BODE plus DOSE plus Pa<sub>O<sub>2</sub></sub> equals DO RE MI BOX?

Jones, Rupert; Harding, S. R. G.; Hyland, Michael E.; Donaldson, Gavin C.; Wedzicha, Jadwiga A.; Chavannes, Niels H.; Kida, Kenji; Price, David E.

doi:10.1164/ajrccm.182.8.1089

Cited by 4 publications

(4 citation statements)

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“…However, these two studies also should be carefully interpreted because the size of the study population was small and the subjects were limited to pediatric patients. There is a considerable number of clinical case series and case reports in which severe patients with encephalopathy or with respiratory complications such as pneumonia improved after the use of a corticosteroid [54-67]. …”

Section: Steroidsmentioning

confidence: 99%

Severe influenza treatment guideline

Choi

Baek

Seo

et al. 2014

Korean J Intern Med

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Section: Steroidsmentioning

confidence: 99%

Severe influenza treatment guideline

Choi

Baek

Seo

et al. 2014

Korean J Intern Med

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“…Roberts et al published a Case series introducing an interesting concept. They called this group of patients as “steroid-sensitive post-viral inflammatory pneumonitis” [ 19 ] They reported three cases of viral pneumonias (H1N1 and RSV) in which high-dose steroids had a dramatical effect on the outcome. The article argues that there is a subset of patients with viral lower respiratory infection who may need treatment with systemic steroids.…”

Section: Discussionmentioning

confidence: 99%

Possible respiratory syncytial virus infection presenting as diffuse alveolar hemorrhage in an elderly treated with systemic corticosteroid: A case report

Nam

Kang

Koh

2021

Respiratory Medicine Case Reports

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Introduction Respiratory syncytial virus infection is gaining interest in the elderly due to its growing morbidity and mortality. We present a Case of respiratory syncytial virus infection presenting as diffuse alveolar hemorrhage that was highly responsive to systemic corticosteroid in an elderly patient. Case presentation An 82-year old man was admitted to the intensive care unit with worsening hypoxic respiratory failure. Chest radiograph showed non-homogeneous air space opacities. Bronchoalveolar lavage showed a finding of alveolar hemorrhage. The diagnosis of diffuse alveolar hemorrhage was made and high-dose systemic corticosteroid was given. However, concomitant respiratory syncytial virus infection was later confirmed. Therefore, ribavirin and human immunoglobulin were added. During the course of his treatment, the steroid was stopped and restarted. Interestingly, the clinical course was highly responsive to systemic corticosteroid. Conclusion It appears that diffuse alveolar hemorrhage in this patient may have been due to an immunological process caused by respiratory syncytial virus. Therefore, corticosteroid therapy was highly effective in improving the patient's hemoptysis and hypoxic respiratory failure. We suggest that further studies are required on the use of steroid in this subset of patients with respiratory syncytial virus lower respiratory tract infection.

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“…[5964] In ICH steroids, possibly increase co-infection by downregulating innate and adaptive immunity (like in IAA). [28] Sporadic reports show its beneficial use in organizing pneumonia,[65] postviral inflammatory pneumonitis,[66] and influenza A (H1N1) pneumonia in a pregnant woman. [67]…”

Section: Therapeutic Challenges In Immunocompromised Hostmentioning

confidence: 99%

Influenza H1N1 infection in immunocompromised host: A concise review

Harish

Ruhatiya

2019

Lung India

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Influenza A (H1N1) infection has a propensity to infect an immunocompromised host (ICH). These patients experience more severe manifestations and related complications with increased mortality. Influenza A (H1N1) infection in ICH differs from non-ICH in terms of clinical features, range of complications, radiological features, treatment response, and outcome. Radiology may show higher number of lesions but with no or minimal corresponding clinical manifestations. Coinfection with streptococci, staphylococci, and Aspergillus further increases mortality. Antiviral resistance compounds the overall picture despite optimal regimen. Use of steroids is detrimental. Extracorporeal membrane oxygenation (ECMO) is usually avoided in ICH. However, ICH groups with influenza A (H1N1) infection complicated by acute respiratory distress syndrome who have received ECMO have recorded mortality up to 61%. Nevertheless, evidence-based recommendation on use of ECMO in ICH is lacking. Annual inactivated influenza vaccine is recommended for most ICH groups with a few exceptions and for their close contacts. Hygiene measures greatly contribute to reducing disease burden. High index of suspicion for influenza A (H1N1) infection in ICH, early antiviral therapy, and treatment of coinfection is recommended. With the threat of transmission of resistant viral strains from ICH to the community, apart from treatment, preventive measures such as vaccination and hygienic practices have a significant role. Through this review, we have attempted to identify clinical and radiological peculiarities in ICH with influenza A (H1N1) infection, treatment guidelines, and prognostic factors. Influenza A (H1N1) infection in ICH may remain clinically silent or mild.

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BODE plus DOSE plus Pa_O₂ equals DO RE MI BOX?

Cited by 4 publications

References 0 publications

Severe influenza treatment guideline

Severe influenza treatment guideline

Possible respiratory syncytial virus infection presenting as diffuse alveolar hemorrhage in an elderly treated with systemic corticosteroid: A case report

Influenza H1N1 infection in immunocompromised host: A concise review

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BODE plus DOSE plus PaO2 equals DO RE MI BOX?

Cited by 4 publications

References 0 publications

Severe influenza treatment guideline

Severe influenza treatment guideline

Possible respiratory syncytial virus infection presenting as diffuse alveolar hemorrhage in an elderly treated with systemic corticosteroid: A case report

Influenza H1N1 infection in immunocompromised host: A concise review

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BODE plus DOSE plus Pa_O₂ equals DO RE MI BOX?