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Fever in Respiratory Diseases
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Fever is the second most common symptom in patients with anaerobic pleuropulmonary infection. Usually the patient presents with radiologic findings (pneumonitis, necrotizing pneumonia, abscess, or empyema). The average duration of symptoms before presentation is 7 weeks.
Necrotizing pneumonia
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
A simple parapneumonic effusion is fluid within the pleural cavity without loculations. Fibrin deposition in the pleural space can lead to a loculated parapneumonic effusion and is best visualized on ultrasound or CT. Empyema is a purulent parapneumonic fluid collection. Lung entrapment with pleural rind formation is seen with an organized multiloculated empyema. Necrotizing pneumonia is usually a result of localized infection and is associated with aspiration. Lung abscess can be the result of aspiration of foreign body or heavily infected oral secretions.
Pleural space problems
Published in Larry R. Kaiser, Sarah K. Thompson, Glyn G. Jamieson, Operative Thoracic Surgery, 2017
Konrad Hoetzenecker, Walter Klepetko
Small abscess formations found during the decortication should be closed by capitonnage with reinforced sutures. Necrotizing pneumonia, extensive pulmonary abscess formations, and lung gangrene are rare situations. They always require resection of all devitalized pulmonary structures. In most cases, an anatomical resection (septic lobectomy, pneumonectomy) is necessary. In these cases, it is of utmost importance to reinforce the bronchial stump with well- vascularized muscle or a pericardial flap.
Bilateral pneumatoceles resulting in spontaneous bilateral pneumothoraces and secondary infection in a previously healthy man with COVID-19
Published in Baylor University Medical Center Proceedings, 2021
Piruthiviraj Natarajan, James Skidmore, Olufemi Aduroja, Vamsi Kunam, Dan Schuller
The patient presented 2 days later with worsening dyspnea, increasing oxygen requirement, and hemoptysis. Chest film revealed a large left tension pneumothorax, small right pneumothorax, pneumomediastinum, and subcutaneous emphysema (Figure 2). He underwent an emergent left thoracostomy tube placement. Subsequent CT scan of the chest showed resolving pneumothoraces, extensive bilateral necrotizing pneumonia with pneumatoceles, and large cysts with air fluid levels (Figure 1b). The sputum culture grew K. aerogenes and P. aeruginosa; the antimicrobials were narrowed to cefepime. He subsequently underwent two separate left-sided chemical pleurodesis at the bedside with intrapleural doxycycline 4 days apart, as the first attempt resulted only in partial resolution. He was discharged home after a 16-day hospital stay to complete a total of 3 weeks of IV cefepime and was subsequently switched to oral ciprofloxacin for 3 months until near complete radiological resolution of the air fluid levels in the pneumatoceles (Figure 1c). Several months from his initial presentation, the patient is still convalescent at home and requires supplemental oxygen with minimal activity. Repeat CT of the chest during an outpatient visit is shown in Figure 1d.
Current and future treatment options for community-associated MRSA infection
Published in Expert Opinion on Pharmacotherapy, 2018
A. Khan, B. Wilson, I. M. Gould
Management of necrotizing pneumonia is complicated by the reduced penetration of antibiotics into necrotic tissue, as well as their weakened activity in anaerobic conditions [80]. There are differing approaches to antimicrobial therapy, as demonstrated by guidance in the UK compared to across the Atlantic. What is clear is that flucloxacillin, even when combined with clindamycin or rifampicin, is not recommended due to its potential for increasing PVL production, as demonstrated in vitro [81]. In the UK, the HPA guidelines on managing PVL-associated staphylococcal pneumonia advises combining antibiotic therapy to include an agent which inhibits toxin production, with reports showing better outcomes [80]. Combinations of clindamycin with rifampicin [82], linezolid with rifampicin[83], vancomycin with rifampicin, and vancomycin with clindamycin have all been effective, but with widely differing durations of parenteral treatment, sometimes up to 4 weeks [84]. Rifampicin should never be used alone as resistance is rapidly selected, but it demonstrates excellent tissue penetration, reaching intracellular staphylococci, and also has synergy with other antibiotics [80]. There is some evidence that rifampicin decreases serum levels of linezolid though this is not reflected in UK dosing recommendations [85,86].
Antibacterial and anti-Toxoplasma activities of Aspergillus niger endophytic fungus isolated from Ficus retusa: in vitro and in vivo approach
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2023
Ehssan Moglad, Engy Elekhnawy, Walaa A. Negm, Duaa Eliwa, Salwa Sami Younis, Basma Mohamed Elmansory, Sebaey Mahgoub, Eman A. Ahmed, Omnia Momtaz Al-Fakhrany
With the global antibiotic resistance crisis, Klebsiella pneumoniae has emerged as one of the most important antibiotic-resistant pathogens associated with severe infections that harshly creep up human health [1]. K. pneumoniae can cause various infections, such as pneumonia, urinary tract infections, surgical wound infections, cystitis and severe community-acquired infections, such as pyogenic liver abscesses, necrotizing pneumonia and endogenous endophthalmitis. Furthermore, it is an important cause of life-threatening severe infections with high morbidity and mortality, including endocarditis and septicaemia [2]. This is due to the limited treatment options, which pose a significant threat to the future of infectious diseases [3].