Abstract A clinical efficacy study of amikacin in the treatment of 15 adults with nonbacteremic, gram-negative bacillary pneumonia is presented. [ncbi.nlm.nih.gov]

The ORs compared with the baseline value (patients with no risk factor present) were 4.2 (95% CI, 1.4-16.7) for 1, 9.1 (95% CI, 2.8-37.2) for 2, and 39.3 (95% CI 9.3-188.3) for 3 or more risk factors present on admission. [jamanetwork.com]

It is impossible to present precise incidence figures, as these vary from centre to centre and are influenced by diagnostic sensitivity, patient populations, etc. [cambridge.org]

The present review has the aim to update the current knowledge about the etiology, classifi cation, antimicrobial resistance, diagnosis, and therapy in CAP due to GNB. [caijournal.com]

• Fever

  Essentially, all had new lung infiltrates as shown by chest radiography, leukocytosis, recent onset of fever, and increased volume of purulent secretions. Half had multilobar pulmonary infiltrates. [ncbi.nlm.nih.gov]

  This results in the fever, chills, and fatigue common in bacterial and fungal pneumonia. The neutrophils, bacteria, and fluid leaked from surrounding blood vessels fill the alveoli and result in impaired oxygen transportation. [en.wikipedia.org]

  I was worried what happened and fever was also there I consulted to doctor regarding fever, he checked blood, and it was typhoid and malaria I took antibiotic for 21 days with lots of pain in my chest my wife used to cut the medicine in four parts then [healthquestions.medhelp.org]

  See your doctor promptly if you Have a high fever Have shaking chills Have a cough with phlegm that doesn't improve or gets worse Develop shortness of breath with normal daily activities Have chest pain when you breathe or cough Feel suddenly worse after [icdlist.com]

  Your doctor might also suggest medication for pain and fever. Other things you can do to help yourself get better: Get lots of rest. Drink plenty of fluids (they’ll loosen up the gunk in your lungs so you can cough it out). [webmd.com]

• Chills

  This results in the fever, chills, and fatigue common in bacterial and fungal pneumonia. The neutrophils, bacteria, and fluid leaked from surrounding blood vessels fill the alveoli and result in impaired oxygen transportation. [en.wikipedia.org]

  See your doctor promptly if you Have a high fever Have shaking chills Have a cough with phlegm that doesn't improve or gets worse Develop shortness of breath with normal daily activities Have chest pain when you breathe or cough Feel suddenly worse after [icdlist.com]

  CAP - PresentationTypical CAP Atypical CAP an abrupt onset,  a progressive onset, high fever, chills,  fever without chills, productive cough,  dry cough, thoracic pain,  headache, myalgia, focal clinical signs,  diffuse crackles, lobar or [slideshare.net]

  Common symptoms are: High fever up to 105 F Coughing out greenish, yellow, or bloody mucus Chills that make you shake Feeling like you can’t catch your breath, especially when you move around a lot Feeling very tired Low appetite Sharp or stabby chest [webmd.com]

• Rigor

  Signs and symptoms[edit] Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia) Dyspnea – shortness of breath Chest pain Shaking chills[2] Pneumococcal pneumonia can cause coughing up of blood [en.wikipedia.org]

  Symptoms and signs include malaise, fever, chills, rigor, cough, dyspnea, and chest pain. [merckmanuals.com]

• Acutely Ill Patient

  Corticosteroid insufficiency in acutely ill patients. N Engl J Med. 2003 Feb 20. 348(8):727-34. [Medline]. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. [medscape.com]

  Since the severity of structural lung disease is difficult to assess in acutely ill patients, comparisons with other series are difficult. A critical issue consists in the criteria for an etiological diagnosis of GNB. [jamanetwork.com]

• Cough

  See your doctor promptly if you Have a high fever Have shaking chills Have a cough with phlegm that doesn't improve or gets worse Develop shortness of breath with normal daily activities Have chest pain when you breathe or cough Feel suddenly worse after [icdlist.com]

  Signs and symptoms[edit] Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia) Dyspnea – shortness of breath Chest pain Shaking chills[2] Pneumococcal pneumonia can cause coughing up of blood [en.wikipedia.org]

  Drink plenty of fluids (they’ll loosen up the gunk in your lungs so you can cough it out). Use a humidifier or take a warm bath (more gunk-loosening). Don’t smoke. Stay home until your fever goes down and you aren’t coughing anything out. [webmd.com]

  Coughing is important because nonpulmonary sources of bleeding are not usually associated with hemoptysis. [ncbi.nlm.nih.gov]

• Dyspnea

  Signs and symptoms[edit] Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia) Dyspnea – shortness of breath Chest pain Shaking chills[2] Pneumococcal pneumonia can cause coughing up of blood [en.wikipedia.org]

  1.0) 20 (1.5) 0.71 0.7 0.1 to 5.1 — e Clinical characteristics CRB-65 score, n (%) 0.93 0 42 (43.3) 592 (44.7) 1 Ref. 1–2 54 (55.7) 716 (54.0) 1.0 0.7 to 1.6 3–4 1 (1.0) 18 (1.4) 0.8 0.1 to 6.0 Severe CAP, n (%) 14 (14.4) 101 (7.6) 0.02 2.0 1.1 to 3.7 Dyspnea [academic.oup.com]

  Symptoms and signs include malaise, fever, chills, rigor, cough, dyspnea, and chest pain. [merckmanuals.com]

  These medications must be used very cautiously if you have severe dyspnea. Discuss the risks and benefits of taking this medication with your doctor or healthcare provider. [chemocare.com]

• Productive Cough

  cough, n (%) 77 (79.4) 948 (71.5) 0.10 1.5 0.9 to 2.5 Haemoptysis, n (%) 12 (13.5) 104 (8.2) 0.09 1.7 0.9 to 3.3 Headache, n (%) 21 (21.7) 169 (12.9) 0.01 1.9 1.2 to 3.2 Fever on admission, n (%) 42 (43.3) 459 (34.6) 0.08 1.4 0.9 to 2.2 Lab results Leucocyte [academic.oup.com]

  Case 7• Male, 65, known diabetic with h/o 30 cpy presents with a 4-day history of productive cough with greenish sputum and shortness of breath. [slideshare.net]

  The material brought up from the lungs after a productive cough constitutes the material desired. [lungindia.com]

  It is important to note that nursing home patients with pneumonia are less likely to present with classic signs and symptoms of the typical pneumonia presentation, such as fever, chills, chest pain, and productive cough, but instead these individuals [emedicine.com]

• Rales

  […] hypothermia ( 35 C) Tachypnea ( 18 respirations/min) Use of accessory respiratory muscles Tachycardia ( 100 bpm) or bradycardia ( 60 bpm) Central cyanosis Altered mental status Physical findings may include the following: Adventitious breath sounds, such as rales [emedicine.com]

  […] the lungs may be normal, but often shows decreased expansion of the chest on the affected side, bronchial breathing on auscultation with a stethoscope (harsher sounds from the larger airways transmitted through the inflamed and consolidated lung), and rales [proz.com]

• Sputum Production

  Chronic cough with fever and weight loss complicated by hemoptysis can be seen both in tuberculosis and bronchiectasis, although the latter often has more marked sputum production. [ncbi.nlm.nih.gov]

  Case 10 A 29-year-old man is admitted with cough, rusty sputum production, fever, chills, and decreased O2 saturation. His chest x-ray shows a right upper lobe nonhomogeneous opacity. He is treated with IV antibiotics but does not improve. [slideshare.net]

  production Hib pericarditis: Fever, respiratory distress, and tachycardia Septic arthritis: Joint pain, swelling, and decreased mobility Occult bacteremia: Fever, anorexia, and lethargy Underlying medical conditions (especially with invasive Hib disease [emedicine.com]

  This form of aspergillus infection may be associated with a variety of nonspecific clinical symptoms such as cough, sputum production, and fever for 6 months. Haemoptysis has been reported in 15% of patients with semi-invasive aspergillosis 37. [erj.ersjournals.com]

[…] specimens from the gastric antrum and corpus and to perform a histologic examination on the obtained specimens Echography plus EGD: Mandatory in patients with positive biopsy results for gastric MALTomas to allow a more precise staging of the disease See Workup [emedicine.medscape.com]

Urine assays Sputum, serum, and/or urinary antigen tests Immune serologic tests Histologic examination Histologic inflammatory lung changes vary according to whether the patient has lobar pneumonia, bronchopneumonia, or interstitial pneumonia. [2] See Workup [emedicine.com]

• Pulmonary Infiltrate

  Half had multilobar pulmonary infiltrates. Their mean age was 73 years, with none under age 50. Most had chronic obstructive pulmonary disease, congestive heart failure, or both. [ncbi.nlm.nih.gov]

  : Etiology and microbial patterns of pulmonary infiltrates in patients with orthotopic liver transplantation. Chest 2000, 117 ( 2 ):494–502. PubMed CrossRef Google Scholar 28. [link.springer.com]

  Of 76 089 patients presenting to the medical emergency department of the hospital clinic during the study period, 719 had pulmonary infiltrates. We selected 559 (78%) of the 719 episodes for this analysis. [jamanetwork.com]

  Indeed, pulmonary infiltrates on imaging in critically ill patients are common and can be due to non-infectious etiologies, including atelectasis, acute respiratory distress syndrome (ARDS), congestive heart failure (CHF), pulmonary hemorrhages, and pulmonary [f1000research.com]

• Blood Culture Positive

  Fungus: Candida spp. mecA vanA/vanB blaKPC 1 h (after blood culture positivity, 8–24 h) Nanosphere/Verigene Microarray (detects 15 different Gram-positive targets and 14 different Gram-negative targets (including nine resistance mechanisms) Blood Other [intechopen.com]

  culture positive for an organism considered not to be a contaminant. [scielosp.org]

  Blood culture collection before initial hospital antibiotics Pre-treatment blood cultures - positive results in 5-14% of patients hospitalized with CAP 32. [slideshare.net]

• Pleural Rub

  Signs: tachypnoea, bronchial breathing, crepitations, pleural rub, dullness with percussion. [patient.info]

Abstract Beta-lactam antibiotics form the backbone of treatment for Gram-negative pneumonia in mechanically ventilated patients in the intensive care unit. [ncbi.nlm.nih.gov]

@inproceedings{Bassetti2015TreatmentOG, title {Treatment of Gram-negative pneumonia in the critical care setting: is the beta-lactam antibiotic backbone broken beyond repair?} [semanticscholar.org]

Community-acquired pneumonia due to gram-negative bacteria and pseudomonas aeruginosa incidence, risk and prognosis. J Am Med Asso. 2002;162(16):1849-58. [msjonline.org]

We determined the incidence of, prognosis of, and risk factors for CAP due to gram-negative bacteria (GNB), including Pseudomonas aeruginosa. [jamanetwork.com]

Overall prognosis is poor, due in part to comorbidities. [merckmanuals.com]

What is the prognosis for H. pylori infections? What if it is not treated? Many infections are mild and produce few, if any, symptoms. The prognosis of these infections is excellent. [medicinenet.com]

A multivariate analysis of risk and prognosis. Chest 1988, 93 :318–324. PubMed Google Scholar 26. Pennington JE: Gram-negative bacterial pneumonia in the immunocompromised host. Semin Respir Infect 1986, 1 :145–150. PubMed Google Scholar 27. [link.springer.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

A critical issue consists in the criteria for an etiological diagnosis of GNB. [jamanetwork.com]

The clinical features, etiologic agents, population at risk, treatment, and outcome in patients with well-documented gram-negative pneumonia were compared in two groups of patients: those with bacteremic pneumonia and those with nonbacteremic pneumonia [ncbi.nlm.nih.gov]

Etiology of community-acquired pneumonia: impact of age, comorbidity, and severity. Am J Respir Crit Care Med. 1999;160:397-405. Almirall J, Mesalles E, Klamburg J, Parra O, Agudo A. [msjonline.org]

Schaberg DR, Culver DH, Gaynes RP: Major trends in the microbial etiology of nosocomial infection. Am J Med 1991, 91 :72S-75S. PubMed CrossRef Google Scholar 24. Marrie TJ: Community-acquired pneumonia: epidemiology, etiology, treatment. [link.springer.com]

This article reviews the epidemiologic characteristics, pathogenesis, and current management issues of GNB pneumonia. [link.springer.com]

Ballot, D.E. and Perovich, O. (2005) Epidemiology of Neonatal Sspsis at Johannesburg Hospital. [scirp.org]

Severe community-acquired pneumonia: risk factors and follow-up epidemiology. Am J Respir Crit Care Med. 1999;160923- 929Google ScholarCrossref 22. [jamanetwork.com]

Risk factors for ventilator-associated pneumonia: from epidemiology to patient management. Clin Infect Dis. 2004; 38 :1141–1149. doi: 10.1086/383039. [ PubMed ] [ CrossRef ] [ Google Scholar ] 19. Torres A, Ferrer M, Badia JR. [ncbi.nlm.nih.gov]

Educational Objectives Upon completion of this activity, participants will be able to: Demonstrate an understanding of the molecular epidemiology of antibiotic resistance in bacterial pathogens. [mycme.com]

This most likely reflects an incomplete understanding of the complex pathophysiologic mechanism and thus invites examination of alternative mechanisms. [ncbi.nlm.nih.gov]

[…] direct bacterial pneumonia or accompanied by primary viral pneumonia) Dyspnea – shortness of breath Chest pain Shaking chills[2] Pneumococcal pneumonia can cause coughing up of blood, or hemoptysis, characteristically associated with "rusty" sputum[3] Pathophysiology [en.wikipedia.org]

Preventing pneumonia is always better than treating it. Vaccines are available to prevent pneumococcal pneumonia and the flu. Other preventive measures include washing your hands frequently and not smoking. [icdlist.com]

The currently available therapeutic interventions to prevent the disease process are of limited usefulness. [ncbi.nlm.nih.gov]

Centers for Disease Control and Prevention: Guidelines for prevention of nosocomial pneumonia. Morbid Mortal Wkly Rep 1997, 46 :1–79. The most current guidelines on infection control measures to prevent nosocomial pneumonia. Google Scholar 15. [link.springer.com]

Prevention[edit] Prevention of bacterial pneumonia is by vaccination against Streptococcus pneumoniae (pneumococcal polysaccharide vaccine for adults and pneumococcal conjugate vaccine for children), Haemophilus influenzae type B, meningococcus, Bordetella [en.wikipedia.org]

Surveillance, infection control, and early detection by means of utilizing rapid diagnostics and other methodologies are important for early prevention of disease. [intechopen.com]