Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.392
Filtrar
1.
World J Emerg Surg ; 17(1): 47, 2022 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-36100861

RESUMO

BACKGROUND: Penetrating diaphragmatic injuries are associated with a high incidence of posttraumatic empyema. We analyzed the contribution of trauma severity, specific organ injury, contamination severity, and surgical management to the risk of posttraumatic empyema in patients who underwent surgical repair of diaphragmatic injuries at a level 1 trauma center. METHODS: This is a retrospective review of the patients who survived more than 48 h. Univariate OR calculations were performed to identify potential risk factors. Multiple logistic regression was used to calculate adjusted ORs and identify independent risk factors. RESULTS: We included 192 patients treated from 2011 to 2020. There were 169 (88.0) males. The mean interquartile range, (IQR) of age, was 27 (22-35) years. Gunshot injuries occurred in 155 subjects (80.7%). Mean (IQR) NISS and ATI were 29 (18-44) and 17 (10-27), respectively. Thoracic AIS was > 3 in 38 patients (19.8%). Hollow viscus was injured in 105 cases (54.7%): stomach in 65 (33.9%), colon in 52 (27.1%), small bowel in 42 (21.9%), and duodenum in 10 (5.2%). Visible contamination was found in 76 patients (39.6%). Potential thoracic contamination was managed with a chest tube in 128 cases (66.7%), with transdiaphragmatic pleural lavage in 42 (21.9%), and with video-assisted thoracoscopy surgery or thoracotomy in 22 (11.5%). Empyema occurred in 11 patients (5.7%). Multiple logistic regression identified thoracic AIS > 3 (OR 6.4, 95% CI 1.77-23. 43), and visible contamination (OR 5.13, 95% IC 1.26-20.90) as independent risk factors. The individual organ injured, or the method used to manage the thoracic contamination did not affect the risk of posttraumatic empyema. CONCLUSION: The severity of the thoracic injury and the presence of visible abdominal contamination were identified as independent risk factors for empyema after penetrating diaphragmatic trauma.


Assuntos
Empiema , Traumatismos Torácicos , Ferimentos Penetrantes , Adulto , Empiema/complicações , Empiema/cirurgia , Humanos , Masculino , Fatores de Risco , Traumatismos Torácicos/complicações , Traumatismos Torácicos/cirurgia , Toracotomia/efeitos adversos , Toracotomia/métodos , Ferimentos Penetrantes/cirurgia
3.
MMWR Morb Mortal Wkly Rep ; 71(37): 1169-1173, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36107787

RESUMO

In May 2022, CDC learned of three children in California hospitalized concurrently for brain abscess, epidural empyema, or subdural empyema caused by Streptococcus intermedius. Discussions with clinicians in multiple states raised concerns about a possible increase in pediatric intracranial infections, particularly those caused by Streptococcus bacteria, during the past year and the possible contributing role of SARS-CoV-2 infection (1). Pediatric bacterial brain abscesses, epidural empyemas, and subdural empyemas, rare complications of respiratory infections and sinusitis, are often caused by Streptococcus species but might also be polymicrobial or caused by other genera, such as Staphylococcus. On June 9, CDC asked clinicians and health departments to report possible cases of these conditions and to submit clinical specimens for laboratory testing. Through collaboration with the Children's Hospital Association (CHA), CDC analyzed nationally representative pediatric hospitalizations for brain abscess and empyema. Hospitalizations declined after the onset of the COVID-19 pandemic in March 2020, increased during summer 2021 to a peak in March 2022, and then declined to baseline levels. After the increase in summer 2021, no evidence of higher levels of intensive care unit (ICU) admission, mortality, genetic relatedness of isolates from different patients, or increased antimicrobial resistance of isolates was observed. The peak in cases in March 2022 was consistent with historical seasonal fluctuations observed since 2016. Based on these findings, initial reports from clinicians (1) are consistent with seasonal fluctuations and a redistribution of cases over time during the COVID-19 pandemic. CDC will continue to work with investigation partners to monitor ongoing trends in pediatric brain abscesses and empyemas.


Assuntos
Anti-Infecciosos , Abscesso Encefálico , COVID-19 , Empiema Subdural , Empiema , Abscesso Epidural , Abscesso Encefálico/epidemiologia , Abscesso Encefálico/microbiologia , Criança , Empiema Subdural/epidemiologia , Humanos , Pandemias , SARS-CoV-2 , Streptococcus , Estados Unidos/epidemiologia
4.
Contrast Media Mol Imaging ; 2022: 8230212, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36110977

RESUMO

The aim of the study is to investigate the effect of CT-guided artificial pneumothorax combined with a thoracoscopic and central venous catheter on empyema drainage effect and pulmonary function in children. A total of 82 pediatric patients with empyema admitted to our hospital from January 2020 to December 2021 were retrospectively analyzed. The control group was treated with artificial pneumothorax combined with thoracoscopy. The study group was treated with a CT-guided and central venous catheter. The operation time, intraoperative bleeding, surgical field exposure, WBC, C-reactive protein, and pulmonary function were compared between the two groups. The size of effusion and sonographic staging were compared between the two groups. All children underwent spirometry and a maximal incremental cardiopulmonary exercise test. The operation indicators (operation time, intraoperative blood loss, etc.) and adverse reactions were compared between the two groups. The differences in the operation time, intraoperative blood loss, postoperative hospital stay, postoperative drainage volume, and surgical field exposure between the two groups had a statistical significance (P < 0.05); the differences in the body temperature, total peripheral white blood cell count, C-reactive protein, size of effusion, and sonographic staging between the two groups had no statistical significance (P > 0.05); before operation, the differences in the expression levels of FVC (%), FEV1 (%), FEV1/FVC, and MVV (%) and indicators of cardiopulmonary function including VE/VO2, breathing reserve(%), VD/VT(%), and VO2/work between the two groups had no statistical significance, but at 6 months after operation, FVC (%), FEV1 (%), FEV1/FVC, and MVV (%) in the study group were significantly higher than those in the control group (P < 0.05) and VE/VO2 and VD/VT(%) in the study group were obviously lower than those in the control group (P < 0.05); the incidence rate of chest pain, pulmonary edema, and skin infection in the study group was lower than that in the control group (P < 0.05). CT-guided artificial pneumothorax combined with thoracoscopic and central venous catheter drainage of empyema in children is more thorough, with less bleeding, less trauma, rapid recovery of pulmonary function, and is worthy of clinical promotion.


Assuntos
Cateterismo Venoso Central , Empiema , Pneumotórax Artificial , Proteína C-Reativa , Criança , Drenagem , Humanos , Estudos Retrospectivos , Toracoscopia , Tomografia Computadorizada por Raios X
5.
Front Cell Infect Microbiol ; 12: 758833, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35967859

RESUMO

Background: Efficient detection tools for determining staphylococcal pleural infection are critical for its eradication. The objective of this meta-analysis was to assess the diagnostic utility of nucleic acid amplification tests (NAAT) in suspected empyema cases to identify staphylococcal strains and avoid unnecessary empiric methicillin-resistant Staphylococcus aureus (MRSA) therapy. Methods: From inception to July 24, 2021, relevant records were retrieved from PubMed, Embase, Scopus, Web of Science, and the Cochrane Library. The quality of studies was determined using the QUADAS-2 tool. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and hierarchical summary receiver operating characteristic (HSROC) curve for NAAT's diagnostic performance were evaluated using an HSROC model. Results: Eight studies comprising 424 samples evaluated NAAT accuracy for Staphylococcus aureus (SA) identification, while four studies comprising 317 samples evaluated methicillin-resistant Staphylococcus aureus (MRSA) identification. The pooled NAAT summary estimates for detection of both SA (sensitivity: 0.35 (95% CI 0.19-0.55), specificity: 0.95 (95% CI 0.92-0.97), PLR: 7.92 (95% CI 4.98-12.59), NLR: 0.44 (95% CI 0.14-1.46), and DOR: 24.0 (95% CI 6.59-87.61) ) and MRSA (sensitivity: 0.45 (95% CI 0.15-0.78), specificity: 0.93 (95% CI 0.89-0.95), PLR: 10.06 (95% CI 1.49-67.69), NLR: 0.69 (95% CI 0.41-1.15), and DOR: 27.18 (95% CI 2.97-248.6) ) were comparable. The I 2 statistical scores for MRSA and SA identification sensitivity were 13.7% and 74.9%, respectively, indicating mild to substantial heterogeneity. PCR was frequently used among NAA tests, and its diagnostic accuracy coincided well with the overall summary estimates. A meta-regression and subgroup analysis of country, setting, study design, patient selection, and sample condition could not explain the heterogeneity (meta-regression P = 0.66, P = 0.46, P = 0.98, P = 0.68, and P = 0.79, respectively) in diagnostic effectiveness. Conclusions: Our study suggested that the diagnostic accuracy of NAA tests is currently inadequate to substitute culture as a principal screening test. NAAT could be used in conjunction with microbiological culture due to the advantage of faster results and in situations where culture tests are not doable.


Assuntos
Empiema , Staphylococcus aureus Resistente à Meticilina , Humanos , Staphylococcus aureus Resistente à Meticilina/genética , Técnicas de Diagnóstico Molecular , Técnicas de Amplificação de Ácido Nucleico , Curva ROC , Staphylococcus
6.
Rev Col Bras Cir ; 49: e20223300, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36000682

RESUMO

OBJECTIVE: to identify variables related to pleural complications in patients undergoing tube thoracostomies due to traumatic injuries. METHOD: we conducted a prospective observational study from May/2019 to January/2021 including adult trauma patients submitted to tube thoracostomies after hospital admission. Patients undergoing thoracotomies as the initial treatment were not included. We excluded patients with suspected and confirmed COVID-19 diagnosis during the hospitalization. Pleural complications were defined as clotted hemothorax, residual pneumothorax and empyema. Students t, Mann Whitneys, Chi square and Fishers exact test were used to compare variables between groups. We considered p<0.05 as significant. RESULTS: we analyzed 68 patients. The mean age was 36.0 + 12.6 years and 91.2% were male. The mean RTS and ISS were, respectively, 7.0 ± 1.6 and 15.9 ± 7.6. The most frequent trauma mechanism was stab wounds in 50.0%, followed by blunt trauma in 38.2%. The severity of thoracic injuries was stratified (AIS) as 2 (4.4%), 3 (80.9%), 4 (13.2%), e 5 (1.5%). Pleural complications happened in 14 (20.5%) patients, being clotted / residual hemothorax (11.8%), residual pneumothorax (4.4%), empyema (2.9%) and miscellaneous (1.4%). These patients were treated by thoracoscopy (5), thoracotomy (3), chest re-drainage (3) and clinical measures alone (3). There was a significant association between pleural complications with the time of permanence (p<0,001) and the necessity of relocation (p<0,001) of the drain. CONCLUSION: the predictors of pleural complications in this series were time of permanence and the necessity of relocation of the drain.


Assuntos
COVID-19 , Empiema , Pneumotórax , Traumatismos Torácicos , Adulto , Teste para COVID-19 , Tubos Torácicos/efeitos adversos , Empiema/etiologia , Feminino , Hemotórax/etiologia , Hemotórax/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumotórax/epidemiologia , Pneumotórax/etiologia , Pneumotórax/cirurgia , Estudos Prospectivos , Traumatismos Torácicos/complicações , Traumatismos Torácicos/cirurgia , Toracostomia , Toracotomia , Adulto Jovem
7.
J Vet Med Sci ; 84(10): 1368-1372, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-35989304

RESUMO

A 5-month-old intact female mixed cat presented with repetitive paraplegia and drainage of pus from the back despite continuous antibiotic medication. Neurologic examination was consistent with below T3-L3 myelopathy. Computed tomography and magnetic resonance imaging revealed a contrast-enhanced mass in the L1-3 spinal canal, and bone fragments in the T13 and L1 spinal canal. Spinal epidural empyema was suspected, and hemilaminectomy was performed for T12-L2 on the right side and T11-12 on the left side. Bone fragments were diagnosed as sequestrum infected with Bacteroides sp. The cat recovered enough to ambulate next day. One month after surgery, there was no deficit in neurological function. This is the first report of spinal epidural empyema concurrent with sequestrum in a cat.


Assuntos
Doenças do Gato , Empiema , Abscesso Epidural , Animais , Antibacterianos/uso terapêutico , Doenças do Gato/diagnóstico por imagem , Doenças do Gato/cirurgia , Gatos , Empiema/cirurgia , Empiema/veterinária , Abscesso Epidural/cirurgia , Abscesso Epidural/veterinária , Feminino , Laminectomia/métodos , Laminectomia/veterinária , Imageamento por Ressonância Magnética/veterinária , Canal Medular/cirurgia
8.
Mikrobiyol Bul ; 56(3): 466-479, 2022 Jul.
Artigo em Turco | MEDLINE | ID: mdl-35960238

RESUMO

The aim of this single-center retrospective study was to determine the changes in the burden of allcause pneumonia, bacterial pneumonia and empyema in children aged 0-18 years after the availability of 7-valent pneumococcal conjugated vaccine (PCV7) and 13-valent pneumococcal conjugated vaccine (PCV13) in our country. Children aged 0-18 years who were hospitalized with the diagnosis of pneumonia and treated in Ankara between January 1, 2006 and December 30, 2019 were included in the study. The burden of disease according to the years was calculated as follows: after determining the number of patients with all-cause pneumonia, bacterial pneumonia and the empyema who were admitted to the pediatric infectious diseases service, we divided those numbers to admission numbers to all outpatient clinics in that year as the ratio in 100 000. The years 2006-2007 were accepted as pre-vaccine period, 2009-2010 as PCV7 period and 2012-2019 as PCV13 period. As 2008 and 2011 were the years when PCV7 and PCV13 vaccines implemented into the routine vaccination schedule, they were accepted as transition years and the patient data from these years were not used. All of the patients data were obtained from the patient files. There was a significant decrease in the disease burden of all-cause pneumonia in 0-18 years age and 0-24 months age group after PCV13 period compared to PCV7 period (p<0.001 and p<0.001). A statistically significant decrease was found in all-cause pneumonia among children older than 60 months after PCV13 period compared to PCV7 period and pre-vaccine period (p<0.05 and p<0.01, respectively). When pre-PCV13 (PCV7 and pre-vaccine periods together) and post-PCV13 periods were compared; in 0-18 years age, 0-24 months age and 24-60 months age groups, there was a significant decrease in the burden of disease due to all-cause pneumonia after PCV13 (p<0.001, p<0.001 and p<0.05) period. When the bacterial pneumonia disease burden in PCV13 period was evaluated, bacterial pneumonia disease burden in 0-18 years and 0-24 months age group was found to be significantly lower than in both pre-vaccine and PCV7 periods (p<0.001 and p<0.001). After PCV13 vaccine, the disease burden due to bacterial pneumonia was found to be significantly lower in 0-18 years age, 0-24 months age and older than 60 months age groups compared to pre-PCV13 period (p<0.001, p<0.001 and p<0.01). When PCV7 and PCV13 periods were compared in 0-18 years age group, a significant decrease was found in hospitalizations due to empyema after PCV13 (p<0.05). In conclusion, PCV7 and PCV13 led to a significant reduction in the incidence of all-cause pneumonia and bacterial pneumonia in children.


Assuntos
Empiema , Infecções Pneumocócicas , Pneumonia Bacteriana , Pneumonia Pneumocócica , Adolescente , Criança , Pré-Escolar , Empiema/epidemiologia , Empiema/prevenção & controle , Vacina Pneumocócica Conjugada Heptavalente , Humanos , Incidência , Lactente , Recém-Nascido , Infecções Pneumocócicas/epidemiologia , Vacinas Pneumocócicas , Pneumonia Pneumocócica/epidemiologia , Pneumonia Pneumocócica/prevenção & controle , Estudos Retrospectivos , Streptococcus pneumoniae
9.
Microbiol Spectr ; 10(4): e0107722, 2022 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-35862941

RESUMO

We previously reported that despite the use of pneumococcal conjugate vaccines (PCVs), vaccine serotypes remained important causes of pneumonia with pleural effusion and empyema (pediatric complicated pneumococcal pneumonia [PCPP]). We cultured and performed PCR on 174 pleural fluid samples recovered from pediatric patients in Portugal from 2016 to 2019 to identify and serotype Streptococcus pneumoniae. Most PCPP cases (n = 87/98) were identified by PCR only. Serotypes 3 (67%), 14, and 8 (5% each) were the most frequent. Vaccine breakthrough cases were seen among age-appropriately, 13-valent, PCV vaccinated children (median: 3 years, range: 17 months to 7 years), mostly with serotype 3 (n = 27) but also with serotypes 14 and 19A (n = 2 each). One breakthrough was seen with serotype 14 in an age-appropriately, 10-valent, PCV-vaccinated child and another with serotype 3 in a child to whom the 23-valent polysaccharide vaccine was administered. While the relative risk of serotype 1 PCPP decreased almost 10-fold from the period of 2010 to 2015 to the period of 2016 to 2019 (relative risk [RR] = 0.106), that of serotype 3 PCPP almost doubled (RR = 1.835). Our data highlight the importance of molecular diagnostics in identifying PCPP and document the continued importance of serotype 3 PCPP, even when PCV13 use with almost universal coverage could be expected to reduce exposure to this serotype. IMPORTANCE The use of conjugate vaccines against Streptococcus pneumoniae in children has led to substantial reductions in pneumococcal invasive disease. However, the reductions seen in each of the 13 serotypes currently included in the highest-valency vaccine approved for use in children (PCV13), were not the same. It is becoming clear that most vaccine breakthroughs worldwide involve serotype 3 and are frequently associated with complicated pneumonia cases, often with empyema or pleural effusion. Here, we show that despite almost universal PCV13 use, which would be expected to reduce vaccine serotype circulation and further reinforce vaccine direct protection, pneumococci and serotype 3 remain the major causes of pediatric complicated pneumonia. Molecular methods are essential to identify and serotype pneumococci in these cases, which frequently reflect vaccine breakthroughs. A broader use of molecular diagnostics will be essential to determine the role of this important serotype in the context of PCV13 use in different geographic regions.


Assuntos
Empiema , Derrame Pleural , Infecções Pneumocócicas , Pneumonia Pneumocócica , Criança , Empiema/complicações , Humanos , Lactente , Derrame Pleural/complicações , Infecções Pneumocócicas/diagnóstico , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Pneumonia Pneumocócica/diagnóstico , Pneumonia Pneumocócica/epidemiologia , Pneumonia Pneumocócica/prevenção & controle , Portugal/epidemiologia , Sorogrupo , Streptococcus pneumoniae/genética , Vacinas Conjugadas
12.
Surg Clin North Am ; 102(3): 413-427, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35671764

RESUMO

Pleural space diseases constitute a wide range of benign and malignant conditions, including pneumothorax, pleural effusion and empyema, chylothorax, pleural-based tumors, and mesothelioma. The focus of this article is the surgical management of the 2 most common pleural disorders seen in modern thoracic surgery practice: spontaneous pneumothorax and empyema.


Assuntos
Quilotórax , Empiema , Doenças Pleurais , Derrame Pleural , Pneumotórax , Quilotórax/etiologia , Quilotórax/cirurgia , Humanos , Doenças Pleurais/cirurgia , Pneumotórax/cirurgia
14.
Indian J Med Microbiol ; 40(3): 440-442, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35654714

RESUMO

Candida empyema is an uncommon complication of febrile neutropenia. We present 4 such cases which highlight the importance of direct inoculation of body fluids in automated blood culture bottle leading to increased yield. Our cases and review of literature also highlight that echinocandins have poor penetration into pleural fluid; azoles (especially voriconazole) should be preferred as drug of choice.


Assuntos
Empiema , Neutropenia Febril , Hemocultura , Candida , Equinocandinas , Empiema/microbiologia , Neutropenia Febril/diagnóstico , Humanos
15.
WMJ ; 121(1): E5-E9, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35442586

RESUMO

INTRODUCTION: Reports of extraintestinal manifestations of Clostridioides difficile (C difficile) infections are rare. The frequency of these infections comprises approximately 0.17% to 0.6% of all C difficile infections. While they are becoming more frequent worldwide, the precise trend is unclear. CASE PRESENTATION: An 83-year-old female patient presented with pleuritic chest pain 2 to 3 months after a needle biopsy of her liver abscess confirmed C difficile. She was found to have extension of the liver abscess into the chest cavity, leading to empyema, and was treated with intravenous antimicrobials. DISCUSSION: This is the fifth known reported case of C difficile leading to a pyogenic liver abscess and the first case where the C difficile liver abscess was associated with an empyema. While long-term metronidazole is considered effective for managing extra intestinal C difficile infection, our patient was treated with vancomycin and meropenem. CONCLUSION: To determine epidemiology and a proper treatment regimen for extraintestinal C difficile infection, a greater accumulation of cases is necessary.


Assuntos
Clostridioides difficile , Infecções por Clostridium , Empiema , Abscesso Hepático Piogênico , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Clostridioides , Infecções por Clostridium/complicações , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/tratamento farmacológico , Empiema/complicações , Empiema/tratamento farmacológico , Feminino , Humanos , Abscesso Hepático Piogênico/complicações , Abscesso Hepático Piogênico/diagnóstico , Abscesso Hepático Piogênico/tratamento farmacológico
16.
Expert Rev Gastroenterol Hepatol ; 16(5): 487-492, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35392755

RESUMO

BACKGROUND: Spontaneous bacterial empyema (SBE) is an infection of a preexisting hepatic hydrothorax (HH). We aim to describe the experience in managing SBE in a liver transplant (LT) referral center and assessing the incidence and mortality rates of SBE after conducting a systematic review. METHODS: 992 patients with cirrhosis were retrospectively reviewed from 2015 to 2020. SBE was diagnosed by (i) positive microbiological culture and polymorphonuclear leukocyte count >250 cells/µL or (ii) negative microbiological culture, compatible clinical course, and polymorphonuclear count >500 cells/µL in pleural fluid. Furthermore, we conducted a comprehensive literature search of MEDLINE, EMBASE, and Google Scholar for studies evaluating SBE. RESULTS: Twelve patients (10.4%) had spontaneous bacterial empyema out of 115 patients with HH. Five patients underwent LT, 6 had died, and 1 did not get transplanted and was alive throughout the duration of follow-up. Ten studies were included in the systematic review. Pooled incidence in patients with HH was 19.03%. Only 20.69% of the patients received a LT. Pooled mortality rate was 46.45%, with only 3.45% of the patients dying post-transplant. CONCLUSION: SBE is a severe complication of cirrhosis and HH. LT may provide a survival benefit. Thus, patients should be considered for early transplant.


Assuntos
Empiema , Hidrotórax , Empiema/diagnóstico , Empiema/epidemiologia , Empiema/etiologia , Humanos , Hidrotórax/complicações , Hidrotórax/diagnóstico , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Estudos Retrospectivos , Centros de Atenção Terciária
17.
Biosci Trends ; 16(2): 158-162, 2022 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-35444073

RESUMO

Pseudomonas aeruginosa is a frequent causative agent of post-pneumonectomy empyema-associated broncho-pleural fistula (BPF) and it has a high mortality rate. In recent years, the therapeutic potential of bacteriophage therapy has recognized anew as antimicrobial resistance increases globally. Studies are increasingly reporting the efficacy and safety of bacteriophage therapy for the treatment of multidrug-resistant bacterial infections. However, the clinical efficacy of bacteriophage therapy in empyema has seldom been studied. The current study reports the authors' experience with bacteriophage therapy for a 68-year-old Chinese man who suffered BPF-associated empyema and pneumonia caused by carbapenem-resistant P. aeruginosa. A personalized lytic pathogen-specific two-phage preparation was administered to the patient continuously for 24 days in combination with conventional antibiotics. The treatment was well-tolerated, resulting in clearance of the pathogen and improvement of the clinical outcome. This experience shows that a combined conventional antibiotic treatment with bacteriophage therapy may be effective at alleviating a multidrug-resistant bacterial infection in BPF-associated empyema.


Assuntos
Empiema , Terapia por Fagos , Infecções por Pseudomonas , Idoso , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Carbapenêmicos/farmacologia , Carbapenêmicos/uso terapêutico , Humanos , Masculino , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/microbiologia , Infecções por Pseudomonas/terapia , Pseudomonas aeruginosa
18.
Rev. patol. respir ; 25(2): 57-59, Abri - Jun 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-207327

RESUMO

El empiema necessitatis es una entidad clínica poco frecuente en la población pediátrica, la principal etiología está asociada a infección por Mycobacterium tuberculosis, en pacientes inmunocompetentes o inmunosuprimidos, el diagnóstico principal debe realizarse de manera oportuna, buscando evitar complicaciones o lesiones permanentes en los pacientes que la padecen.(AU)


Empyema necessitatis is a rare clinical entity in the pediatric population, the main etiology is associated with infection by Mycobacterium tuberculosis, in immunocompetent or immunosuppressed patients, the main diagnosis must be made in a timely manner, seeking to avoid complications or permanent injuries in the patients who suffer from it.(AU)


Assuntos
Humanos , Masculino , Lactente , Empiema , Mycobacterium tuberculosis , Pediatria , Tuberculose/complicações , Tuberculose/diagnóstico , Tuberculose/etiologia , Tratamento Farmacológico , Saúde da Criança , Pneumopatias , Doenças Respiratórias
20.
Pediatr Pulmonol ; 57(6): 1416-1424, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35293151

RESUMO

OBJECTIVES: Anemia is associated with severe outcomes in adult community-acquired pneumonia (CAP), but few studies investigated its association with pediatric CAP. Hence, we tried to delineate the association of anemia with the clinical outcomes of CAP in children. METHODS: This retrospective cohort study was conducted from 2010 to 2019 in a medical center. Inpatients aged 6 months to 17 years who were diagnosed with CAP and without major underlying diseases were included. The subjects' clinical data within 24 h of admission and clinical outcomes were collected. We accessed the rates of adverse outcomes and the adjusted odds ratios (ORs) of these outcomes between anemic and nonanemic patients, as well as among patients with different types of anemia. RESULTS: In this study of 3601 patients, the prevalence of anemia was 11.6% (418/3601). Anemic patients had higher rates of intensive care (16.8% vs. 3.6%; p < 0.001), endotracheal intubation (11.0% vs. 1.3%; p < 0.001), and empyema (8.6% vs. 0.6%; p < 0.001) than nonanemic patients. In addition, anemia was independently associated with intensive care (adjusted OR, 3.00; 95% confidence interval [CI], 2.03-4.42), endotracheal intubation (adjusted OR, 3.79; 95% CI, 2.17-6.63), and empyema (adjusted OR, 4.72; 95% CI, 2.30-9.69). Iron-deficiency anemia (IDA) and normocytic anemia were associated with these adverse outcomes but not with anemia due to thalassemia trait. CONCLUSION: Anemia is a biomarker associated with poor outcomes in pediatric CAP, and patients with IDA or normocytic anemia should be carefully monitored and managed since they may have higher disease severity.


Assuntos
Anemia Ferropriva , Anemia , Infecções Comunitárias Adquiridas , Empiema , Pneumonia , Adulto , Anemia/epidemiologia , Anemia Ferropriva/complicações , Criança , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/epidemiologia , Humanos , Pneumonia/complicações , Pneumonia/epidemiologia , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...