The CT Appearance of Lower Respiratory Infection Due to Parainfluenza Virus in Adults

Herbst, Timothy; Deerlin, Vivianna M. Van; Miller, Wallace T.

doi:10.2214/ajr.12.9613

Cited by 18 publications

(20 citation statements)

References 23 publications

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“…Bronchial wall thickening was determined to be present, in accordance with the previous studies, if the bronchus seemed more prominent than the adjacent artery in the absence of bronchiectasis. [ 24 , 32 – 34 ] Normal appearance was defined as the absence of pathologic findings except for preexisting lung parenchymal conditions such as emphysema, bronchiectasis, or interstitial lung disease (ILD). Furthermore, the anatomical distribution of changes was analyzed according to their zonal predominance (upper and mid, lower, and whole lung), localization (segmental and lobar, diffuse and random, and other), and symmetry (bilateral, unilateral).…”

Section: Methodsmentioning

confidence: 99%

CT findings in viral lower respiratory tract infections caused by parainfluenza virus, influenza virus and respiratory syncytial virus

Kim¹,

Kim

Lee

et al. 2016

Medicine

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Viral lower respiratory tract infections (LRTIs) can present with a variety of computed tomography (CT) findings. However, identifying the contribution of a particular virus to CT findings is challenging due to concomitant infections and the limited data on the CT findings in viral LRTIs. We therefore investigate the CT findings in different pure viral LRTIs.All patients who underwent bronchoalveolar lavage (BAL) and were diagnosed with LRTIs caused by parainfluenza virus (PIV), influenza virus, or respiratory syncytial virus (RSV) between 1998 and 2014 were enrolled in a tertiary hospital in Seoul, South Korea. A pure viral LRTI was defined as a positive viral culture from BAL without any positive evidence from respiratory or blood cultures, or from polymerase chain reaction (PCR), or from serologic tests for bacteria, fungi, mycobacteria, or other viruses.CT images of 40 patients with viral LRTIs were analyzed: 14 with PIV, 14 with influenza virus, and 12 with RSV. Patch consolidation (≥1 cm or more than 1 segmental level) was found only in PIV (29%) (P = 0.03), by which CT findings caused by PIV could resemble those seen in bacterial LRTIs. Ground-glass opacities were seen in all cases of influenza virus and were more frequent than in PIV (71%) and RSV (67%) (P = 0.05). Bronchial wall thickening was more common in influenza virus (71%) and RSV (67%) LRTIs than PIV LRTIs (21%) (P = 0.02). With respect to anatomical distribution, PIV infections generally affected the lower lobes (69%), while influenza virus mostly caused diffuse changes throughout the lungs (57%), and RSV frequently formed localized patterns in the upper and mid lobes (44%).The CT findings in LRTIs of PIV, influenza virus, and RSV can be distinguished by certain characteristics. These differences could be useful for early differentiation of these viral LRTIs, and empirical use of appropriate antiviral agents.

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Section: Methodsmentioning

confidence: 99%

CT findings in viral lower respiratory tract infections caused by parainfluenza virus, influenza virus and respiratory syncytial virus

Kim¹,

Kim

Lee

et al. 2016

Medicine

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“…Traditionally, only infections that have become systemic or have caused significant anatomical tissue damages 4 could be diagnosed using several inconvenient and time-consuming methods including laboratory culture tests, 5 nuclear medicine imaging, 6 and computed tomography (CT). 7,8 Hence, many researchers have switched to the direction of designing bacteria-targeting probes with tissue-selective ligands, e.g., antibodies, lectin, sugar, etc., 9,10 to improve the bacterial diagnosis. 11,12 A more effective approach to achieve broad bacteria-targeting has been utilized in nanoparticle surface modifications, ligand−acceptor interactions, and so on.…”

Section: Introductionmentioning

confidence: 99%

Bacteria-Targeting Conjugates Based on Antimicrobial Peptide for Bacteria Diagnosis and Therapy

et al. 2015

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Chloramphenicol (CAP) is one of the most effective antimicrobial agents, but its therapeutic efficacy is greatly limited by its nonspecific distribution and consequent side effects in neutrophils. Targeting to the infection sites, and thus restricting CAP nonselective delivery, provides an alternative way to overcome this limitation. The antibacterial peptide fragment UBI29-41 was identified to have a high bacterial affinity. However, no research so far has been carried out to utilize UBI29-41 as a ligand for bacteria-targeting therapies. In this Article, we first labeled a near-infrared fluorescent dye (ICG02) with UBI29-41 to investigate its targeting capability in different bacteria (S. aureus, E. coli, and P. auruginosa) and bacteria-infected mouse models. Subsequently, UBI29-41 was conjugated with the typical antibiotic (CAP) through the linker glutaric anhydride to form the conjugate CAP-UBI29-41 for the bacteria-targeting therapy. In vitro studies demonstrated the enhanced antibacterial effects of CAP-UBI29-41 on S. aureus and E.coil. Meanwhile, the toxicity of CAP-UBI29-41 on normal cells decreased distinctly in comparison with CAP. Most importantly, CAP-UBI29-41 exhibited more favorable antibacterial efficacy than CAP in bacteria-bearing mouse models. All these results demonstrated that UBI29-41 is an ideal targeting ligand to construct antibacterial agents for bacteria-targeting therapy.

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“…In their follow-up analysis of their randomized trial, Branche and colleagues found that while several factors were mentioned by providers as reasons for deviation from their PCT de-escalation protocol including illness severity, fever, abnormal complete blood count, and others, only diagnosis of pneumonia was significantly associated with nonadherence [25]. An important distinction in this case is that viruses are able to cause radiographic changes [26][27][28].…”

Section: Discussionmentioning

confidence: 95%

Use of Procalcitonin and a Respiratory Polymerase Chain Reaction Panel to Reduce Antibiotic Use via an Electronic Medical Record Alert

Moradi

Bennett

Shemanski

et al. 2019

Clinical Infectious Diseases

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Background. Respiratory tract infections are often viral and but are frequently treated with antibiotics, providing a significant opportunity for antibiotic de-escalation in patients. We sought to determine whether an automated electronic medical record best practice alert (BPA) based on procalcitonin and respiratory polymerase chain reaction (PCR) results could help reduce inappropriate antibiotic use in patients with likely viral respiratory illness.Methods. This multisite, pre-post, quasi-experimental study included patients 18 years and older with a procalcitonin level <0.25 ng/mL and a virus identified on respiratory PCR within 48 hours of each other, and 1 or more systemic antibiotics ordered. In the study group, a BPA alerted providers of the diagnostic results suggesting viral infection and prompted them to reassess the need for antibiotics. The primary outcome measured was total antibiotic-days of therapy.Results. The BPA reduced inpatient antibiotic-days of therapy by a mean of 2.2 days compared with patients who met criteria but did not have the alert fire (8.0 vs 5.8 days, respectively, P < .001). The BPA also reduced the percentage of patients prescribed antibiotics on discharge (20% vs 47.8%, P < .001), whereas there was no difference in need for antibiotic escalation after initial discontinuation (7.6% vs 4.3%, P = .198).Conclusions. The automated antimicrobial stewardship BPA effectively reduced antibiotic use and discharge prescribing rates when diagnostics suggested viral respiratory tract infection, without a higher rate for reinitiation of antibiotics after discontinuation.

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The CT Appearance of Lower Respiratory Infection Due to Parainfluenza Virus in Adults

Abstract: Despite varying CT appearances of PIV LRTI, it most often shows airway-centric disease and is similar to the appearance of RSV infection, both of which are members of the Paramyxoviridae family of viruses.

Cited by 18 publications

References 23 publications

CT findings in viral lower respiratory tract infections caused by parainfluenza virus, influenza virus and respiratory syncytial virus

CT findings in viral lower respiratory tract infections caused by parainfluenza virus, influenza virus and respiratory syncytial virus

Bacteria-Targeting Conjugates Based on Antimicrobial Peptide for Bacteria Diagnosis and Therapy

Use of Procalcitonin and a Respiratory Polymerase Chain Reaction Panel to Reduce Antibiotic Use via an Electronic Medical Record Alert

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