11 research outputs found
Clinical, Radiological and Bacteriological Profile of Lung Abscess - An Observational Hospital Based Study
BACKGROUND: The incidence of lung abscess acquired in the community is unknown, but this is a common clinical problem encountered in developing countries. The incidence of lung abscess was high in the pre-antibiotic era but the advent of susceptible antibiotics it has reduced with an equal fall in mortality to 8.7%. With the emerging antibiotic resistance and change in the trends of bacteriological profile causing lung abscess, it is the need of time to reevaluate lung abscess.
AIM: The study aimed to determine the clinical, radiological and bacteriological profile of lung abscess.
MATERIAL AND METHOD: The study was a non-randomized prospective observational study conducted in the department of pulmonary medicine for 18 months. In the study, patients > 15 years of age with clinical features of lung abscess were recruited and were subjected to chest X-ray, routine blood test. Sputum gram stain and culture, as well as antibiotic sensitivity according to the organism, were evaluated. Reports of all investigations along with patient characteristics and risk factors were analysed statistically using SPSS 20.0.
RESULTS: Forty-six cases of lung abscess were included, and the majority of patients were found to be adults with a mean age of 42.9 years with a male to female ratio of 6.6:1. The most common predisposing factor was an unhygienic oral cavity in 28% of cases with alcohol ingestion being the most important risk factor in 22% of cases. The most common organism found in lung abscess cases was Klebsiella pneumoniae, and they were sensitive to ceftazidime.
CONCLUSION: Our study shows that Klebsiella pneumoniae should be considered an important pathogen in community-acquired lung abscesses
An overview of treatment options for COVID-19
Severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) which emerged in Wuhan initially as pneumonia of unknown origin in December 2019, later spread to whole world and became pandemic on 11th March, 2020. Many drugs have been proposed but are backed without clinical evidence. Scientific bodies are in the row to discover a reliable vaccine and effective drugs against the novel coronavirus. Many antiviral and anti-parasitic drugs which were thought to have some effect on Coronavirus disease 2019 (COVID-19) have been tried during the crisis but none have shown concrete evidence of action. Randomized clinical trials on the repurposed drugs are now registered under clinical trial registry to look at the safety profile and efficacy of the drugs to be used against SARS-CoV-2. Many meta-analyses are being conducted worldwide to frame evidence for the fight against this novel coronavirus. We are providing below a review of various drugs that have been tried for treatment of COVID-19 as well as different clinical trials which are underway
Endocrine paraneoplastic syndromes in lung cancer: a respiratory physician’s perspective
Lung malignancy is known to be one of the leading causes of cancer-related mortality. Endocrine paraneoplastic syndromes in lung cancer are common. These are due to secretion of various substances and not because of direct tumour invasion or me-tastasis. These syndromes have also been associated with lung cancer prognosis. This review describes the many endocrine paraneoplastic syndromes seen in lung cancer and narrates their incidence, biology, clinical features, diagnosis, and management
HIV status among presumptive tuberculosis cases attending tertiary care centre in South India
Introduction: In India, to increase human immunodeficiency virus (HIV) case detection, the National Technical Working Group onTB /HIV had made it mandatory to screen for HIV infection among presumptive tuberculosis (TB) cases.
Material and methods: Our study was a cross-sectional study, conducted between June 2015 and December 2016 in a tertiarycare institute (JIPMER), in South India, to estimate the prevalence of HIV among presumptive TB cases.
Results: Among the 964 presumptive TB cases who attended pulmonary medicine OPD, 189 patients were sputum acid-fastbacilli (AFB) positive. Among the 189 sputum positive cases, 9 were HIV positive. Of the 964 presumptive TB cases, 879 gaveconsent for HIV testing and 33 (3.7%) turned out to be HIV positive. If only sputum positive cases had been screened for HIV,we would have missed 24 new HIV positive cases. The number needed to screen was 27 among presumptive TB cases and 18among TB patients.
Conclusions: The uptake of HIV testing (91%) and the diagnostic yield of 3.7% of HIV positive cases among the presumptiveTB patients is quite high compared to that of the Revised National Tuberculosis Control Programme (RNTCP) mechanism of Puducherry.This reinforces the need to screen all the presumptive cases for HIV infection, to increase HIV case detection so thatanti-retroviral therapy (ART) can be initiated early
Fungal pneumonia concealing bacterial pneumonia: a diagnostic dilemma
We describe the case of a 61-year-old diabetic man affected by Achromobacter denitrificans. He was immunocompetent and did not have any past history of chronic lung disease. The patient was treated with sensitive antibiotic meropenem 1 g three times daily. To our knowledge, only one case of A. denitrificans pneumonia has been reported from the Indian subcontinent, in an individual with underlying lung disease, and none in a healthy person
Streptomyces pneumonia in an immunocompetent adult — a rare isolate
Streptomyces belongs to the Actinomycetes group of bacteria which are gram-positive non acid-fast bacilli, widely recognised for their potential to produce antimicrobials active against bacterial, mycobacterial, parasitic and fungal infections. They commonly cause cutaneous infections following traumatic inoculation. Visceral infections are relatively rare and limited to immunocompro-mised hosts. We describe a case of Streptomyces pneumonia in a healthy immunocompetent female, who when investigated for voluntary kidney donation, resulted in the isolation of Streptomyces species from bronchial wash cultures. Streptomyces, a potential pathogen in immunocompetent hosts is frequently underdiagnosed. Once isolated, both physicians and microbiologists should pay attention to differentiate true infection from contamination
Zakażenie wirusem HIV u pacjentów z podejrzeniem gruźlicy diagnozowanych w ośrodku specjalistycznym w południowych Indiach
WSTĘP: W celu zwiększenia wykrywalności zakażenia wirusem HIV w Indiach narodowa grupa robocza ds. zakażenia wirusem HIV i gruźlicy wprowadziła obowiązek badań przesiewowych w kierunku zakażenia wirusem HIV u wszystkich chorych z podejrzeniem gruźlicy. MATERIAŁ I METODY: Badanie miało charakter przesiewowy i miało na celu ocenę występowania zakażenia wirusem HIV wśród chorych z podejrzeniem gruźlicy. Przeprowadzono je w okresie od czerwca 2015 do grudnia 2016 roku w trzeciorzędowym ośrodku referencyjnym JIPMER w południowych Indiach. WYNIKI: Spośród 964 chorych z podejrzeniem gruźlicy przyjętych w poradni pulmonologicznej, u 189 chorych stwierdzono dodatni wynik plwociny w kierunku prątków kwasoodpornych (AFB). Spośród 189 chorych z dodatnim wynikiem plwociny u 9 stwierdzono zakażenie wirusem HIV. Spośród 879 chorych, którzy wyrazili zgodę na badanie w kierunku zakażenia wirusem HIV, u 33 wynik był dodatni (3,7%). Gdyby zbadano jedynie chorych z dodatnim wynikiem plwociny, nie wykryto by 24 nowych przypadków zakażenia wirusem HIV. Liczba badań, które należałoby wykonać, aby wykryć jeden przypadek zakażenia wirusem HIV (number needed to screen), wynosi 27 dla chorych z podejrzeniem gruźlicy i 18 dla chorych z potwierdzoną gruźlicą. WNIOSKI: Wykrywalność zakażenia HIV (91%) i skuteczność diagnostyczna 3,7% w grupie chorych z domniemaną gruźlicą jest wysoka w porównaniu z danymi zaktualizowanego programu narodowego kontroli gruźlicy. W związku z tym w celu zwiększenia wykrywalności zakażenia wirusem HIV konieczne jest objęcie badaniami przesiewowymi również chorych z podejrzeniem gruźlicy, aby można było wcześnie wdrożyć leczenie anty-retrowirusowe.WSTĘP: W celu zwiększenia wykrywalności zakażenia wirusem HIV w Indiach narodowa grupa robocza ds. zakażenia wirusem HIV i gruźlicy wprowadziła obowiązek badań przesiewowych w kierunku zakażenia wirusem HIV u wszystkich chorych z podejrzeniem gruźlicy. MATERIAŁ I METODY: Badanie miało charakter przesiewowy i miało na celu ocenę występowania zakażenia wirusem HIV wśród chorych z podejrzeniem gruźlicy. Przeprowadzono je w okresie od czerwca 2015 do grudnia 2016 roku w trzeciorzędowym ośrodku referencyjnym JIPMER w południowych Indiach. WYNIKI: Spośród 964 chorych z podejrzeniem gruźlicy przyjętych w poradni pulmonologicznej, u 189 chorych stwierdzono dodatni wynik plwociny w kierunku prątków kwasoodpornych (AFB). Spośród 189 chorych z dodatnim wynikiem plwociny u 9 stwierdzono zakażenie wirusem HIV. Spośród 879 chorych, którzy wyrazili zgodę na badanie w kierunku zakażenia wirusem HIV, u 33 wynik był dodatni (3,7%). Gdyby zbadano jedynie chorych z dodatnim wynikiem plwociny, nie wykryto by 24 nowych przypadków zakażenia wirusem HIV. Liczba badań, które należałoby wykonać, aby wykryć jeden przypadek zakażenia wirusem HIV (number needed to screen), wynosi 27 dla chorych z podejrzeniem gruźlicy i 18 dla chorych z potwierdzoną gruźlicą. WNIOSKI: Wykrywalność zakażenia HIV (91%) i skuteczność diagnostyczna 3,7% w grupie chorych z domniemaną gruźlicą jest wysoka w porównaniu z danymi zaktualizowanego programu narodowego kontroli gruźlicy. W związku z tym w celu zwiększenia wykrywalności zakażenia wirusem HIV konieczne jest objęcie badaniami przesiewowymi również chorych z podejrzeniem gruźlicy, aby można było wcześnie wdrożyć leczenie anty-retrowirusowe
Pneumorrhachis in a patient with stable bronchial asthma
The presence of air in the spinal canal, called pneumorrhachis, is an important radiographic finding. Pneumorrhachis is usually asymptomatic and resolves spontaneously. Sometimes, neurological complications might develop. We report a case of pneumorrhachis occurring in an adolescent male with stable bronchial asthma who presented with pneumomediastinum and subcutaneous emphysema without a pneumothorax