Community-acquired pneumonia in adults with Down syndrome. Three clinical cases and a review of the literature

Pérez, J.A. Hermida; Guerra, J.S. Hernández

doi:10.1016/s2171-9748(10)70008-8

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…). This susceptibility in respiratory infection is attributed to functional and anatomical defects in respiratory system, the presence of congenital heart disease, obstructive sleep apnoea, immunodeficiency, GERD and chronic silent aspiration (Hermida Pérez & Hernandez Guerra ; Ross & Olsen ). We speculate that during adulthood, GERD and dysphagia play a major role in pneumonia and aspiration syndrome and consequently result in poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Chenbhanich

Phupitakphol

et al. 2018

J intellect Disabil Res

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Background Life expectancy of individuals with Down syndrome (DS) has improved significantly over the past decades. However, there are sparse data documenting the co‐morbidities and hospitalisation of adult patients with DS in the literature. The aim of this study was to characterise the co‐morbidities and pattern of hospitalisation in adult patients with DS during a 10‐year period at the community hospital as well as to compare hospitalisation parameters with the general adult population during the same years. Method We reviewed the medical records of 81 hospitalisations from 37 patients with DS aged 21 to 68 years at Metrowest Medical Center during a 10‐year period and compared with those of the general adult population during the same time. Co‐morbidities were also described. Results Adults with DS had a mean age at admission of 48.6 ± 8.8 years with the median length of stay of 3 days (interquartile range 4 days). Male patients were hospitalised longer than female patients (mean 5.0 vs. 2.8 days; P < 0.05), and patients who lived at home were admitted at earlier ages than those who came from residential healthcare facility (mean 41.5 vs. 52.2 years; P < 0.001). The most common cause of hospitalisation was pneumonia/aspiration syndrome (29.6%), and the most common co‐morbidity was gastroesophageal reflux disease (GERD)/dysphagia (70.3%). Presence of GERD/dysphagia or seizure disorder was significantly associated with multiple admission and readmission within 1 month (P < 0.05). The mortality rate was 4.9%, and the rate of intensive care unit admission was 8.6%. Conclusions Our cohort did not show statistically significant different hospitalisation parameters such as inpatient mortality and average length of stay when compared with general adult population hospitalised at the same years. The care of adult patients with DS presents challenges in internal medicine due to its unique co‐morbid profile and signifies the importance of multidisciplinary approach. In order to improve the care of this patient population, their co‐morbidities, particularly GERD/dysphagia and seizure disorder, should be optimally managed and comprehensively addressed when patients are hospitalised.

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Section: Discussionmentioning

confidence: 99%

Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Chenbhanich

Phupitakphol

et al. 2018

J intellect Disabil Res

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Oral management of a patient with down syndrome and agammaglobulinemia: a case report

et al. 2020

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Background: Down syndrome is characterized by a variety of dysmorphic features and congenital malformations, such as congenital heart disease, gastrointestinal disease, and other conditions like leukemia and autoimmune disorders. Patients with Down syndrome are highly prone to respiratory tract infections, which might be fatal to them. However, there are only few available data on patients diagnosed with Down syndrome and agammaglobulinemia. In this report, we describe a case of successful prevention of post-dental treatment complications (e.g., pneumonia and other bacterial infections) in a patient with Down syndrome and agammaglobulinemia. Case presentation: A 43-year-old man with Down syndrome, untreated agammaglobulinemia, and a history of recurrent pneumonia, was referred to our clinic for tooth mobility. To reduce the risk of post-operative infections, gammaglobulin treatment and prophylactic administration of antibiotics was scheduled before the dental procedure. Furthermore, the dental treatment, which included a filling and extractions, was conducted under general anesthesia and with the supervision of a hematologist. The dental procedures were successfully performed without any post-operative infection, and the patient is undergoing follow-up care. Conclusions: The purpose of this case report was to recommend a close liaison between physicians and dentists who may encounter a similar case, and to emphasize the importance of improving oral health of immunodeficient patients to prevent infections caused by oral microbial flora.

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Profil Pasien Pneumonia Komunitas di Bagian Anak RSUP DR. M. Djamil Padang Sumatera Barat

Monita¹,

Yani²,

Lestari³

2015

JKA

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AbstrakPneumonia adalah proses inflamasi pada parenkim paru dan merupakan penyebab utama morbiditas dan mortalitas anak berusia di bawah lima tahun, terutama di negara berkembang. Prevalensi kejadian pneumonia komunitas pada anak di Sumatera Barat cukup tinggi. Tujuan penelitian ini yaitu untuk mengetahui gambaran pasien pneumonia komunitas di Bagian Anak RSUP Dr. M. Djamil Padang tahun 2010-2012. Penelitian ini bersifat deskriptif dengan menggunakan data rekam medik anak yang dirawat dengan diagnosis utama pneumonia periode 1 Januari 2010 sampai 31 Desember 2012 dan diperoleh jumlah sampel sebanyak 178 orang anak. Hasil penelitian yang didapatkan yaitu pneumonia komunitas pada anak banyak terdapat pada anak laki-laki 55,6%, terutama pada kelompok usia 2-<12 bulan 60% dengan status gizi anak yang kurang 62% dan status imunisasi masih belum lengkap 34,8%. Keluhan utama anak dengan pneumonia yaitu sesak napas 97,8% dan gejala klinis yang ditemukan yaitu demam 92,7% dengan suhu rata-rata 37.6 C, batuk 92,1%, takipneu rata-rata laju napas 66 kali/menit pada kelompok usia < 2bulan, takikardi rata-rata denyut nadi 124 kali/menit pada kelompok usia >48-72 bulan, disertai nafas cuping hidung 92,7%, retraksi dinding dada 86%, ronkhi 91,6% dan wheezing 14,6%. Pada pemeriksaan penunjang didapatkan jumlah leukosit dalam batas normal 63% dan gambaran foto rontgen thoraks berupa infiltrat 96,6%.Penyakit yang sering menyertai pneumonia pada anak yaitu anemia 30,9% dan komplikasi yang terjadi berupa gangguan keseimbangan asam-basa 48,3%. Lama rawatan paling banyak 5-10 hari dengan outcome perbaikan 56,7%. Tingginya insiden pneumonia anak di RSUP DR. M. Djamil dipengaruhi oleh beberapa faktor, diantaranya yaitu status gizi kurang, status imunisasi yang belum lengkap, serta faktor lingkungan tempat tinggal anak. Kata kunci: profil, pneumonia komunitas, anak AbstractPneumonia is infection or inflammation of the lung and it is a major cause of morbidity and mortality in children aged under five years, especially in developing countries. Prevalence of CAP in children at West Sumatra is quite high. The objective of the study was to report the profile of CAP in pediatric ward of DR. M. Djamil Hospital Padang in 2010-2012This research was a descriptive study using medical records of children with primary diagnosis of CAP in the period of January 1, 2010 until December 31, 2012. During the study period, 178 patients were diagnosed as CAP, 55.6% found in boys, especially in the age group 2 -<12 months 43.8% with the poor nutritional status 62% and 34.8% have incomplete immunization status. The chief complaint of children with pneumonia are shortness of breath 97.8%, and clinical symptoms such as fever found 92.7% with an average temperature of 37.6 C, cough 92.1%, takipneu average respiratory rate 66 breaths/min in the age group <2 months, tachycardia average pulse rate 124 beats/min in the age group >48-72 months, with nasal flaring 92.7%, chest wall indrawing 86%, rhonchi 91.6% and wheezing 14.6%. The laboratory test showed leucocyte ...

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Community-acquired pneumonia in adults with Down syndrome. Three clinical cases and a review of the literature

Cited by 3 publications

References 18 publications

Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Oral management of a patient with down syndrome and agammaglobulinemia: a case report

Profil Pasien Pneumonia Komunitas di Bagian Anak RSUP DR. M. Djamil Padang Sumatera Barat

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