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Battlefield Chemical Inhalation Injury
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Pathology (Bruner and Coman, 1945; Buscher, 1931; Clay and Rossing, 1964; Coman et al, 1947; Delepine, 1923; Gross et al., 1965; Winternitz, 1919) Description of the pathologic effects of phosgene is best undertaken chronologically and is drawn primarily from animal studies. There is an immediate effect (30 min or less) and in a severe exposure there is bronchiolar constriction, swelling, necrosis, and perivascular edema. During the early effects (0.5-6 hr) with moderate exposure, bronchiolar constriction, and pulmonary arteriolar constriction with dilatation/engorgement of capillaries and veins are noted. In addition, polymorphonuclear leukocytes move into interstitial spaces and emphysematous change is seen particularly at lung margins and in areas showing prior bronchial constriction. In severe exposure, interstitial edema is seen as early as 30-45 min and noted after perivascular edema. Also bronchiolar epithelial sloughing with plugging by necrotic cells or mucus is noted. Eight to 24 hr after mild exposure there is perivascular and interstitial edema; with moderate and severe exposures bronchiolar dilatation and bronchiolar epithelial sloughing is seen. During the first 3 days, edema peaks and begins to resolve, and right heart failure is seen. During the repair period (days 4 and later), bronchopneumonia may appear. There is resolution of edema and bronchiolar inflammation and repair of mucosal sloughing.
Respiratory system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Acute bronchopneumonia is usually due to a bacterial infection. The neutrophil count would suggest such a diagnosis but would not identify the organisms. The most common pathogen is Haemophilus influenzae. There is no contraindication for administering oxygen as the condition is of acute onset and there is no danger of respiratory arrest. Tetracycline is not recommended for infants as it stains the teeth. The more severe the disease the more likely the respiratory rate and excursion will be increased, and vice-versa.
Paediatric Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Bacterial pneumonia is associated with high fever, localized findings on chest examination and lobar consolidation and pleural effusion on CXR. Bronchopneumonia occurs more frequently in children with chronic illness, e.g. cerebral palsy, and may be bacterial or viral.However, bacterial and viral aetiologies cannot be reliably distinguished on either clinical or radiological criteria.
Airway disease in hematologic malignancies
Published in Expert Review of Respiratory Medicine, 2022
Ricardo J José, Burton F. Dickey, Ajay Sheshadri
The exact incidence of viral bronchiolitis is difficult to isolate from that of viral bronchopneumonia in immunocompromised patients due to definitional overlap [24]. Most definitions require a combination of symptoms and radiographic findings in the presence of symptoms. However, mucus plugging, a common finding in viral bronchiolitis, can often manifest as a tree-in-bud nodular infiltrate on chest CT and be misinterpreted as ‘pneumonia’[25]. Furthermore, mucus plugs can be extensive in inflammatory airway diseases, causing subsegmental atelectasis that can be misinterpreted as a bronchopneumonia [26]. Finally, viral infection is well-known to increase the incidence of secondary bacterial pneumonia, possibly due to enhanced adhesion of bacteria to epithelial surfaces [27]. Therefore, a finding of a lobar infiltrate does not rule out bronchiolitis as the etiologic cause of clinical presentation.
LncRNA NEAT1 activates MyD88/NF-κB pathway in bronchopneumonia through targeting miR-155-5p
Published in Autoimmunity, 2021
Ling-jia Chen, Jian-min Li, Wei-dong Zhang, Wei Liu, Xiu-ying Li, Bin Ouyang, Jian-long Tan, Yun Li, Jiang-chuan Chen, Zhi-guang Liu
Bronchopneumonia is actually an inflammation occurring in lung, bronchial, and mucosa tissues [6]. Enormous studies showed that long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) were closely associated with inflammatory diseases [7–9]. Nuclear paraspeckle assembly transcript 1 (NEAT1) is a nuclear restricted lncRNA and forms the key component of the paraspeckle suborganelles [10,11]. NEAT1 played an important role in the growth, migration, and invasion of cancer cells [12–14]. It was reported that NEAT1 regulated lipopolysaccharide (LPS)-induced injury in WI-38 cells through the mediation of miR-193a-3p/TLR4/NF-κB axis [15]. Meanwhile, a previous study showed that NEAT1 was also involved in the inflammatory response [15]. Furthermore, NEAT1 might promote ox-LDL-induced inflammation in vitro via the mediation of miR-128 [16]. Taken together, NEAT1 is an important regulator in the inflammatory response. However, the function of NEAT1 in bronchopneumonia is still largely unknown.
Severe pulmonary infections complicating nivolumab treatment for lung cancer: a report of two cases
Published in Acta Clinica Belgica, 2020
Valentine Inthasot, Marie Bruyneel, Inge Muylle, Vincent Ninane
Case 1: A 69-year-old man was diagnosed with a metastatic lung adenocarcinoma of the upper right lobe. He received first-line treatment with 4 cycles of cisplatin-pemetrexed, followed by 4 cycles of maintenance pemetrexed but discontinued due to intolerance. Tumor progression four months later was treated with a second-line regimen of 18 cycles of nivolumab with a good initial response. At follow-up, the patient was diagnosed with bronchopneumonia. No pathogen was identified and he only showed mild improvement after amoxicillin-clavulanic acid treatment. Given the persistence of symptoms and the evidence of pulmonary infiltrate in the upper right lobe on chest radiograph one month later (Figure 1), a bronchoscopy with bronchoalveolar lavage (BAL) was performed and demonstrated positivity for Mycobacterium tuberculosis in both cultures and by polymerase chain reaction (PCR) analysis. Anti-tuberculosis treatment was started accordingly.