👉Time to Say Goodbye to Bronchiolitis, Viral Wheeze, Reactive Airways Disease, Wheeze Bronchitis and All That
📌A proposed simplified approach to the nomenclature used to categorize virus associated LRTIs is presented based on an understanding of the underlying pathological processes and how these contribute to the physical signs.
🔗https://www.frontiersin.org/articles/10.3389/fped.2020.00218/full
👉open access
#pulmonology #infections #orvi #bronchitis #resparatory #frontiersin
📌A proposed simplified approach to the nomenclature used to categorize virus associated LRTIs is presented based on an understanding of the underlying pathological processes and how these contribute to the physical signs.
🔗https://www.frontiersin.org/articles/10.3389/fped.2020.00218/full
👉open access
#pulmonology #infections #orvi #bronchitis #resparatory #frontiersin
👉Testing Individuals for Coronavirus Disease 2019 (COVID-19)
📌PCR Test
🔗https://jamanetwork.com/journals/jama/fullarticle/2764238
#pcr #infographics #infections #jama #virus #testing
📌PCR Test
🔗https://jamanetwork.com/journals/jama/fullarticle/2764238
#pcr #infographics #infections #jama #virus #testing
👉Evaluation for Neonatal HSV in Infants Undergoing Workup for Serious Bacterial Infection: A 5-Year Retrospective Review
📌Neonatal herpes simplex virus (HSV) infection carries a high risk of mortality and, among survivors, morbidity, including developmental delay and seizures. Accurate and timely diagnosis, which is necessary to reduce mortality, is complicated by the range of clinical presentations, which can include few or no signs, symptoms, or characteristic laboratory findings. Although diagnosis in infants with skin-eye-mucosal (SEM) disease may be immediately apparent on the basis of the presence of vesicles,9 other manifestations of HSV may be more difficult to identify. Infants with disseminated disease, for example, can present with fulminant sepsis and disseminated intravascular coagulation or simply with hypothermia and lethargy.Similarly, infants with isolated central nervous system (CNS) HSV can present with few nonspecific clinical and laboratory findings, especially early in the disease.
🔗https://hosppeds.aappublications.org/content/early/2020/05/07/hpeds.2020-0033
👉open access
#herpes #infections #aap #pediatricshospital #neonatology
📌Neonatal herpes simplex virus (HSV) infection carries a high risk of mortality and, among survivors, morbidity, including developmental delay and seizures. Accurate and timely diagnosis, which is necessary to reduce mortality, is complicated by the range of clinical presentations, which can include few or no signs, symptoms, or characteristic laboratory findings. Although diagnosis in infants with skin-eye-mucosal (SEM) disease may be immediately apparent on the basis of the presence of vesicles,9 other manifestations of HSV may be more difficult to identify. Infants with disseminated disease, for example, can present with fulminant sepsis and disseminated intravascular coagulation or simply with hypothermia and lethargy.Similarly, infants with isolated central nervous system (CNS) HSV can present with few nonspecific clinical and laboratory findings, especially early in the disease.
🔗https://hosppeds.aappublications.org/content/early/2020/05/07/hpeds.2020-0033
👉open access
#herpes #infections #aap #pediatricshospital #neonatology
👉Lyme borreliosis: diagnosis and management
📌Lyme borreliosis is the most common vectorborne disease in the northern hemisphere. It usually begins with erythema migrans; early disseminated infection particularly causes multiple erythema migrans or neurologic disease, and late manifestations predominantly include arthritis in North America, and acrodermatitis chronica atrophicans (ACA) in Europe. Diagnosis of Lyme borreliosis is based on characteristic clinical signs and symptoms, complemented by serological confirmation of infection once an antibody response has been mounted. Manifestations usually respond to appropriate antibiotic regimens, but the disease can be followed by sequelae, such as immune arthritis or residual damage to affected tissues. A subset of individuals reports persistent symptoms, including fatigue, pain, arthralgia, and neurocognitive symptoms, which in some people are severe enough to fulfil the criteria for post-treatment Lyme disease syndrome. The reported prevalence of such persistent symptoms following antimicrobial treatment varies considerably, and its pathophysiology is unclear. Persistent active infection in humans has not been identified as a cause of this syndrome, and randomized treatment trials have invariably failed to show any benefit of prolonged antibiotic treatment. For prevention of Lyme borreliosis, post-exposure prophylaxis may be indicated in specific cases, and novel vaccine strategies are under development.
🔗https://www.bmj.com/content/369/bmj.m1041
👉open access
#lyme #review #infections #bmj
📌Lyme borreliosis is the most common vectorborne disease in the northern hemisphere. It usually begins with erythema migrans; early disseminated infection particularly causes multiple erythema migrans or neurologic disease, and late manifestations predominantly include arthritis in North America, and acrodermatitis chronica atrophicans (ACA) in Europe. Diagnosis of Lyme borreliosis is based on characteristic clinical signs and symptoms, complemented by serological confirmation of infection once an antibody response has been mounted. Manifestations usually respond to appropriate antibiotic regimens, but the disease can be followed by sequelae, such as immune arthritis or residual damage to affected tissues. A subset of individuals reports persistent symptoms, including fatigue, pain, arthralgia, and neurocognitive symptoms, which in some people are severe enough to fulfil the criteria for post-treatment Lyme disease syndrome. The reported prevalence of such persistent symptoms following antimicrobial treatment varies considerably, and its pathophysiology is unclear. Persistent active infection in humans has not been identified as a cause of this syndrome, and randomized treatment trials have invariably failed to show any benefit of prolonged antibiotic treatment. For prevention of Lyme borreliosis, post-exposure prophylaxis may be indicated in specific cases, and novel vaccine strategies are under development.
🔗https://www.bmj.com/content/369/bmj.m1041
👉open access
#lyme #review #infections #bmj
👉Biomarkers and Disease Severity in Children With Community-Acquired Pneumonia
📌WBC count, ANC, CRP, and procalcitonin are generally not useful to discriminate nonsevere from severe disease in children with CAP, although CRP and procalcitonin may have some utility in predicting the most severe outcomes.
🔗https://pediatrics.aappublications.org/content/145/6/e20193728
#pneumonia #crp #pct #respiration #aap #pulmonology #infections #pediatrics
📌WBC count, ANC, CRP, and procalcitonin are generally not useful to discriminate nonsevere from severe disease in children with CAP, although CRP and procalcitonin may have some utility in predicting the most severe outcomes.
🔗https://pediatrics.aappublications.org/content/145/6/e20193728
#pneumonia #crp #pct #respiration #aap #pulmonology #infections #pediatrics
👉Typical RSV cough: myth or reality? A diagnostic accuracy study
📌Respiratory syncytial virus (RSV) is well known for causing a potentially severe course of bronchiolitis in infants. Many paediatric healthcare workers claim to be able to diagnose RSV based on cough sound, which was evaluated in this study. Parents of children < 1 year old admitted to the paediatric ward because of airway complaints were asked to record cough sounds of their child. In all children, MLPA analysis—a variation of PCR analysis—on nasopharyngeal swab was performed (golden standard). Sixteen cough fragments representing 4 different viral pathogens were selected and presented to paediatric healthcare workers. Thirty-two paediatric nurses, 16 residents and 16 senior staff members were asked to classify the audio files and state whether the cough was due to RSV infection or not. Senior staff, nurses and residents correctly identified RSV with a sensitivity of 76.2%, 73.1% and 51.3% respectively. Correct exclusion of RSV cases was performed with a specificity of 60.8%, 60.2% and 65.3% respectively. Sensitivity ranged from 0 to 100% between colleagues; no one correctly identified all negatives. Residents had significantly lower rates of sensitivity than senior staff and nurses. This was strongly related to work experience, in which more than 3.5 years of work experience was related to the best result.
🔗https://link.springer.com/article/10.1007%2Fs00431-020-03709-1
#cough #rsv #infections #pulmonology #springer
📌Respiratory syncytial virus (RSV) is well known for causing a potentially severe course of bronchiolitis in infants. Many paediatric healthcare workers claim to be able to diagnose RSV based on cough sound, which was evaluated in this study. Parents of children < 1 year old admitted to the paediatric ward because of airway complaints were asked to record cough sounds of their child. In all children, MLPA analysis—a variation of PCR analysis—on nasopharyngeal swab was performed (golden standard). Sixteen cough fragments representing 4 different viral pathogens were selected and presented to paediatric healthcare workers. Thirty-two paediatric nurses, 16 residents and 16 senior staff members were asked to classify the audio files and state whether the cough was due to RSV infection or not. Senior staff, nurses and residents correctly identified RSV with a sensitivity of 76.2%, 73.1% and 51.3% respectively. Correct exclusion of RSV cases was performed with a specificity of 60.8%, 60.2% and 65.3% respectively. Sensitivity ranged from 0 to 100% between colleagues; no one correctly identified all negatives. Residents had significantly lower rates of sensitivity than senior staff and nurses. This was strongly related to work experience, in which more than 3.5 years of work experience was related to the best result.
🔗https://link.springer.com/article/10.1007%2Fs00431-020-03709-1
#cough #rsv #infections #pulmonology #springer
In this review, the authors highlight the current and future developments that could allow transition to a more precise manner of #antibiotic treatment in late preterm and term neonates, and propose a research agenda toward precision medicine for neonatal bacterial #infections.
doi.org/10.3389/fped.2021.590969
*The full text is here
doi.org/10.3389/fped.2021.590969
*The full text is here
In premature infants, complicated intraabdominal #infections (cIAIs) are a leading cause of morbidity and mortality.
Each of the #antibiotic regimens - ampicillin, gentamicin, and metronidazole (group 1); ampicillin, gentamicin, and clindamycin (group 2); or piperacillin-tazobactam and gentamicin (group 3) at doses stratified by postmenstrual age - are safe in premature infants with cIAI.
https://doi.org/10.1097/inf.0000000000003034
Each of the #antibiotic regimens - ampicillin, gentamicin, and metronidazole (group 1); ampicillin, gentamicin, and clindamycin (group 2); or piperacillin-tazobactam and gentamicin (group 3) at doses stratified by postmenstrual age - are safe in premature infants with cIAI.
https://doi.org/10.1097/inf.0000000000003034
There are several promising novel biomarkers in the pipeline, but well-designed randomized controlled trials are needed to evaluate the safety of using these novel biomarkers to guide clinical decisions.
#infections
https://doi.org/10.3390/children8111070
#infections
https://doi.org/10.3390/children8111070
Long-term CHG use may select for CHG and OCT tolerance in CoNS. This highlights the different potential for separate antiseptic regimens to select for resistance development. This could be an important factor in developing future infection control policies.
#infections
https://doi.org/10.1093/jacamr/dlab173
#infections
https://doi.org/10.1093/jacamr/dlab173