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Gram-Negative Pneumonia


Presentation

  • In 12 patients in whom other organisms resistant to gentamicin were also present, other antimicrobial agents were concomitantly administered.[ncbi.nlm.nih.gov]
  • 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 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]
  • Wunderink, MD Professor of Medicine, Northwestern Medicine, Feinberg School of Medicine, Chicago, IL, United States Date Tuesday, October 31 @ 5:30 AM 5:30am - 6:00am Breakfast & Registration 6:00am - 7:00am Presentation Welcome and Introductions Marin[medscape.org]
  • This may mean that there is no bacterial infection present or that there were not enough bacteria present in the sample to be seen with the stain under a microscope.[labtestsonline.org]
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]
  • Bacterial pneumonia is a type of pneumonia caused by bacterial infection . [1] Signs and symptoms [ edit ] Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia ) Dyspnea – shortness of breath[en.wikipedia.org]
  • Cough Medications/Decongestants - may help you to be more comfortable if you are coughing a lot.[chemocare.com]
  • Then breathe deeply and cough hard until sputum comes up. Spit out the sputum into your sample cup. Keep coughing up sputum until the cup is filled to the marker, which should equal approximately 1 teaspoon.[healthline.com]
  • The hacking, dry cough can be very persistent.[patient.info]
Dyspnea
  • Bacterial pneumonia is a type of pneumonia caused by bacterial infection . [1] Signs and symptoms [ edit ] Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia ) Dyspnea – shortness of breath[en.wikipedia.org]
  • 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]
  • In most cases (60%), the symptoms of dyspnea, cough, hypoxia, and low-grade fever resolve over 2-4 days.[clincalc.com]
  • Typical symptoms include rapid onset of dyspnea, pleuritic chest pain, fever, cough (often bloody). Salmonella typhi/paratyphi These bacterium produce a spectrum of symptoms classically known as Typhoid Fever (Enteric Fever).[clinicaladvisor.com]
Productive Cough
  • The material brought up from the lungs after a productive cough constitutes the material desired.[lungindia.com]
Painful Cough
  • The symptoms of pneumonia can range from moderate to life-threatening, and include: wheezing shortness of breath rapid breathing chest pain cough fever chills fatigue headache muscle aches nausea and vomiting sputum that’s colored or has an odor confusion[healthline.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]
  • 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]
  • Bacterial pneumonia is a type of pneumonia caused by bacterial infection . [1] Signs and symptoms [ edit ] Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia ) Dyspnea – shortness of breath[en.wikipedia.org]
  • Typical symptoms include rapid onset of dyspnea, pleuritic chest pain, fever, cough (often bloody). Salmonella typhi/paratyphi These bacterium produce a spectrum of symptoms classically known as Typhoid Fever (Enteric Fever).[clinicaladvisor.com]
Chills
  • 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]
  • 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]
  • Describe a diagnostic approach/method to the patient with gram negative rod infections Gram negative sepsis/bacteremia, in general, will present abruptly with fever and chills.[clinicaladvisor.com]
  • You may have fever, shaking chills, or a headache. You may feel confused, or have a heart rate that is faster than normal.[chemocare.com]
  • The genus Pseudomonas can be found almost everywhere: hospitals, nursing homes, and medical equipment; it’s all around us. [6],[8] Signs and symptoms of disease General symptoms of bacterial infections have a quick onset such as shaking chills and fever[austincc.edu]
Rigor
  • Bacterial pneumonia is a type of pneumonia caused by bacterial infection . [1] Signs and symptoms [ edit ] Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia ) Dyspnea – shortness of breath[en.wikipedia.org]
  • Initial mild headache and myalgia leading to high fever, chills and repeated rigors; non-chest symptoms often predominate early on. Cough is nearly always present, initially unproductive but may lead to expectoration later.[patient.info]

Workup

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]
  • Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med. 2000;162:505–11.[ccforum.biomedcentral.com]
Pleural Rub
  • Signs: tachypnoea, bronchial breathing, crepitations, pleural rub, dullness with percussion.[patient.info]

Treatment

  • 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]
  • Currently, the successful treatment of hospital-acquired gram-negative pneumonia depends on a clear and consistent definition of the disease process, knowledge that therapy with a single antibiotic is effective, and use of a concise treatment protocol[ncbi.nlm.nih.gov]
  • Key therapeutic questions are whether beta-lactams can safely replace aminoglycosides for the treatment of gram-negative pneumonia, and whether monotherapy or aminoglycoside and beta-lactam combination antibiotic treatment is superior.[ncbi.nlm.nih.gov]
  • There were no differences in the minor adverse effects observed in the two treatment groups. Overall, aztreonam was superior to tobramycin for treatment of pneumonia due to susceptible gram-negative bacteria in these critical care patients.[ncbi.nlm.nih.gov]
  • Number of Participants With Organ Failure [ Time Frame: Up to 7 days after the end of study treatment ] The overall number of participants with any organ failure was summarized for each treatment group.[clinicaltrials.gov]

Prognosis

  • 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]
  • Community-acquired pneumonia due to gram-negative bacteria and pseudomonas aeruginosa: Incidence, risk, and prognosis. Arch Intern Med 2002;162:1849-58. 8.[caijournal.com]
  • Prognosis Mortality from CAP is less than 1% in those well enough to be managed in the community. [ 16 ] The mortality rate in patients admitted to hospital is 5-10% in those not requiring intensive care unit admission, as high as 25% in intubated patients[patient.info]
  • Validation and application of the pneumonia prognosis index to nursing home residents with pneumonia. J Am Geriatr Soc . 1998;46(12):1538–1544. 21. Mandell LA, et al.[aafp.org]

Etiology

  • Etiology of community-acquired pneumonia in a population-based study: Link between etiology and patients characteristics, process-of-care, clinical evolution and outcomes. BMC Infect Dis 2012;12:134. 20.[caijournal.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]
  • Although gram staining of sputum may provide immediate etiologic clues, the diagnosis is proven only by isolation of the pathogen from blood or pleural fluid or by various invasive techniques since expectorated specimens from highly susceptible patients[ncbi.nlm.nih.gov]
  • 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]
  • Etiology The distribution of pathogens that comprise the etiology of pneumonia (including HAP, VAP, and HCAP) varies from region to region [ 22 , 23 ].[ccforum.biomedcentral.com]

Epidemiology

  • ., Ballot, D.E. and Perovich, O. (2005) Epidemiology of Neonatal Sspsis at Johannesburg Hospital.[scirp.org]
  • This article reviews the epidemiologic characteristics, pathogenesis, and current management issues of GNB pneumonia.[link.springer.com]
  • Epidemiology of community-acquired pneumonia in adults: A population-based study. Eur Respir J 2000;15:757-63. 13. Laing R, Slater W, Coles C, Chambers S, Frampton C, Jackson R, et al .[caijournal.com]
  • Hospital-acquired pneumonia and ventilator-associated pneumonia: recent advances in epidemiology and management. Curr Opin Pulm Med. 2013;19:216–28.[ccforum.biomedcentral.com]
  • [The genus Serratia: its biology, clinical effects and epidemiology]. Rev Clin Esp . 1994 Apr. 194(4):294-9. [Medline] . Aron M, Goel R, Gupta NP, et al.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • This most likely reflects an incomplete understanding of the complex pathophysiologic mechanism and thus invites examination of alternative mechanisms.[ncbi.nlm.nih.gov]
  • Pathophysiology [ edit ] Bacteria typically enter the lung with inhalation, though they can reach the lung through the bloodstream if other parts of the body are infected.[en.wikipedia.org]
  • The effect of pathophysiology on pharmacokinetics in the critically ill patient—concepts appraised by the example of antimicrobial agents. Adv Drug Deliv Rev. 2014;77:3–11.[ccforum.biomedcentral.com]
  • […] opportunistic pathogen in humans. [ 10 ] Derivatives of prodigiosin have recently been found to have immunosuppressive properties and antitumor activity in vivo [11, 12 ] and are also currently being considered as a candidate treatment for Chagas disease. [13] Pathophysiology[emedicine.medscape.com]
  • The effect of pathophysiology on pharmacokinetics in the critically ill patient—concepts appraised by the example of antimicrobial agents. Adv Drug Deliv Rev. 2014;77:3–11. View Article PubMed Google Scholar Vinks A, Derendorf H, Mouton J.[annalsofintensivecare.springeropen.com]

Prevention

  • The currently available therapeutic interventions to prevent the disease process are of limited usefulness.[ncbi.nlm.nih.gov]
  • 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]
  • 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]
  • […] cardiac failure, etc.) should be among the preventive measures.[caijournal.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 ,[en.wikipedia.org]

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