bronchoscopic, and Imaging Findings of e-Cigarette, or Vaping, Product Use–Associated Lung Injury Among Patients Treated at an Academic Medical Center

et al. 2020

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IMPORTANCE e-Cigarette, or vaping, product use-associated lung injury (EVALI) has caused more than 2800 illnesses and 68 deaths in the United States. Better characterization of this novel illness is needed to inform diagnosis and management. OBJECTIVE To describe the clinical features, bronchoscopic findings, imaging patterns, and outcomes of EVALI. DESIGN, SETTING, AND PARTICIPANTS This case series of 31 adult patients diagnosed with EVALI between June 24 and December 10, 2019, took place at an academic medical center in Salt Lake City, Utah. EXPOSURES e-Cigarette use, also known as vaping. MAIN OUTCOMES AND MEASURES Symptoms, laboratory findings, bronchoscopic results, imaging patterns, and clinical outcomes. RESULTS Data from 31 patients (median [interquartile range] age, 24 [21-31] years) were included in the study. Patients were primarily men (24 [77%]) and White individuals (27 [87%]) who used e-cigarette products containing tetrahydrocannabinol (THC) (29 [94%]). Patients presented with respiratory (30 [97%]), constitutional (28 [90%]), and gastrointestinal (28 [90%]) symptoms. Serum inflammatory markers were elevated in all patients. Bronchoscopy was performed in 23 of 28 inpatients (82%) and bronchoalveolar lavage (BAL) revealed the presence of lipid-laden macrophages (LLMs) in 22 of 24 cases (91%). BAL samples tested positive for Pneumocystis jirovecii (3 patients [13%]), rhinovirus (2 patients [8%]), human metapneumovirus and Aspergillus (1 patient each [4%]); all except human metapneumovirus were determined to be false-positives or clinically inconsequential. The exclusive or dominant computed tomography (CT) pattern was organizing pneumonia in 23 of 26 cases (89%). Patients received antibiotics (26 [84%]) and corticosteroids (24 [77%]), and all survived; 20 patients (65%) seen in follow-up showed marked improvement, but residual symptoms (13 [65%]), radiographic opacities (8 [40%]), and abnormal pulmonary function tests (8 of 18 [44%]) were common. CONCLUSIONS AND RELEVANCE In this case series, patients with EVALI characteristically presented with a flu-like illness with elevated inflammatory markers, LLMs on BAL samples, and an organizing pneumonia pattern on CT imaging. Bronchoscopic testing for infection had a high incidence of false-positive results. Patients had substantial residual abnormal results at early (continued) Key Points Question What are the typical clinical, radiographic, and bronchoscopic findings and clinical outcomes of e-cigarette, or vaping, product use-associated lung injury (EVALI)? Findings This case series of 31 patients found that EVALI typically presented as a flu-like illness with elevated inflammatory markers and an organizing pneumonia pattern on computed tomography imaging. Bronchoscopy showed lipid-laden macrophages and had a high rate of false-positive results for infection. Meaning The findings of this study suggest that EVALI has a characteristic clinical and radiographic presentation and that bronchoscopy has limited utility in its evaluation.

show abstract

Rhinovirus is associated with severe adult community-acquired pneumonia in China

Abstract: HRV is a common etiology in CAP among China adults, especially in severe CAP. Clinicians should be vigilant considering of the poor outcome. Highly qualified multiplex PCR techniques with invasive sampling are needed to increase the detection rate.

Cited by 24 publications

References 34 publications

Distribution of the atypical pathogens of community-acquired pneumonia to disease severity

Distribution of the atypical pathogens of community-acquired pneumonia to disease severity

Influenza and Viral Pneumonia

Clinical, Bronchoscopic, and Imaging Findings of e-Cigarette, or Vaping, Product Use–Associated Lung Injury Among Patients Treated at an Academic Medical Center

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