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2.1
Unresolved Pneumonia
Pneumonia Unresolved

Presentation

Case 3 Presentation A 56-year-old widow, housewife from Kolkata, Mrs. EB, presented to our O.P.D on 09.10.2008 with complaints of cough for one and a half years. [lungindia.com]

EBM can present as a secondary bacterial infection that may alter the clinical and radiological presentation, thereby delaying the diagnosis of pulmonary mucormycosis. [rc.rcjournal.com]

The presentation of lobar pneumonia depends on the severity of the disease, host factors and the presence of complications. [radiopaedia.org]

The full scope of disease presentation in children is therefore not known. [cochranelibrary.com]

The mild dose of roentgen ray given to the child was apparently a factor in the resolution of pneumonia which was present. The child had been ill for several weeks and had shown no improvement previous to this examination. [jamanetwork.com]

Entire Body System

  • Sepsis

    Take for example a provider who documents sepsis. When the sepsis resolves, the clinician no longer needs to document sepsis to justify its presence. [fortherecordmag.com]

    Fever, tachycardia, tachypnea, and altered consciousness are symptoms of sepsis that overlap with the clinical presentation of acute pneumonia; early diagnosis of CAP is therefore essential to avoid or forestall severe sepsis, septic shock, and death. [consultant360.com]

    Amongst pathophysiological causes, tachypnea can be a symptom of sepsis, compensation for diabetic ketoacidosis or other metabolic acidosis, pneumonia, pleural effusion, carbon monoxide poisoning, pulmonary embolism, asthma, COPD, laryngospasm, allergic [en.wikipedia.org]

    […] obliterans-organizing pneumonia (BOOP), Acute or Chronic eosinophilic pneumonia, Acute interstitial pneumonia, Pulmonary alveolar proteinosis, Sarcoidosis, Systemic lupus erythematosus, Heart failure, Pulmonary embolism See general reasons for unresolved sepsis [litfl.com]

    Early onset group B streptococci infection usually presents via ascending perinatal infection as sepsis or pneumonia within the first 24 hours of life. [emedicine.medscape.com]

  • Weakness

    As audits reveal new areas of weakness, actively manage templates and queries. Audits and Education Documentation and coding audits have increased under ICD-10. [fortherecordmag.com]

    Skeletal Muscle Index at Intensive Care Unit Admission Is a Predictor of Intensive Care Unit-Acquired Weakness in Patients With Sepsis. [physio-pedia.com]

    Symptoms include cough, shortness of breath, fevers, chills, chest pain, headache, sweating, and weakness. Inflammation of any part, segment or lobe, of the lung parenchyma. Inflammation of the lungs with consolidation and exudation. [icd10data.com]

    Because your immune system is already weak due to cancer, it’s especially important that you try to protect against germs. Take care of your health A cancer diagnosis requires you to pay attention to your health in ways you may not have before. [healthline.com]

    The patient also complained generalized weakness and significant weight loss over last 2 months. There was no history of convulsions or foreign body aspiration. Menstrual history was normal. Before admission, she had taken several oral antibiotics. [lungindia.com]

  • Hodgkin Lymphoma

    lymphoma QUANTIFERON TB GOLD -whole blood testing looking for interferon gamma -advantages: quick test, just blood draw, not affected by vaccine, develops in the course of TB treatment with inappropriate dosing or incomplete dosing. [quizlet.com]

Respiratoric

  • Cough

    One case showed asthma; both, vasomotor rhinitis and cough. 6. Case I showed intervals of recurrence varying from ten months to ten years. 7. Case II showed cough of twenty years standing. 8. [link.springer.com]

    SSX: sx of pneumonia: fever, cough, fatigue, SOB, chest pain, bad breath -in severe cases may become dehydrated or cough up bloody sputum and have very high fever then slip into coma free air or gas in the pleural cavity entering through perforation [quizlet.com]

    In this case, it presents as chronic cough with recurrent pneumonia. Bronchoscopy is recommended as initial management for diagnosis and possible treatment. 2. [hindawi.com]

    This can lead to symptoms of pneumonia, which include cough or productive cough with mucus, chest pain, fever or chills, fatigue, aches, and trouble breathing. [wisegeek.com]

    While pneumonia causes a high fever and cough that produces mucus, walking pneumonia involves a very low fever and a dry cough. Walking pneumonia and pneumonia are both the result of an infection of the respiratory tract. [healthline.com]

  • Sputum

    Postbronchoscopic sputum did show AFB in smear examination. [lungindia.com]

    pneumococcus=bloody or rust colored sputum and severe shaking chills, pleuritic chest pain Pseudomonas, Haemphilus and pneumococcal spp=green sputum -anaerobic infections may produce foul smelling...klebsiella resembles jelly, legionella=headache, anorexia [quizlet.com]

    Blood for complete hemogram, blood glucose, urea, creatinine, liver function test, chest X-rays (posteroanterior and lateral view), sputum culture for Mycobacterium tuberculosis in mycobacterial growth indicator tube (MGIT 960) and sputum for malignant [ncbi.nlm.nih.gov]

  • Sputum Production

    Home | CCC | Progressive Pneumonia Nonresolving or Progressive Pneumonia OVERVIEW Treatment failure in pneumonia is, despite antimicrobial therapy: failure to normalize the clinical features (eg, fever, cough, sputum production), or nonresolving image [litfl.com]

    Study protocol Detailed demographic and clinical parameters including age, sex, smoking history, clinical symptoms with duration (cough, fever more than 100°F, sputum production, hemoptysis, chest pain, breathlessness) and clinical signs (pallor, cyanosis [ncbi.nlm.nih.gov]

  • Persistent Cough

    Endobronchial foreign body is one of the suspected causes of persistent obstructive pneumonia [4]. Signs and symptoms are nonspecific which include cough, shortness of breath, wheezing, and/or hemoptysis [2]. [hindawi.com]

    Initial symptoms of lung cancer may include one or more of the following: Persistent cough. Coughing up blood or bloodstained phlegm (sputum). Chest and/or shoulder pains. Tiredness and loss of energy. Weight loss. [patient.info]

    Older adolescents infected with pertussis present with a paroxysmal cough, which persists for more than 3 weeks and may last up to 3 months, unlike the whooping cough of younger children. [emedicine.medscape.com]

  • Sneezing

    This includes washing your hands, sneezing or coughing into the bend of your arm, and avoiding people who are sick. Because your immune system is already weak due to cancer, it’s especially important that you try to protect against germs. [healthline.com]

    Restrict HCWs who are in the acute stages of an upper respiratory illness (i.e., those who are sneezing and/or coughing) from providing care to infants and other patients at high risk for complications from RSV infection (e.g., children who have severe [cdc.gov]

Urogenital

  • Kidney Failure

    Examples of transudate pleural effusions include: Congestive heart failure Liver failure or cirrhosis Kidney failure or nephritic syndrome Peritoneal dialysis 2. [emedicinehealth.com]

    Have a weakened immune system because of HIV/AIDS, kidney failure, a damaged or removed spleen, a recent organ transplant, or receiving chemotherapy. Have cochlear implants (an electronic device that helps you hear). [familydoctor.org]

    failure, arrhythmias, or fluid overload, e.g., from kidney failure or intravenous therapy. [en.wikipedia.org]

  • Renal Insufficiency

    insufficiency, arthralgia and myocarditis and pericarditis) Pulmonary infarcts The images on the left show the similarities between chronic eosinophilic pneumonia and organizing pneumonia. [radiologyassistant.nl]

    insufficiency) and the clinical severity of CAP. [cochranelibrary.com]

    Dose reductions of both amantadine and rimantadine are recommended for certain patients, such as persons greater than or equal to 65 years of age and/or those who have renal insufficiency. [cdc.gov]

Workup

[…] acute pulmonary: crackles or wheezes, pericardial friction rub, erythema multiforme or nodosum 2. chronic pulmonary: crackles and wheezes 3. chronic progressive disseminated histoplasmosis: mouth ulcers, eyes may have vision loss, hepatosplenomegaly WORKUP [quizlet.com]

A recent guideline has made recommendations regarding the minimal diagnostic workup when a resident has a suspected case of pneumonia. [academic.oup.com]

These patients merit special mention because they require a more extensive workup by a specialist. One useful way to categorize these patients is based on radiographic findings with and without symptoms. [emedicine.medscape.com]

X-Ray

  • Pulmonary Infiltrate

    B-Symptoms and pulmonary infiltrate were improved immediately by a therapy with steroids. [ncbi.nlm.nih.gov]

    Peripheral eosinophilia and pulmonary infiltrates are common manifestations of both acute and chronic pneumonia. [mdmag.com]

    […] sequestration, bronchial stenosis, or bronchiectasis 2 Persistent radiologic findings No clinical findings Anatomic abnormality (eg, sequestration, fibrosis, pleural lesion) 3 Recurrent pulmonary infiltrates with interval radiologic clearing No clinical [emedicine.medscape.com]

Microbiology

  • Streptococcus Pneumoniae

    2013 ICD-9-CM Diagnosis Code 481 Pneumococcal pneumonia [Streptococcus pneumoniae pneumonia] Short description: Pneumococcal pneumonia. [icd9data.com]

    The most common cause of lobar pneumonia is Streptococcus pneumoniae. [radiopaedia.org]

    The most common cause of pneumonia in adults > 30 years is Streptococcus pneumoniae is the most common pathogen in all age groups, settings, and geographic regions. However, pathogens of every sort, from viruses to parasites, can cause pneumonia. [msdmanuals.com]

    non-bacteremic Streptococcus pneumoniae, Chlamydophila (formerly Chlamydia) spp, and Moraxella catarrhalis than with other organisms Unusual pathogens may not be covered by antibiotics or may be more resistant to treatment — e.g. [litfl.com]

    […] influenzae, Streptococcus pyogenes, Moraxella catahhralis, Staphylococcus aureus, and S pneumoniae are the major bacterial pathogens in pediatric pneumonia. [accesspediatrics.mhmedical.com]

  • Staphylococcus Aureus

    unspecified 482.41 Methicillin susceptible pneumonia due to Staphylococcus aureus 482.42 Methicillin resistant pneumonia due to Staphylococcus aureus 482.49 Other Staphylococcus pneumonia 482.81 Pneumonia due to anaerobes 482.82 Pneumonia due to escherichia [healthprovidersdata.com]

    This is particularly true for methicillin-resistant Staphylococcus aureus. [docs11.minhateca.com.br]

    aureus, and S pneumoniae are the major bacterial pathogens in pediatric pneumonia. [accesspediatrics.mhmedical.com]

    Failure of clindamycin treatment of methicillin-resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. [scielo.br]

    Among bacterial pneumonia, gram-negative bacilli were the predominant organisms isolated in 30 out of 32 cases of bacterial pneumonia (93.75%); Staphylococcus aureus accounted for 2 cases (6.25%). [ncbi.nlm.nih.gov]

Treatment

treatment of CAP, along with specific patient characteristics, can portend complications from continuing pneumonia despite appropriate antibiotic treatment, including parapneumonic effusions, empyema, and lung abscess, leading to unresolved acute pneumonia [consultant360.com]

In consulting the literature for a period of ten years, it was found that there was only one report of the use of roentgen ray in the treatment of a series of cases of unresolved pneumonia. [jamanetwork.com]

Treatment New agents for treatment of nosocomial pneumonia include linezolid and tigecycline. The latter is effective 327 Copyright © Lippincott Williams & Wilkins. [docs11.minhateca.com.br]

What are the treatment options for lung cancer? Treatment options which may be considered include surgery, chemotherapy and radiotherapy. [patient.info]

This collaboration ensures comprehensive diagnosis and targeted treatment for patients. [brighamandwomens.org]

Prognosis

[…] high fever, tachycardia or bradycardia, bronchial breath sounds, dullness to percussion, pallor -Work up: CXR, CMP, CBC, CT, bronchoscopy -prognosis: normal resolution of sx vary but most people see improvements in 3-5 days of treatment, if unresolved [quizlet.com]

Treatment and prognosis Radiological follow-up of lobar pneumonia is often recommended - one study found ~5% of initially suspected community-acquired pneumonia were re-diagnosed with malignant or important benign pulmonary pathology on follow-up chest [radiopaedia.org]

Causes, symptoms, treatment, preventive measures, and prognosis differ depending on whether the infection is bacterial, mycobacterial, viral, fungal, or parasitic; whether it is acquired in the community or hospital; whether it occurs in a patient treated [msdmanuals.com]

Pleural Effusion Prognosis Since a pleural effusion is a symptom of another disease, the prognosis depends upon the underlying illness. Pleural effusions are never normal. [emedicinehealth.com]

What is the outlook (prognosis)? The outlook is best in those who are diagnosed when the cancer is still small and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure. [patient.info]

Etiology

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

In this study, finally a specific etiology could be found in 59 out of 60 cases (98.3%), and in one case, no etiology could be established even after thorough investigations [Table 5]. [ncbi.nlm.nih.gov]

Epidemiology

Non-neoplastic causes (e.g., pulmonary vasculitis, hypersensitivity pneumonia, etc.) should be considered when specific features are present (e.g., hematuria, appropriate epidemiologic exposures). [ncbi.nlm.nih.gov]

ASPERGILLOSIS Epidemiology Aspergillus sp. are ubiquitous fungi that commonly occur in soil, water, and decaying vegetation. [cdc.gov]

Epidemiology and predictors of multidrug-resistant community-acquired and health care-associated pneumonia. [scielo.br]

Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. Pediatrics. 2004;113(4):701-7. [ Links ] 25. Palafox M, Guiscafre H, Reyes H, Munoz O, Martinez H. [scielo.org.co]

[…] third-generation cephalosporin (ceftriaxone), plus azithromycin or levofloxacin, with or without vancomycin (if methicillin-resistant Staphylococcus aureus infection is suspected), but the selection of empiric antibiotic treatment should always conform to the epidemiology [consultant360.com]

Pathophysiology

Amongst pathophysiological causes, tachypnea can be a symptom of sepsis, compensation for diabetic ketoacidosis or other metabolic acidosis, pneumonia, pleural effusion, carbon monoxide poisoning, pulmonary embolism, asthma, COPD, laryngospasm, allergic [en.wikipedia.org]

The most frequent reason for failure to respond to treatment in CAP is the progression of pathophysiologic changes despite appropriate antibiotic treatment. 6 When a patient is failing to recover in the expected time period from the original acute pneumonia [consultant360.com]

Prevention

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]

Prevention and Control Measures Prevention of Legionnaires Disease in Hospitals with No Identified Cases (Primary Prevention) Prevention strategies in health-care facilities in which no cases of nosocomial legionellosis have been identified have differed [cdc.gov]

Pneumococcal and influenza vaccination have been the primary prevention measures. However, additional methods to prevent NHAP should be evaluated, including improving the oral hygiene of residents and instituting pharmacological interventions. [academic.oup.com]

Pleural Effusion Prevention Pleural effusions are caused by a variety of conditions and illnesses. Preventing the underlying cause will decrease the potential of developing an effusion. [emedicinehealth.com]

Here are five things you can do to help prevent pneumonia: Get a flu vaccine The flu is a common cause of pneumonia. Getting a vaccine helps you prevent both the flu and a possible pneumonia infection. [healthline.com]

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2.1
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