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1.
Ann Otol Rhinol Laryngol ; 129(1): 82-86, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31522522

RESUMEN

OBJECTIVE: The identification of rare sources of laryngeal infection in immunocompetent patients. Recovered organisms were Mycobacterium tuberculosis (laryngeal tuberculosis [LTB]), Mycobacterium fortuitum (laryngeal Mycobacterium fortuitum [LMF]), and Blastomyces dermatiditis (laryngeal blastomycosis [LB]). METHOD: Single institution retrospective case series of three patients over a 2.5-year period and review of the literature on laryngeal infections by three atypical organisms. RESULTS: Three patients presented with hoarseness and cough; one additionally had throat pain (LTB). Indirect laryngoscopy demonstrated diffuse laryngeal ulceration (LTB, LMF) and an exophytic, contiguous glottic mass (LB). Direct microlaryngoscopic biopsies and cultures established the diagnoses, including a frozen section in one case (LB), which prevented a simultaneously planned surgical resection. Appropriate antimicrobial therapy yielded dramatic laryngeal and corresponding vocal improvement, for which we provide unique photo and audio documentation. In the last 10 years, fewer than 500 cases of LTB have been reported in the English language medical literature, principally outside the United States. To date, there have been reports of only 34 LB and no cases of LMF. CONCLUSION: Atypical infections of the larynx may be localized and mimic laryngeal cancer on endoscopy. Tissue examination as well as microbiologic samples are diagnostic and complementary.


Asunto(s)
Blastomicosis/diagnóstico , Neoplasias Laríngeas/diagnóstico , Laringoscopía , Infecciones por Micobacterias no Tuberculosas/diagnóstico , Tuberculosis Laríngea/diagnóstico , Adulto , Biopsia , Blastomyces , Blastomicosis/complicaciones , Blastomicosis/patología , Tos/etiología , Técnicas de Cultivo , Diagnóstico Diferencial , Femenino , Ronquera/etiología , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Micobacterias no Tuberculosas/complicaciones , Infecciones por Micobacterias no Tuberculosas/patología , Mycobacterium fortuitum , Infecciones del Sistema Respiratorio/complicaciones , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/patología , Tuberculosis Laríngea/complicaciones , Tuberculosis Laríngea/patología
2.
Infect Immun ; 87(12)2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31548321

RESUMEN

Leptospirosis caused by pathogenic Leptospira is one of the most common zoonoses in the world. It is believed that humans become infected with it mainly through their skin and mucous membranes by contact with water or soil that is contaminated with urine excreted from infected animals. Recently, outbreaks have frequently occurred in the tropics, especially after flooding, but how leptospires cause mass infection remains poorly understood. In this study, we injected leptospires into the tracheas of hamsters under direct view and prove for the first time that leptospires can infect through the respiratory tract. We determined that a 50% lethal dose (LD50) of the Leptospira interrogans strain UP-MMC-SM (L495) for hamsters in transtracheal infection was 3.2 × 102 cells. The results of culture, macroscopic findings, and histopathological analysis suggested that intratracheally injected leptospires invaded the lung tissue, proliferated in the collagen-rich stroma adjacent to the bronchus and blood vessels, and then spread throughout the body via the bloodstream. In the lung, leptospires continuously infiltrated the alveolar wall without inflammatory cell infiltration, spread throughout the lung, and finally caused pulmonary hemorrhage. Our results revealed that the respiratory tract might be a portal of entry for leptospires. We speculate that some cases of leptospirosis might be caused by transbronchial infection from inhaling infectious aerosols containing leptospires during floods. Leptospira was also confirmed to be a unique pathogen that invades through the bronchus, proliferates in the collagen-rich lung stroma, and spreads through the alveolar interstitium throughout the lung without causing pneumonia.


Asunto(s)
Leptospira interrogans/patogenicidad , Leptospirosis/patología , Leptospirosis/transmisión , Enfermedades Pulmonares/patología , Infecciones del Sistema Respiratorio/transmisión , Animales , Líquido del Lavado Bronquioalveolar/microbiología , Cricetinae , Modelos Animales de Enfermedad , Leptospirosis/microbiología , Pulmón/patología , Enfermedades Pulmonares/microbiología , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/patología
3.
Biomed Res Int ; 2019: 7150942, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31534961

RESUMEN

To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper airways (UA). Recently, topical administration of ectoine has just been recognized as adjuvant treatment in the Allergic Rhinitis (AR) and Rhinosinusitis (ARS). The aim of this work is to review the published literature regarding all the potential therapeutic effects of ectoine in the acute and chronic inflammatory diseases of UA. Pertinent studies published without temporal limitation were selected searching on MEDLINE the following terms: "ectoine" and "nasal spray," "oral spray," "upper respiratory tract infections," "rhinosinusitis," "rhinitis," "rhinoconjunctivitis," "pharyngitis," and "laryngitis." At the end of our selection process, six relevant publications were included: two studies about the effect of ectoine on AR, one study about ARS, one study about rhinitis sicca anterior, and two studies about acute pharyngitis and/or laryngitis. Due to its moisturizing and anti-inflammatory properties, topical administration of ectoine could play a potential additional role in treatment of acute and chronic inflammatory diseases of UA, in particular in the management of sinonasal conditions improving symptoms and endoscopic findings. However, these results should be viewed cautiously as they are based on a limited number of studies; some of them were probably underpowered because of their small patient samples.


Asunto(s)
Aminoácidos Diaminos/uso terapéutico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Enfermedad Aguda , Administración Tópica , Enfermedad Crónica , Humanos , Inflamación/tratamiento farmacológico , Inflamación/patología , Laringitis/tratamiento farmacológico , Laringitis/patología , Vaporizadores Orales , Infecciones del Sistema Respiratorio/patología , Rinitis/tratamiento farmacológico , Rinitis/patología , Sinusitis/tratamiento farmacológico , Sinusitis/patología
4.
Nutrients ; 11(8)2019 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-31412594

RESUMEN

Black ginseng (BG, CJ EnerG), prepared via nine repeated cycles of steaming and drying of fresh ginseng, contains more accessible acid polysaccharides and smaller and less polar ginsenosides than red ginseng (RG) processed only once. Because RG exhibits the ability to increase host protection against viral respiratory infections, we investigated the antiviral effects of BG. Mice were orally administered either BG or RG extract at 10 mg/kg bw daily for two weeks. Mice were then infected with a A(H1N1) pdm09 (A/California/04/2009) virus and fed extracts for an additional week. Untreated, infected mice were assigned to either the negative control, without treatments, or the positive control, treated with Tamiflu. Infected mice were monitored for 14 days to determine the survival rate. Lung tissues were evaluated for virus titer and by histological analyses. Cytokine levels were measured in bronchoalveolar lavage fluid. Mice treated with BG displayed a 100% survival rate against infection, while mice treated with RG had a 50% survival rate. Further, mice treated with BG had fewer accumulated inflammatory cells in bronchioles following viral infection than did mice treated with RG. BG also enhanced the levels of GM-CSF and IL-10 during the early and late stages of infection, respectively, compared to RG. Thus, BG may be useful as an alternative antiviral adjuvant to modulate immune responses to influenza A virus.


Asunto(s)
Antivirales/farmacología , Subtipo H1N1 del Virus de la Influenza A/efectos de los fármacos , Infecciones por Orthomyxoviridae/prevención & control , Panax , Extractos Vegetales/farmacología , Infecciones del Sistema Respiratorio/prevención & control , Animales , Antivirales/aislamiento & purificación , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Interacciones Huésped-Patógeno , Subtipo H1N1 del Virus de la Influenza A/patogenicidad , Pulmón/metabolismo , Pulmón/patología , Pulmón/virología , Ratones Endogámicos BALB C , Infecciones por Orthomyxoviridae/metabolismo , Infecciones por Orthomyxoviridae/patología , Infecciones por Orthomyxoviridae/virología , Panax/química , Extractos Vegetales/aislamiento & purificación , Infecciones del Sistema Respiratorio/metabolismo , Infecciones del Sistema Respiratorio/patología , Infecciones del Sistema Respiratorio/virología , Carga Viral
5.
Arch Immunol Ther Exp (Warsz) ; 67(5): 325-334, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31363786

RESUMEN

The purpose of this study is to describe both clinical and immunological features in large cohort of adult patients with IgG subclass deficiency, and response to immunoglobulin therapy. This is a retrospective study of data obtained from electronic medical records and paper charts of 78 patients with IgG subclass deficiency seen and followed at our immunology clinics from 2010 to 2016. Both isolated selective IgG subclass deficiency as well as combined (two) subclass deficiencies were observed. IgG3 subclass deficiency, isolated and in combination with other IgG subclass deficiency, is the most frequent of IgG subclass deficiency. A majority of patients presented with upper and lower respiratory tract infections, especially chronic sinusitis. Both allergic and autoimmune manifestations are common; however, there is no subclass preference. The proportions and absolute numbers of CD3+ T cells, CD4+ T and CD8+ T cells, CD19+ B cells, and CD3-CD16+CD56+ NK cells were normal in the majority of patients in all IgG subclass deficiencies. Total serum IgG levels did not correlate with IgG subclass levels across all IgG subclass deficiencies. Anti-pneumococcal polysaccharide antibody responses were impaired in 56% of patients. IgG3 subclass deficiency is the most common IgG subclass deficiency, and anti-polysaccharide antibody responses are distributed among IgG subclasses with modest preference in IgG2 subclass. The majority of patients treated with immunoglobulin responded by reduction in frequency of infections and requirement of antibiotics.


Asunto(s)
Deficiencia de IgG/inmunología , Deficiencia de IgG/patología , Adulto , Anciano , Femenino , Humanos , Deficiencia de IgG/sangre , Deficiencia de IgG/tratamiento farmacológico , Inmunoglobulina G/administración & dosificación , Inmunoglobulina G/sangre , Subgrupos Linfocitarios/inmunología , Subgrupos Linfocitarios/patología , Masculino , Persona de Mediana Edad , Vacunas Neumococicas/inmunología , Infecciones del Sistema Respiratorio/sangre , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/inmunología , Infecciones del Sistema Respiratorio/patología , Estudios Retrospectivos , Sinusitis/sangre , Sinusitis/tratamiento farmacológico , Sinusitis/inmunología , Sinusitis/patología , Resultado del Tratamiento , Adulto Joven
6.
Eur J Clin Microbiol Infect Dis ; 38(11): 2177-2184, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31372902

RESUMEN

The aim of this study was to analyze the clinical and laboratory characteristics of children with peripheral facial nerve palsy (pFP) with a focus on identifying infectious etiology and long-term outcome. We conducted an ICD-10-based retrospective chart review on children hospitalized with pFP between January 1, 2006, and December 31, 2016. Furthermore, a telephone-based follow-up survey was performed. A total of 158 patients were identified, with a median age of 10.9 years (interquartile range 6.4-13.7). An infectious disease was associated with pFP in 82 patients (51.9%); 73 cases were classified as idiopathic pFP (46.2%). Three cases occurred postoperatively or due to a peripheral tumor. Among the infectious diseases, we identified 33 cases of neuroborreliosis and 12 viral infections of the central nervous system (CNS), caused by the varicella-zoster virus, human herpesvirus 6, herpes simplex virus, enterovirus, and Epstein-Barr virus. Other infections were mainly respiratory tract infections (RTIs; 37 cases). Children with an associated CNS infection had more often headache and nuchal rigidity, a higher cerebrospinal fluid cell count, and a longer length of hospital stay. Long-term follow-up revealed an associated lower risk of relapse in CNS infection-associated pFP. Among all groups, permanent sequelae were associated with female sex, a shorter length of hospitalization, and a lower white blood cell count at presentation. pFP is frequently caused by an CNS infection or is associated with concurrent RTIs, with a potential impact on the short- and long-term clinical course.


Asunto(s)
Infecciones del Sistema Nervioso Central/complicaciones , Parálisis Facial/etiología , Infecciones del Sistema Respiratorio/complicaciones , Adolescente , Parálisis de Bell/complicaciones , Parálisis de Bell/patología , Parálisis de Bell/fisiopatología , Borrelia/aislamiento & purificación , Infecciones del Sistema Nervioso Central/líquido cefalorraquídeo , Infecciones del Sistema Nervioso Central/patología , Infecciones del Sistema Nervioso Central/fisiopatología , Líquido Cefalorraquídeo/citología , Líquido Cefalorraquídeo/microbiología , Líquido Cefalorraquídeo/virología , Niño , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/patología , Parálisis Facial/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Infecciones del Sistema Respiratorio/líquido cefalorraquídeo , Infecciones del Sistema Respiratorio/patología , Infecciones del Sistema Respiratorio/fisiopatología , Estudios Retrospectivos , Estaciones del Año , Virus/aislamiento & purificación
7.
BMC Infect Dis ; 19(1): 613, 2019 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-31299924

RESUMEN

BACKGROUND: The Respiratory Syncytial Virus (RSV) A genotype ON1, which was first detected in Ontario (Canada) in 2010/11, appeared in Germany in 2011/12. Preliminary observations suggested a higher clinical severity in children infected with this new genotype. We investigated spread and disease severity of RSV-A ON1 in pediatric in- and outpatient settings. METHODS: During 2010/11 to 2016/17, clinical characteristics and respiratory samples from children with acute respiratory tract infections (RTI) were obtained from ongoing surveillance studies in 33 pediatric practices (PP), one pediatric hospital ward (PW) and 23 pediatric intensive care units (PICU) in Germany. RSV was detected in the respiratory samples by PCR; genotypes were identified by sequencing. Within each setting, clinical severity markers were compared between RSV-A ON1 and RSV-A non-ON1 genotypes. RESULTS: A total of 603 children with RSV-RTI were included (132 children in PP, 288 in PW, and 183 in PICU). Of these children, 341 (56.6%) were infected with RSV-A, 235 (39.0%) with RSV-B, and one child (0.2%) with both RSV-A and RSV-B; in 26 (4.3%) children, the subtype could not be identified. In the 341 RSV-A positive samples, genotype ON1 was detected in 247 (72.4%), NA1 in 92 (26.9%), and GA5 in 2 children (0.6%). RSV-A ON1, rarely observed in 2011/12, was the predominant RSV-A genotype in all settings by 2012/13 and remained predominant until 2016/17. Children in PP or PW infected with RSV-A ON1 did not show a more severe clinical course of disease compared with RSV-A non-ON1 infections. In the PICU group, hospital stay was one day longer (median 8 days, inter-quartile range (IQR) 7-12 vs. 7 days, IQR 5-9; p = 0.02) and duration of oxygen treatment two days longer (median 6 days, IQR 4-9 vs. 4 days, IQR 2-6; p = 0.03) for children infected with RSV-A ON1. CONCLUSIONS: In children, RSV-A ON1 largely replaced RSV-A non-ON1 genotypes within two seasons and remained the predominant RSV-A genotype in Germany during subsequent seasons. A higher clinical severity of RSV-A ON1 was observed within the group of children receiving PICU treatment, whereas in other settings clinical severity of RSV-A ON1 and non-ON1 genotypes was largely similar.


Asunto(s)
Infecciones por Virus Sincitial Respiratorio/patología , Virus Sincitial Respiratorio Humano/genética , Infecciones del Sistema Respiratorio/patología , Preescolar , Femenino , Genotipo , Alemania/epidemiología , Hospitales Pediátricos , Humanos , Lactante , Unidades de Cuidado Intensivo Pediátrico , Tiempo de Internación , Masculino , Filogenia , ARN Viral/metabolismo , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitial Respiratorio Humano/aislamiento & purificación , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Estaciones del Año , Índice de Severidad de la Enfermedad
9.
Biomed Res Int ; 2019: 4834396, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31119172

RESUMEN

Lower respiratory tract infections (LRTIs) remain a challenge in African healthcare settings and only few data are available on their aetiology in Cameroon. The purpose of this study was to access the bacterial cause of LRTIs in patients in Cameroon by two methods. Methods. Participants with LRTIs were enrolled in the referral centre for respiratory diseases in Yaoundé city and its surroundings. To detect bacteria, specimens were tested by conventional bacterial culture and a commercial reverse-transcriptase real-time polymerase chain reaction (RT-PCR) assay. One hundred forty-one adult patients with LRTIs were enrolled in the study. Among the participants, 46.8% were positive for at least one bacterium. Streptococcus pneumoniae and Haemophilus influenzae were the most detected bacteria with 14.2% (20/141) followed by Klebsiella pneumoniae, 9.2% (13/141), Staphylococcus aureus, 7.1% (10/141), and Moraxella catarrhalis, 4.3% (6/141). Bacterial coinfection accounted for 23% (14/61) with Haemophilus influenzae being implicated in 19.7% (12/61). The diagnostic performance of RT-PCR for bacteria detection (43.3%) was significantly different from that of culture (17.7%) (p< 0.001). Only Streptococcus pneumoniae detection was associated with empyema by RT-PCR (p<0.001). These findings enhance understanding of bacterial aetiologies in order to improve respiratory infection management and treatment. It also highlights the need to implement molecular tools as part of the diagnosis of LRTIs.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/microbiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Camerún/epidemiología , Femenino , Haemophilus influenzae/aislamiento & purificación , Haemophilus influenzae/patogenicidad , Humanos , Klebsiella pneumoniae/aislamiento & purificación , Klebsiella pneumoniae/patogenicidad , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Mycobacterium tuberculosis/patogenicidad , Pseudomonas aeruginosa/aislamiento & purificación , Pseudomonas aeruginosa/patogenicidad , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/patología , Staphylococcus aureus/aislamiento & purificación , Staphylococcus aureus/patogenicidad , Streptococcus pneumoniae/aislamiento & purificación , Streptococcus pneumoniae/patogenicidad , Adulto Joven
10.
Laryngoscope ; 129(9): 1993-1997, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31059600

RESUMEN

OBJECTIVES/HYPOTHESIS: To describe recurrence patterns in patients with recurrent respiratory papillomatosis (RRP) following surgical intervention. STUDY DESIGN: Single-center, retrospective, longitudinal case series. METHODS: Initial and follow-up laryngoscopic examinations of seven previously untreated adult-onset RRP patients were reviewed. Patients were followed longitudinally for periods ranging from 3 months to 7 years. Lesion locations were recorded using a twenty-one region laryngeal schematic, and maps were generated to illustrate the distribution of disease before and after cold-knife or potassium-titanyl-phosphate laser intervention. Univariate and multivariate analyses were employed to examine variables affecting recurrence patterns. RESULTS: Across all patients, a statistically significant correlation between initial distribution and primary recurrence was observed. Seventy-five percent of new lesions were adjacent to regions with preexisting disease; 83% of new glottic lesions were adjacent to preexisting glottic lesions, and 66% of supraglottic lesions were adjacent to preexisting supraglottic regions. No statistically significant differences in recurrence rate were observed across sites. CONCLUSIONS: In previously untreated patients with adult-onset recurrent respiratory papillomatosis, lesions tended to recur either in the same regions or regions adjacent to those affected at the time of initial surgery. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:1993-1997, 2019.


Asunto(s)
Glotis/patología , Infecciones por Papillomavirus/patología , Infecciones del Sistema Respiratorio/patología , Adulto , Femenino , Glotis/cirugía , Humanos , Laringoscopía , Laringe/patología , Laringe/cirugía , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Infecciones por Papillomavirus/cirugía , Infecciones del Sistema Respiratorio/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
11.
J BUON ; 24(2): 436-441, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31127988

RESUMEN

PURPOSE: To investigate the risk factors for concurrent pulmonary infection after radical operation for colon cancer, providing a reference for the prevention and treatment of this condition. METHODS: A total of 486 patients subjected to radical operation for colon cancer in Shanghai Hudong Hospital from December 2014 to December 2017 composed the study group. Their clinicopathologic data and postoperative follow-up were reviewed, including gender, age, body mass index (BMI), preoperative albumin (ALB), preoperative hemoglobin (Hb), hypertension (HBP), diabetes mellitus (DM), smoking history, preoperative pulmonary ventilation dysfunction, tumor size, lymph node metastasis, operative time, intraoperative blood loss, blood transfusion and surgical method. Univariate and multivariate analyses were applied to investigate the risk factors influencing concurrent pulmonary infection after radical operation for colon cancer. The severity of pulmonary infection was assessed using the Clavien-Dindo classification system, and the severity ≥ Grade II suggested that postoperative pulmonary infection (POPI) occurred. RESULTS: Among 486 patients, 20 (4.12%) patients suffered from POPI, including 17 (3.50%) cases of Grade II infection, 2 (0.41%) cases of Grade IIIa infection and 1 (0.21%) case of Grade IVa infection. Univariate analysis showed that POPI was associated with age (≥75 years), gender (male), DM, smoking history, preoperative pulmonary function impairment and blood transfusion. Multivariate analysis indicated that age, preoperative pulmonary ventilation dysfunction, DM and blood transfusion were independent risk factors for POPI. CONCLUSIONS: Age, preoperative respiratory function impairment, DM and blood transfusion are considered as independent risk factors for pulmonary infection after radical operation for colon cancer.


Asunto(s)
Neoplasias del Colon/epidemiología , Enfermedades Pulmonares/epidemiología , Complicaciones Posoperatorias/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Sangre Quirúrgica/fisiopatología , Neoplasias del Colon/complicaciones , Neoplasias del Colon/patología , Neoplasias del Colon/cirugía , Femenino , Gastrectomía/efectos adversos , Humanos , Enfermedades Pulmonares/etiología , Enfermedades Pulmonares/patología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/patología , Infecciones del Sistema Respiratorio/etiología , Infecciones del Sistema Respiratorio/patología , Factores de Riesgo
12.
Semin Diagn Pathol ; 36(3): 152-159, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31054790

RESUMEN

Lower respiratory infections remain one of the top global causes of death and the emergence of new diseases continues to be a concern. In the first two decades of the 21st century, we have born witness to the emergence of newly recognized coronaviruses that have rapidly spread around the globe, including severe acute respiratory syndrome virus (SARS) and Middle Eastern respiratory syndrome virus (MERS). We have also experienced the emergence of a novel H1N1 pandemic influenza strain in 2009 that caused substantial morbidity and mortality around the world and has transitioned into a seasonal strain. Although we perhaps most frequently think of viruses when discussing emerging respiratory infections, bacteria have not been left out of the mix, as we have witnessed an increase in the number of infections from Legionella spp. since the organisms' initial discovery in 1976. Here, we explore the basic epidemiology, clinical presentation, histopathology, and clinical laboratory diagnosis of these four pathogens and emphasize themes in humans' evolving relationship with our natural environment that have contributed to the infectious burden. Histology alone is rarely diagnostic for these infections, but has been crucial to bettering our understanding of these diseases. Together, we rely on the diagnostic acumen of pathologists to identify the clinicopathologic features that raise the suspicion of these diseases and lead to the early control of the spread in our populations.


Asunto(s)
Infecciones por Coronavirus/patología , Gripe Humana/patología , Legionelosis/patología , Infecciones del Sistema Respiratorio/patología , Síndrome Respiratorio Agudo Grave/patología , Infecciones por Coronavirus/diagnóstico , Humanos , Gripe Humana/diagnóstico , Legionelosis/diagnóstico , Infecciones del Sistema Respiratorio/diagnóstico , Síndrome Respiratorio Agudo Grave/diagnóstico
13.
Rev Mal Respir ; 36(4): 451-454, 2019 Apr.
Artículo en Francés | MEDLINE | ID: mdl-31005423

RESUMEN

Pneumonia is frequently complicated by occurrence of acute respiratory distress syndrome (ARDS), consequently to dysregulated inflammatory response. However, mechanisms driving this dysregulation are poorly understood. To address this, "unconventional T-cells (UTC)" -γδT, NKT and MAIT cells- appear to be relevant targets due to their key role in orchestrating anti-microbial immune response in the lung. Thus, using an experimental and translational approach, we test the hypothesis that a tight regulation of UTC is mandatory to fine-tune host response, and, subsequently to prevent emergence of an aberrant response leading to excessive tissue damages, and eventually, ARDS.


Asunto(s)
Neumonía/inmunología , Síndrome de Dificultad Respiratoria del Adulto/inmunología , Linfocitos T/fisiología , Enfermedad Aguda , Disnea/etiología , Disnea/patología , Humanos , Pulmón/inmunología , Pulmón/patología , Neumonía/etiología , Neumonía/patología , Síndrome de Dificultad Respiratoria del Adulto/etiología , Síndrome de Dificultad Respiratoria del Adulto/patología , Infecciones del Sistema Respiratorio/inmunología , Infecciones del Sistema Respiratorio/patología , Índice de Severidad de la Enfermedad
14.
PLoS One ; 14(4): e0214686, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30978196

RESUMEN

BACKGROUND: The Gram-negative bacterium Kerstersia gyiorum, a potential etiological agent of clinical infections, was isolated from several human patients presenting clinical symptoms. Its significance as a possible pathogen has been previously overlooked as no disease has thus far been definitively associated with this bacterium. To better understand how the organism contributes to the infectious disease, we determined the complete genomic sequence of K. gyiorum SWMUKG01, the first clinical isolate from southwest China. RESULTS: The genomic data obtained displayed a single circular chromosome of 3, 945, 801 base pairs in length, which contains 3, 441 protein-coding genes, 55 tRNA genes and 9 rRNA genes. Analysis on the full spectrum of protein coding genes for cellular structures, two-component regulatory systems and iron uptake pathways that may be important for the success of the bacterial survival, colonization and establishment in the host conferred new insights into the virulence characteristics of K. gyiorum. Phylogenomic comparisons with Alcaligenaceae species indicated that K. gyiorum SWMUKG01 had a close evolutionary relationships with Alcaligenes aquatilis and Alcaligenes faecalis. CONCLUSIONS: The comprehensive analysis presented in this work determinates for the first time a complete genome sequence of K. gyiorum, which is expected to provide useful information for subsequent studies on pathogenesis of this species.


Asunto(s)
Alcaligenaceae/genética , Genoma Bacteriano , Infecciones del Sistema Respiratorio/patología , Alcaligenaceae/clasificación , Alcaligenaceae/aislamiento & purificación , China , ADN Bacteriano/química , ADN Bacteriano/metabolismo , Humanos , Hierro/metabolismo , Lipopolisacáridos/biosíntesis , Filogenia , Infecciones del Sistema Respiratorio/microbiología , Factores de Virulencia/genética
15.
Benef Microbes ; 10(5): 533-541, 2019 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-30964327

RESUMEN

Streptococcus pneumoniae is able to activate coagulation and induce platelet aggregation, both of which are typical responses to systemic inflammation. The interactions between inflammation and coagulation and between soluble adhesion molecules and endothelial cells are important in the pathogenesis of an unbalanced haemostatic system. Therefore, an exaggerated and/or insufficiently controlled haemostatic activity may appreciably contribute to the severity of the disease. The aim of the present study was to evaluate the effect of the oral administration of Lactobacillus casei CRL 431 on platelet and endothelial activation mechanisms in a respiratory pneumococcal infection model in mice. S. pneumoniae induced an increase in platelet counts and enhanced the expression of P-selectin in control group, with higher endothelial activation in lung shown by the increase in von Willebrand factor (vWF) and vascular cell adhesion molecule 1 (VCAM-1) expression. Also, infection induced a decrease in CXCR-4 leukocytes, increased expression in annexinV and cell death at the pulmonary level and decreased antithrombin levels in bronchoalveolar lavage. In contrast, L. casei mice restored platelet counts, favoured faster P-selectin expression, lower vWF levels and VCAM-1 expression than control group. Also, L. casei induced higher levels of annexinV expression and lower cell death in the lung. Moreover, it was able to modulate antithrombin levels within the normal range, which would indicate lower coagulation activation and a protective effect locally exerted by L. casei. In this work, the ability of L. casei to favourably modulate platelet and endothelial functionality during a pulmonary infection with S. pneumoniae was demonstrated. Our findings offer a promising perspective for the use of this probiotic strain in the prevention of thrombotic complications associated with pneumococcal pneumonia, especially in at-risk patients. In addition, the use of L. casei would provide novel alternatives for the prevention and treatment of thrombosis associated with various diseases.


Asunto(s)
Plaquetas/fisiología , Células Endoteliales/fisiología , Lactobacillus casei/crecimiento & desarrollo , Infecciones Neumocócicas/terapia , Probióticos/administración & dosificación , Infecciones del Sistema Respiratorio/terapia , Animales , Análisis Químico de la Sangre , Modelos Animales de Enfermedad , Ratones , Recuento de Plaquetas , Infecciones Neumocócicas/patología , Infecciones del Sistema Respiratorio/patología , Resultado del Tratamiento
16.
PLoS One ; 14(4): e0214207, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30951544

RESUMEN

Respiratory diseases are a major contributor to morbidity and mortality in many tropical countries, including Lao PDR. However, little has been published regarding viral or bacterial pathogens that can contribute to influenza-like illness (ILI) in a community setting. We report on the results of a community-based surveillance that prospectively monitored the incidence of ILI and its causative pathogens in Vientiane capital in Lao PDR. A cohort of 995 households, including 4885 study participants, were followed-up between May 2015 and May 2016. Nasopharyngeal swabs, throat swabs, and sputum specimens were collected from ILI cases identified through active case-finding. Real-Time PCR was used to test nasopharyngeal swabs for 21 respiratory pathogens, while throat and sputum samples were subjected to bacterial culture. Generalized linear mixed models were used to assess potential risk factors for associations with ILI. In total, 548 episodes of ILI were reported among 476 (9.7%) of the study participants and 330 (33.2%) of the study households. The adjusted estimated incidence of ILI within the study area was 10.7 (95%CI: 9.4-11.9) episodes per 100 person-years. ILI was significantly associated with age group (p<0.001), sex (p<0.001), and number of bedrooms (p = 0.04) in multivariate analysis. In 548 nasopharyngeal swabs, the most commonly detected potential pathogens were Streptococcus pneumoniae (17.0%), Staphylococcus aureus (11.3%), influenza A (11.1%; mostly subtype H3N2), rhinovirus (7.5%), and influenza B (8.0%). Streptococci were isolated from 42 (8.6%) of 536 throat swabs, most (27) of which were Lancefield Group G. Co-infections were observed in 132 (24.1%) of the 548 ILI episodes. Our study generated valuable data on respiratory disease burden and patterns of etiologies associated with community-acquired acute respiratory illness Laos. Establishment of a surveillance strategy in Laos to monitor trends in the epidemiology and burden of acute respiratory infections is required to minimize their impact on human health.


Asunto(s)
Subtipo H3N2 del Virus de la Influenza A/patogenicidad , Gripe Humana/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Rhinovirus/patogenicidad , Adolescente , Adulto , Niño , Preescolar , Estudios de Cohortes , Composición Familiar , Femenino , Humanos , Lactante , Subtipo H3N2 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/diagnóstico , Gripe Humana/patología , Gripe Humana/virología , Laos/epidemiología , Masculino , Persona de Mediana Edad , Faringe/patología , Faringe/virología , Reacción en Cadena en Tiempo Real de la Polimerasa , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/patología , Infecciones del Sistema Respiratorio/virología
17.
Jpn J Infect Dis ; 72(4): 237-242, 2019 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-30814460

RESUMEN

Human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) are the leading causes of acute respiratory tract infection in children, and clinical manifestations of these virus infections are considered similar. To investigate the differences in clinical characteristics between HMPV and RSV infections in young children, we prospectively enrolled children < 3 years old who required hospitalization with acute respiratory tract infection due to HMPV or RSV at 10 hospitals in Japan. We enrolled 48 children with HMPV infection and 141 with RSV infection. Patients with HMPV infection were older than those with RSV infection. High-grade fever was more frequently observed in patients with HMPV infection, whereas no significant differences in respiratory symptoms were apparent. Abnormal serum lactate dehydrogenase values and consolidation shadows on chest X-ray were more frequently observed in patients with HMPV infection. During hospitalization, nasal mucus suction was more frequently required in patients with RSV infection. On the other hand, ß2-adrenergic agonists, corticosteroids, and leukotriene receptor antagonists were more frequently used in patients with HMPV infection. These findings suggest that HMPV and RSV infections show similar respiratory symptoms, but HMPV infection is more likely to lead to the development of pneumonia, at least among hospitalized young children.


Asunto(s)
Metapneumovirus , Infecciones por Paramyxoviridae/patología , Infecciones por Virus Sincitial Respiratorio/patología , Virus Sincitial Respiratorio Humano , Infecciones del Sistema Respiratorio/patología , Infecciones del Sistema Respiratorio/virología , Enfermedad Aguda , Preescolar , Femenino , Hospitalización , Humanos , Lactante , Japón , Masculino , Nasofaringe/virología , Infecciones por Paramyxoviridae/terapia , Neumonía Viral/patología , Neumonía Viral/terapia , Neumonía Viral/virología , Infecciones por Virus Sincitial Respiratorio/terapia , Infecciones del Sistema Respiratorio/terapia
18.
Med Mycol ; 57(Supplement_2): S228-S232, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-30816973

RESUMEN

In airways of immunocompromised patients and individuals with cystic fibrosis, Pseudomonas aeruginosa and Aspergillus fumigatus are the most common opportunistic bacterial and fungal pathogens. Both pathogens form biofilms and cause acute and chronic illnesses. Previous studies revealed that P. aeruginosa is able to inhibit A. fumigatus biofilms in vitro. While numerous P. aeruginosa molecules have been shown to affect A. fumigatus, there never has been a systematic approach to define the principal causative agent. We studied 24 P. aeruginosa mutants, with deletions in genes important for virulence, iron acquisition, or quorum sensing, for their ability to interfere with A. fumigatus biofilms. Cells, planktonic or biofilm culture filtrates of four P. aeruginosa mutants, pvdD-pchE-, pvdD-, lasR-rhlR-, and lasR-, inhibited A. fumigatus biofilm metabolism or planktonic A. fumigatus growth significantly less than P. aeruginosa wild type. The common defect of these four mutants was a lack in the production of the P. aeruginosa siderophore pyoverdine. Pure pyoverdine affected A. fumigatus biofilm metabolism, and restored inhibition by the above mutants. In lungs from cystic fibrosis patients, pyoverdine production and antifungal activity correlated. The key inhibitory mechanism for pyoverdine was iron-chelation and denial of iron to A. fumigatus. Further experiments revealed a counteracting, self-protective mechanism by A. fumigatus, based on A. fumigatus siderophore production.


Asunto(s)
Aspergilosis/microbiología , Aspergillus fumigatus/crecimiento & desarrollo , Interacciones Microbianas , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/crecimiento & desarrollo , Infecciones del Sistema Respiratorio/microbiología , Aspergilosis/patología , Humanos , Mutación , Oligopéptidos/genética , Oligopéptidos/metabolismo , Infecciones por Pseudomonas/patología , Pseudomonas aeruginosa/genética , Infecciones del Sistema Respiratorio/patología , Factores de Virulencia/genética , Factores de Virulencia/metabolismo
19.
Biomed Res Int ; 2019: 7945091, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30834276

RESUMEN

Purpose: This study investigated an inhalation solution containing ectoine, a bacterial-derived extremolyte, for the treatment of acute bronchitis and acute respiratory infections in comparison with saline inhalation solution. Methods: This prospective, controlled, observational study comprised an inclusion visit (day 1), a final visit (day 7), and a follow-up questionnaire (day 17). The treatment itself was administered from day 1 to day 7. The Bronchitis Severity Score, patients' general health, general effectiveness of the treatment, tolerability, and adverse events were compared between two groups. Results: In total, 135 patients were recruited; 79 patients received ectoine inhalation solution and 56 saline inhalation solution. After treatment, symptom scores decreased significantly in both groups (P < 0.05); the reduction in symptom scores was slightly greater in the ectoine group than in the saline group. The first significant reduction in symptom scores (P < 0.05) occurred earlier in the ectoine group than in the saline group. The differences in the area under the curve for the symptoms of dyspnea and auscultation findings were significant in favor of ectoine (P < 0.05). After treatment, more patients and physicians in the ectoine group assessed their or their patients' condition as "completely recovered" or "greatly improved" than those in the saline group. Almost all patients and physicians assessed the tolerability of both treatments as "good" or "very good". Conclusions: Ectoine inhalation solution seems to be slightly more effective than saline inhalation solution for the treatment of acute bronchitis and acute respiratory infections.


Asunto(s)
Enfermedad Aguda/terapia , Aminoácidos Diaminos/administración & dosificación , Bronquitis/tratamiento farmacológico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Administración por Inhalación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bronquitis/patología , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones del Sistema Respiratorio/patología , Solución Salina/administración & dosificación , Adulto Joven
20.
Br J Nurs ; 28(5): 295-298, 2019 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-30907645

RESUMEN

Respiratory disease has a major impact on the NHS and continues to be a growing problem as each year passes. However, through improving diagnosis and management of respiratory disease the problem could be lessened. Taking a sputum sample is common practice within respiratory medicine especially for patients with chronic obstructive pulmonary disease (COPD) and helps to diagnose, confirm infection and offer correct treatment. It is important that the multidisciplinary team are aware of how to appropriately obtain sputum samples and when to request them. It is important as a respiratory health professional to understand the patient's usual sputum history including colour, amount and viscosity. Antibiotic stewardship aims to reduce antibiotic resistance through offering the most appropriate antibiotics for those with a bacterial infection and to discourage antibiotic prescribing for those that have not. This should result in better patient outcomes and lower healthcare costs.


Asunto(s)
Diagnóstico de Enfermería , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Infecciones del Sistema Respiratorio/diagnóstico , Manejo de Especímenes , Humanos , Enfermedad Pulmonar Obstructiva Crónica/enfermería , Enfermedad Pulmonar Obstructiva Crónica/patología , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/enfermería , Infecciones del Sistema Respiratorio/patología , Esputo/microbiología , Medicina Estatal , Reino Unido
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