Influenza B/Streptococcal co-infection complicated by organizing pneumonia.

Organizing pneumonia is a rare complication of influenza infection that has substantial morbidity. We report the first case of organizing pneumonia associated with influenza B and Streptococcus pneumoniae coinfection that had significant improvement with corticosteroid treatment. The clinical and radiological features of organizing pneumonia associated with this coinfection are similar to those after influenza A infection. Timely use of systemic glucocorticosteroids would be of benefit in promoting resolution for influenza-associated organizing pneumonia.

Pulmonary and extrapulmonary complications of human rhinovirus infection in critically ill patients.

BACKGROUND: Human rhinovirus (HRV) is frequently detected in patients with respiratory tract infection. However, the full clinical spectrum of HRV infection in critically ill patients is not well characterized. OBJECTIVE: To evaluate the clinical and virological characteristics of critically ill patients with HRV infection. STUDY DESIGN: HRV-specific reverse transcription-polymerase chain reaction (RT-PCR) was performed on nasopharyngeal aspirate (NPA) specimens from 294 adult patients who required admission into the intensive care unit (ICU). Clinical characteristics were analyzed. HRV genotyping using the 5'UTR-VP4-VP2 region was performed. RESULTS: HRV was detected in NPA specimens of 22 patients (7.5%) by RT-PCR. Dyspnea was the most common presenting symptom (16/22; 72.7%), but seizure also occurred in 5 (22.7%) patients. Exacerbation of underlying disease occurred in 12 (54.5%) patients. Four (18.2%) patients died, and HRV was considered to play a role as the cause of death in 3 patients. Thirteen (59.1%) patients had pneumonia, and the most common radiological finding was consolidation (6/13; 46.2%). Streptococcus pneumoniae was the most common co-pathogen among patients with pneumonia. Among the 9 patients without pneumonia, 3 patients had exacerbation of underlying lung diseases, 3 patients had acute pulmonary edema, 2 patients with diabetes mellitus had acute complications from poor glycemic control, and 1 patient had status epilepticus. HRV-A was the most common species (64.3%), but there was no clear relationship between HRV species and clinical presentation. CONCLUSION: Both pulmonary and extrapulmonary complications of HRV were common in critically ill patients.

Prevalence of scoliosis in cystic fibrosis.

BACKGROUND: The prevalence of idiopathic scoliosis in the general pediatric population is reported to be between 0.5% and 3.2%. Previous studies have reported an increased prevalence of scoliosis in children with cystic fibrosis (CF). HYPOTHESIS: The prevalence of scoliosis in CF children is greater than in the normal population. METHODS: Chest X-rays of 319 patients attending the Royal Brompton CF Centre were reviewed. The Cobb angle of any spinal lateral curvature was measured. Scoliosis was defined as a Cobb angle of more than 10°. RESULTS: Median age of the whole group of patients was 10.9 years (range 1.1-18 years), 53% were females. Seven patients (2.2%) had radiological signs of scoliosis, their mean age was 14.5 ± 2.3 years (range: 11.5-18 years), 5 were females. Age at onset of scoliosis was between 5 and 10 years for three patients and over 10 years for the others. All the curves were thoracic and with right convexity: apices between T7 and T9 for the single curves (n = 5) and between T4 and T5 (n = 2) for the double curves. CONCLUSION: CF patients showed a similar prevalence of scoliosis as in the normal population (2.2% vs. 0.5-3.2%). There was the same gender (female) and side (right-sided) predilection as in normal population.