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Pneumonitis


Presentation

  • […] secondary to inhaled allergens Alternate/Historical Names Extrinsic allergic alveolitis (equvalent term) Many allergen specific names, a few of which are: Bird fancier's lung Farmer's lung Hot tub lung Humidifier lung Diagnostic Criteria Clinical May present[surgpathcriteria.stanford.edu]
  • Upon physical examination, the patient presented no fever, tachycardia (140 bpm), tachypnea (36 breaths per minute) and baseline oxygen saturation (breathing room air) of 91%.[archbronconeumol.org]
  • […] obliterans Infectious pneumonia – especially M. tuberculosis Usual interstitial pneumonia Desquamative interstitial pneumonia Nonspecific interstitial pneumonia Drug-induced pneumonitis Chronic presentation Nonspecific interstitial pneumonia Unusual[arupconsult.com]
  • The first is always to consider a reaction to e-cigarettes in someone presenting with an atypical respiratory illness.[adc.bmj.com]
  • However, the potential for massive inhalation with the use of vaping devices could account for the more acute presentations of the current cases.[reliasmedia.com]
Fatigue
  • The subacute form is characterized by the insidious onset of productive cough, dyspnea, and fatigue over weeks to months. Chronic hypersensitivity pneumonitis is characterized by long-term progressive dyspnea, weight loss, cough, and fatigue.[amboss.com]
  • To save this word, you'll need to log in. pneu·mo·ni·tis \ ˌnü-mə-ˈnī-təs, ˌnyü- \ : acute or chronic inflammation of the lungs that is characterized especially by cough, shortness of breath, fatigue, and fever, and may result in the development of fibrotic[merriam-webster.com]
  • Subacute and chronic patients may present with acute exacerbation Subacute Gradual onset of dyspnea, cough over days or weeks Follows continued intermittent exposure Good response to steroids and avoidance/removal of antigen Chronic Chronic dyspnea, fatigue[surgpathcriteria.stanford.edu]
  • Other symptoms include wheezing, fatigue, decreased pulse oximetry, and chest pain. Time to onset after initiation of therapy varies (reported at 9 days to 19 months), but the median is 2.8 months.[voice.ons.org]
Collapse
  • Radiation pneumonitis generally occurs within 6 months of completing irradiation treatment [ 15 ], subsiding spontaneously or after steroid therapy, resulting in a fibrous lesion with collapse.[futuremedicine.com]
Fever of Unknown Origin
  • Thus, pneumonitis should be included in the differential diagnosis of patients receiving sirolimus who present with fever of unknown origin.[academic.oup.com]
Tachypnea
  • Upon physical examination, the patient presented no fever, tachycardia (140 bpm), tachypnea (36 breaths per minute) and baseline oxygen saturation (breathing room air) of 91%.[archbronconeumol.org]
  • Its symptoms were nonspecific, usually manifests through cough, dyspnea, tachypnea, and hypoxia ( 28 ).[frontiersin.org]
Tachycardia
  • Upon physical examination, the patient presented no fever, tachycardia (140 bpm), tachypnea (36 breaths per minute) and baseline oxygen saturation (breathing room air) of 91%.[archbronconeumol.org]
  • For the patient with nonspecific symptoms, such as cough, dyspnea, fatigue, and hypoxia, the following factors can raise flags for certain conditions: Hypercarbia: immune checkpoint inhibitor–associated myasthenia gravis Superventricular tachycardia,[ascopost.com]
Palpitations
  • Two weeks later, she came to the emergency department once again due to sudden dyspnea when climbing stairs associated with a feeling of retrosternal oppression that increased with deep breathing and palpitations.[archbronconeumol.org]
Myopathy
  • He developed a critical illness and steroid myopathy and required prolonged rehabilitation.[adc.bmj.com]

Workup

  • Grade it per the Common Terminology Criteria for Adverse Events and direct further workup and management by the toxicity grade. For grade 2 or higher, perform a nasal swab and sputum and urine culture and sensitivity as part of an infectious workup.[voice.ons.org]
  • Workup Recommendations Workup of patients with suspected pneumonitis includes sputum cultures and nasopharyngeal swabs. It is especially important to look for evidence of viral infection in the winter months.[ascopost.com]
  • Blood workup revealed normal ionogram, C-reactive protein 80 g/dl, leukocytes 11 430 mm 3 (90% neutrophils and 1.4% eosinophils), hemoglobin 12.4 g/dl, hematocrits 36.4%, platelets 309 000 mm 3.[archbronconeumol.org]
Mycobacterium Avium Complex
  • A case of "hot tub lung" due to Mycobacterium avium complex in an immunocompetent host. Arch Intern Med. 2003 Apr 14. 163(7):845-8. [Medline]. Embil J, Warren P, Yakrus M, et al.[emedicine.medscape.com]
  • The NTM that has been described in practically all these cases is Mycobacterium avium-complex, although M. immunogenicum has also been reported. 2 We present the case of a 29-year-old woman, originally from Colombia, who has been living in Spain for the[archbronconeumol.org]
Staphylococcus Aureus
  • A pan-culture was performed at this time (sputum, peripheral blood, and methicillin-resistant Staphylococcus aureus surveillance culture; see Table); results did not reveal a causative microbial organism.[cancernetwork.com]

Treatment

  • The most common risk factor is related to treatment protocols.[curetoday.com]
  • His symptoms improved with corticosteroid treatment, worsened when corticosteroids were tapered, and then finally resolved after treatment with the TNF-alpha-inhibitor infliximab.[jitc.biomedcentral.com]
  • In this study, opacity confined to the ipsilateral lung was observed after nivolumab treatment.[futuremedicine.com]
  • […] may begin as soon as possible: discontinuation or a change of immunosuppressive treatment and addition of corticosteroid treatment if necessary.[revistanefrologia.com]
  • Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only.[drugs.com]

Prognosis

  • Steroid therapy is helpful for symptomatic relief, but probably does not affect the long-term prognosis.[mayoclinic.pure.elsevier.com]
  • Prognosis Prognosis is good with early diagnosis and management. Late-diagnosed chronic pneumonitis may lead to progressive, irreversible lung disease.[patient.info]
  • However, when smokers do develop hypersensitivity pneumonitis, it is more commonly fibrosing disease with a worse prognosis 10.[radiopaedia.org]
  • Centrilobular accentuation of peribronchiolar fibrosis is very suggestive of hypersensitivity pneumonitis Surrounds and may occlude bronchiole Fibrosis may bridge from centrilobular to peripheral zones Fibrosis is generally not reversible and imparts a poor prognosis[surgpathcriteria.stanford.edu]
  • The prognosis for the acute form is good. Once severe damage to lung structures has occurred, however, few treatment options remain. Chronic hypersensitivity pneumonitis may lead to pulmonary fibrosis, which may ultimately require transplantation.[amboss.com]

Etiology

  • They received empiric antibiotics recommended for treatment of community-acquired pneumonia, but tests for microbiological etiologies proved negative.[reliasmedia.com]
  • One is confronted with the same difficulty in placing the pneumonias, though some progress is being made toward adoption of an etiological classification.[annals.org]
  • […] type of pulmonary inflammation on the basis of roentgen findings alone, it is both sensible and convenient for the radiologist to report findings which suggest chronic fibroid pneumonia as “interstitial pneumonitis,” making no attempt to identify the etiologic[pubs.rsna.org]
  • Etiology Combined type III and type IV hypersensitivity reaction with genetic predisposition Inhalation of organic particles ( 5 microns ), primarily through occupational exposure (notifiable occupational disease) Antigen Source Disease Animal proteins[amboss.com]
  • Etiology The triggering particles are usually in the range of 1-5 micrometers in size 5.[radiopaedia.org]

Epidemiology

  • Epidemiology It is common, if all causes of pneumonitis are considered.[patient.info]
  • Chronic presentation Nonspecific interstitial pneumonia Unusual interstitial pneumonia Bronchiolitis obliterans Chronic obstructive pulmonary disease (COPD) Idiopathic pulmonary fibrosis Sarcoidosis Asthma Silicosis Drug-induced pneumonitis Background Epidemiology[arupconsult.com]
  • Epidemiological study of farmer's lung in five districts of the French Doubs province. Thorax. 1988 Jun. 43(6):429-35. [Medline]. [Full Text]. Terho EO. Work-related respiratory disorders among Finnish farmers. Am J Ind Med. 1990. 18(3):269-72.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • […] s lung, paprika slicer’s lung, wine maker’s lung, tobacco grower’s lung Animal proteins Pituitary snuff taker’s lung, pigeon breeder's lung, bird fancier’s disease, furrier’s lung, poultry worker's lung Chemicals Bathtub finisher's lung, Coptic lung Pathophysiology[arupconsult.com]
  • Details of the pathophysiology of this disease are still unknown, but for drugs with a high volume of distribution, one possibility would be specific accumulation of the mTOR inhibitor or its metabolites in the lung parenchyma.[revistanefrologia.com]
  • Despite the frequency with which both radiation- and ICB- related pneumonitis occur, the pathophysiology remains unclear, and there is little data to suggest which clinical risk factors might be the most relevant.[jitc.biomedcentral.com]
  • The precise pathophysiology of the differences between PD1/PDL-1 inhibitors and CTL-4 inhibitors is yet to be uncovered.[frontiersin.org]

Prevention

  • Oxygen therapy to prevent a low level of oxygen in the body. Bronchodilators may be given to help open up the lungs for better oxygenation. Steroids may be given to lessen inflammation and help the lungs heal. If you smoke, stop.[oncolink.org]
  • The chronic form of this condition can be prevented by avoiding the material that causes the lung inflammation.[uihc.org]
  • The chronic form can be prevented by avoiding the material that causes the lung inflammation.[medlineplus.gov]
  • The inflammation can make it hard to breathe and prevent you from getting enough oxygen. Anything that irritates your lung tissues can lead to pneumonitis. The longer you are exposed, the more damage your lungs will develop.[drugs.com]
  • Prevention Avoiding exposure to dust or chemicals is important. If a person cannot change jobs, he or she should wear a protective masks and work in a well-ventilated place, if possible.[cedars-sinai.edu]

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