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Yeung SHM, Rotin LE, Singh K, Wu R, Stanbrook MB. Pneumonie lipoïde exogène associée à des produits oraux et intranasaux à base d’huile. CMAJ 2021; 193:E1897-E1900. [PMID: 34903596 PMCID: PMC8677575 DOI: 10.1503/cmaj.210439-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Sabrina H M Yeung
- Faculté de médecine Temerty (Yeung, Rotin, Singh, Wu, Stanbrook), Université de Toronto; Division de médecine interne générale (Wu), Réseau universitaire de santé; Division de pneumologie (Stanbrook), Réseau universitaire de santé, Toronto, Ont
| | - Lianne E Rotin
- Faculté de médecine Temerty (Yeung, Rotin, Singh, Wu, Stanbrook), Université de Toronto; Division de médecine interne générale (Wu), Réseau universitaire de santé; Division de pneumologie (Stanbrook), Réseau universitaire de santé, Toronto, Ont
| | - Kevin Singh
- Faculté de médecine Temerty (Yeung, Rotin, Singh, Wu, Stanbrook), Université de Toronto; Division de médecine interne générale (Wu), Réseau universitaire de santé; Division de pneumologie (Stanbrook), Réseau universitaire de santé, Toronto, Ont
| | - Robert Wu
- Faculté de médecine Temerty (Yeung, Rotin, Singh, Wu, Stanbrook), Université de Toronto; Division de médecine interne générale (Wu), Réseau universitaire de santé; Division de pneumologie (Stanbrook), Réseau universitaire de santé, Toronto, Ont
| | - Matthew B Stanbrook
- Faculté de médecine Temerty (Yeung, Rotin, Singh, Wu, Stanbrook), Université de Toronto; Division de médecine interne générale (Wu), Réseau universitaire de santé; Division de pneumologie (Stanbrook), Réseau universitaire de santé, Toronto, Ont.
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Yeung SHM, Rotin LE, Singh K, Wu R, Stanbrook MB. Exogenous lipoid pneumonia associated with oil-based oral and nasal products. CMAJ 2021; 193:E1568-E1571. [PMID: 34642160 PMCID: PMC8568072 DOI: 10.1503/cmaj.210439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sabrina H M Yeung
- Temerty Faculty of Medicine (Yeung, Rotin, Singh, Wu, Stanbrook), University of Toronto; Division of General Internal Medicine (Wu), University Health Network; Division of Respirology (Stanbrook), University Health Network, Toronto, Ont
| | - Lianne E Rotin
- Temerty Faculty of Medicine (Yeung, Rotin, Singh, Wu, Stanbrook), University of Toronto; Division of General Internal Medicine (Wu), University Health Network; Division of Respirology (Stanbrook), University Health Network, Toronto, Ont
| | - Kevin Singh
- Temerty Faculty of Medicine (Yeung, Rotin, Singh, Wu, Stanbrook), University of Toronto; Division of General Internal Medicine (Wu), University Health Network; Division of Respirology (Stanbrook), University Health Network, Toronto, Ont
| | - Robert Wu
- Temerty Faculty of Medicine (Yeung, Rotin, Singh, Wu, Stanbrook), University of Toronto; Division of General Internal Medicine (Wu), University Health Network; Division of Respirology (Stanbrook), University Health Network, Toronto, Ont
| | - Matthew B Stanbrook
- Temerty Faculty of Medicine (Yeung, Rotin, Singh, Wu, Stanbrook), University of Toronto; Division of General Internal Medicine (Wu), University Health Network; Division of Respirology (Stanbrook), University Health Network, Toronto, Ont.
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Parsons CS, Helm EJ. Pneumonia and acute respiratory distress syndrome. IMAGING 2016. [DOI: 10.1183/2312508x.10003315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Li M, Liu J, Tan R, Liu Z, Yin J, Qu H. Risk factors for slowly resolving pneumonia in the intensive care unit. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 49:654-662. [PMID: 25553993 DOI: 10.1016/j.jmii.2014.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 06/02/2014] [Accepted: 11/06/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Slowly resolving pneumonia (SRP) poses early challenges for identification and medical expense for clinicians in intensive care units (ICUs); to date, the literature has been very limited in this regard. METHODS This was a retrospective and cohort-based study in the ICU of a university-affiliated hospital in Shanghai. Medical records of pneumonia patients in the ICU between April 2008 and February 2011were reviewed retrospectively to evaluate the risk factors for SRP. RESULTS In all, 106 pneumonia patients in the ICU were identified as immune-competent with a diagnosis of bacterial pneumonia. There were 62 (58.49%) patients who showed SRP and their radiographic infiltrations were completely resolved between 5 weeks and 8 weeks. Multivariate logistic regression analysis demonstrated that initial treatment with an inappropriate antibiotic, multilobar infiltration, and a high CURB-65 score were independent risk factors for SRP, with odds ratio (OR) values of 8.338 [95% confidence interval (CI) 2.117-32.848], 11.184 (95% CI 2.526-49.514), and 2.329 (95% CI 1.172-4.626), respectively. The length of the ICU stay in the SRP group was twice as long as that of the normally resolving pneumonia (NRP) group (62.27 ± 73.73 vs. 32.25 ± 23, p = 0.002). The 28-day and 60-day mortality rates in the SRP group were 17.74% and 25.81%, respectively. In addition, the 60-day mortality rate was significantly higher in the SRP group than the NRP group (25.81% vs. 6.82%, respectively; p = 0.012). Moreover, SRP was an independent risk factor for 60-day mortality (OR 5.687, 95% CI 1.334-24.240). CONCLUSION Treatment with an inappropriate antibiotic, multilobar infiltration, and a high CURB-65 score were independent risk factors for SRP.
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Affiliation(s)
- Meiling Li
- Department of Critical Care Medicine and Respiratory Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jialin Liu
- Department of Pulmonary Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ruoming Tan
- Department of Critical Care Medicine and Respiratory Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaojun Liu
- Department of Critical Care Medicine and Respiratory Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyong Yin
- Department of Critical Care Medicine and Respiratory Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongping Qu
- Department of Critical Care Medicine and Respiratory Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kumar M, Biswal N, Bhuvaneswari V, Srinivasan S. Persistent pneumonia: Underlying cause and outcome. Indian J Pediatr 2009; 76:1223-6. [PMID: 19941090 DOI: 10.1007/s12098-009-0272-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 04/16/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify the causes and contributing factors of persistent pneumonia in children. METHODS 41 cases with persistent pneumonia were investigated (biochemical, microbiological, histopathological, immunological and radiological tests) to find out the underlying cause. RESULTS Out of 41 cases, 8 had pulmonary tuberculosis and 12 had Gram negative bacterial infections, 12 had aspiration due to gastroesophageal reflux disease or oil instillation, 3 had immunodeficiency due to HIV infection, 2 had congenital lung malformation, 2 had cardiac disorders and one had foreign body aspiration as causes of persistent pneumonia. The etiology could not be established in one case. CONCLUSION The most common underlying cause of persistent pneumonia were persistent infection followed by aspiration and acquired immunodeficiency.
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Sharma S. Computed tomography for the diagnosis of infectious diseases of the chest. ACTA ACUST UNITED AC 2008; 2:1247-62. [PMID: 23496684 DOI: 10.1517/17530059.2.11.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pulmonary infection is a common reason for imaging of the lung in immunocompetent and immunosuppressed patients. Findings on chest radiography are nonspecific and encompass poor sensitivity. The role of computed tomography (CT) has been evolving in the diagnosis of lung infections. OBJECTIVE This paper reviews recent developments in the efficacy and utility of CT in the diagnosis of suspected pulmonary infections in a variety of patient populations. METHODS Recent published literature was reviewed to prepare this treatise on the role of CT. CONCLUSION Knowledge and skills at pattern recognition are crucial for the CT interpretation in lung infections. Computed tomography scan is increasingly used to increase the sensitivity of the radiologic diagnosis of thoracic infections. The greatest value of CT is when the radiograph is normal, findings are equivocal, and to differentiate infection from non-infectious disorders.
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Affiliation(s)
- Sat Sharma
- Professor and Head University of Manitoba, St Boniface General Hospital, Section of Respirology, Department of Internal Medicine, BG034, 409 Tache Avenue, Winnipeg MB, R2H 2A6, Canada +204 237 2217 ; +204 231 1927 ;
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Washington L, Palacio D. Imaging of Bacterial Pulmonary Infection in the Immunocompetent Patient. Semin Roentgenol 2007; 42:122-45. [PMID: 17394925 DOI: 10.1053/j.ro.2006.08.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pulmonary infection is a common reason for imaging of the lung and a common incidental finding in immunocompetent patients. Findings on chest radiography are nonspecific in defining acute infection; however, the radiologist should be aware of classically described patterns of infection, including air space, bronchopneumonia, and interstitial patterns. The radiologist must also be aware of potential limitations of the sensitivity of chest radiography. Imaging findings at computed tomography in acute infection have been poorly studied but may be more specific. Aspiration and septic emboli are additional potential radiographic patterns of infection that may be very characteristic in appearance. In the setting of nonresolving pneumonia, the differential diagnosis includes noninfectious causes as well as a variety of atypical infectious agents, specifically, mycobacterial and fungal agents, which have overlapping but distinctive clinical and radiographic presentations.
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Affiliation(s)
- Lacey Washington
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
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Abstract
Uncertainty over the expected clinical course of a community-acquired or nosocomial pneumonia is a common reason for pulmonary consultation. Determining which patients with prolonged pneumonia and at what point during therapy they should undergo further evaluation can be challenging. This article reviews "normal" resolution times for the most common pneumonias, risk factors for delayed resolution, and infectious and noninfectious conditions that can cause nonresolving pneumonia. An approach to the evaluation of the patient with this common problem is described.
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Affiliation(s)
- Cheryl M Weyers
- Pulmonary Medicine, Emory University, 550 Peachtree Street Northeast, MOT 6th Floor, Atlanta, GA 30308, USA.
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