Complication of Community-Acquired Pneumonia (Including Cardiac Complications)

Restrepo, Marcos I.; Reyes, Luis Felipe; Anzueto, Antonio

doi:10.1055/s-0036-1593754

Cited by 28 publications

(7 citation statements)

References 64 publications

(106 reference statements)

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“…Studies have shown that underlying conditions such as renal, cardiovascular diseases and diabetes mellitus increase the risk and severity of CAP in individuals. 1,25 This may serve as a prognostic factor for the physicians to make better decisions on the diagnosis and overall patient management. 2 Although this study does not show any statistical difference between the presence of M. pneumoniae and underlying diseases (p value >0.05), the odds ratio of MPP were 1.99, 1.80 and 0.7 in kidney disease, diabetes and cardiovascular disease respectively.…”

Section: Discussionmentioning

confidence: 99%

High frequency of Mycoplasma pneumoniae among patients with atypical pneumonia in Tehran, Iran

Arfaatabar¹,

Aminharati²,

Azimi³

et al. 2018

Germs

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Introduction Mycoplasma pneumoniae is a major cause of atypical community-acquired pneumonia) CAP) with a prevalence range of 15-20% and up to 40% in adults and children, respectively. In Iran, the recorded frequency ranges between 1-6.15%. We aimed to investigate the frequency of M. pneumoniae among patients with atypical pneumonia acquired from the community. Methods Over a period of 5 months between January and June 2017, 520 patients with suspected CAP, who had been to the hospital outpatient clinics of Tehran University, were enrolled in this study. Throat swab specimens were obtained from 110 outpatients who presented with symptoms of atypical pneumonia. M. pneumoniae was identified via culture and biochemical tests, such as fermentation of glucose and arginine, hemolysis, and hemadsorption. For confirmation, PCR was performed to amplify the gene fragment coding for p1 adhesin. Results The major and minor clinical signs of the patients were dyspnea (67.3%) and nausea (15.5%), respectively. Out of 110 specimens, 25 (22.7%) and 29 (26.4%) isolates were identified to be M. pneumoniae via culture and molecular assay, respectively. Comparing the results of the two methods, the PCR showed better sensitivity and rapidity for the detection of M. pneumoniae. There was a high congruence between culture and the PCR assay; kappa level was 'almost perfect' (κ=0.90). Conclusion This is the first report of high frequency of M. pneumoniae in our region. This finding can serve as baseline information for further investigation and confirmation of the potential epidemics of M. pneumoniae pneumonia in our community.

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Section: Discussionmentioning

confidence: 99%

High frequency of Mycoplasma pneumoniae among patients with atypical pneumonia in Tehran, Iran

Arfaatabar¹,

Aminharati²,

Azimi³

et al. 2018

Germs

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“…Important systemic complications related to pneumonia include direct progression of the disease in the lungs to involve the pleural space or indirect effects on other organ systems such as the central nervous system, hematological, cardiac, renal, endocrine, and/or hepatic systems, and others ( 69 – 71 ). Workshop participants emphasized the concept that pneumonia is not a disease solely confined to the lung parenchyma but should be considered to be a systemic disease leading to organ dysfunction with impacts on short-term and long-term outcomes.…”

Section: Host Clinical Consequences Of Pneumoniamentioning

confidence: 99%

Understanding the Host in the Management of Pneumonia. An Official American Thoracic Society Workshop Report

Cruz¹,

Evans²,

Restrepo³

et al. 2021

Annals ATS

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Pneumonia causes a significant burden of disease worldwide. Although all populations are at risk of pneumonia, those at extremes of age and those with immunosuppressive disorders, underlying respiratory disease, and critical illness are particularly vulnerable. Although clinical practice guidelines addressing the management and treatment of pneumonia exist, few of the supporting studies focus on the crucial contributions of the host in pneumonia pathogenesis and recovery. Such essential considerations include the host risk factors that lead to susceptibility to lung infections; biomarkers reflecting the host response and the means to pursue host-directed pneumonia therapy; systemic effects of pneumonia on the host; and long-term health outcomes after pneumonia. To address these gaps, the Pneumonia Working Group of the Assembly on Pulmonary Infection and Tuberculosis led a workshop held at the American Thoracic Society meeting in May 2018 with overarching objectives to foster attention, stimulate research, and promote funding for short-term and long-term investigations into the host contributions to pneumonia. The workshop involved participants from various disciplines with expertise in lung infection, pneumonia, sepsis, immunocompromised patients, translational biology, data science, genomics, systems biology, and clinical trials. This workshop report summarizes the presentations and discussions and important recommendations for future clinical pneumonia studies. These recommendations include establishing consensus disease and outcome definitions, improved phenotyping, development of clinical study networks, standardized data and biospecimen collection and protocols, and development of innovative trial designs.

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“…It is now well recognized that cardiovascular events (CVEs) represent one of the most important and frequent complications of CAP, occurring in up to 30% of cases and associated with significant mortality [ 20 , 41 ]. Among the common cardiac complications are acute myocardial infarction, new or worsening arrhythmia (most commonly atrial fibrillation) and new or worsening cardiac failure.…”

Section: Cardiac Complications Of Capmentioning

confidence: 99%

Multifaceted Role of Pneumolysin in the Pathogenesis of Myocardial Injury in Community-Acquired Pneumonia

Anderson

Nel

Feldman

2018

IJMS

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Pneumolysin (PLY), a member of the family of Gram-positive bacterial, cholesterol-dependent, β-barrel pore-forming cytolysins, is the major protein virulence factor of the dangerous respiratory pathogen, Streptococcus pneumoniae (pneumococcus). PLY plays a major role in the pathogenesis of community-acquired pneumonia (CAP), promoting colonization and invasion of the upper and lower respiratory tracts respectively, as well as extra-pulmonary dissemination of the pneumococcus. Notwithstanding its role in causing acute lung injury in severe CAP, PLY has also been implicated in the development of potentially fatal acute and delayed-onset cardiovascular events, which are now recognized as being fairly common complications of this condition. This review is focused firstly on updating mechanisms involved in the immunopathogenesis of PLY-mediated myocardial damage, specifically the direct cardiotoxic and immunosuppressive activities, as well as the indirect pro-inflammatory/pro-thrombotic activities of the toxin. Secondly, on PLY-targeted therapeutic strategies including, among others, macrolide antibiotics, natural product antagonists, cholesterol-containing liposomes, and fully humanized monoclonal antibodies, as well as on vaccine-based preventive strategies. These sections are preceded by overviews of CAP in general, the role of the pneumococcus as the causative pathogen, the occurrence and types of CAP-associated cardiac complication, and the structure and biological activities of PLY.

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Complication of Community-Acquired Pneumonia (Including Cardiac Complications)

Cited by 28 publications

References 64 publications

High frequency of Mycoplasma pneumoniae among patients with atypical pneumonia in Tehran, Iran

High frequency of Mycoplasma pneumoniae among patients with atypical pneumonia in Tehran, Iran

Understanding the Host in the Management of Pneumonia. An Official American Thoracic Society Workshop Report

Multifaceted Role of Pneumolysin in the Pathogenesis of Myocardial Injury in Community-Acquired Pneumonia

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