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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.
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.
BackgroundViral and atypical bacterial pathogens play an important role in respiratory tract infection. Using the Pneumoslide IgM test, the presented study explored the aetiology of community-acquired pneumonia and investigated further whether there was an association between age or season and aetiological organisms.MethodsSerum samples, taken between August 2011 and August 2013, from patients with CAP were tested with the Pneumoslide IgM kit. The Pneumoslide IgM technology can simultaneously diagnose 9 viral and atypical bacterial pathogens: Legionella pneumophila serogroup 1 (LP1), Mycoplasma pneumoniae (MP), Coxiella burnetii (COX), Chlamydophila pneumonia (CP), Adenovirus (ADV), Respiratory syncytial virus (RSV), Influenza A (INFA), Influenza B (INFB), Parainfluenza 1, 2 and 3 (PIVs). The data was analyzed by using Statistical Package for the Social Sciences for Windows (SPSS, version 11.0).ResultsOf a total of 1204 serum samples tested, 624 samples were positive. M. pneumoniae was the dominant pathogen, with INFB, PIVs, and RSV ranking second to fourth, respectively. The positive percentages of MP, INFB, PIVs and RSV were found to be associated with age, especially MP, INFB and PIVs. The positive percentages of MP, PIVs and RSV were also found to be associated with season. The positive percentage of MP in autumn was the highest. The positive percentages of LP1 in August and September, ADV in June and INFB in March were relatively higher than that in other months.ConclusionsThe results show there were 4 main viral and atypical bacterial pathogens causing CAP in our study. Some pathogens were found to be associated with age and season. M. pneumoniae was the most predominant pathogen among these 9 pathogens. It is necessary to take preventative measures in order to prevent the spread of these pathogens in susceptible age groups during peak season.
Objectives: Lower respiratory infections (LRTIs) are the leading reason of death infectious diseases in the world and the fifth leading cause of death in general. The study aimed to identify the general characteristics of LRTI, the causative bacteria and the results of sensitivity to antibiotics. Subjects and methods: A multicentre prospective study was performed at 3 University hospitals. The study included 555 clinical diagnostic cases as LRTI cases, 328 male and 227 female, aged 3 to 69 years. Clinical and demographic data were collected in the standard questionnaire, and samples included sputum or bronchial lavage (BAL) staining and culture. Samples were cultured in 3 different bacterial media, blood agar and LJ slope, chocolate agar with Co2; cultures were then examined for possible bacterial pathogens of LRTI. Possible bacterial pathogens were isolated and identified by standard laboratory techniques, and microbial sensitivity testing was carried out by disc diffusion method. Results: LRTI was recorded among all age groups and with less frequency in children less than 16 years of age. A large number of LRTI (36.2%) was not diagnosed, most in CAP (52.4%), followed by HAP (33.9%) while unidentified cases were lower in AECOPD (22.8%). CAP isolates are K. pneumoniae (26.2%), S. pyogens (12.3%), and S. pneumoniae (9%); in HAP are MSSA (24%), E. Coli (12.9%), MRAS (11.1%), K. pneumoniae (10.5%) and P. aeruginosa (7%); and in AECOPD are M. catarrhalis (47.2%), K. pneumoniae (17.2%), H. influnzae (10.7%) and P. aeruginosa (2%). In Gram-positive bacteria, high resistance to ampicillin/sulbactam (100%) and amoxicillin/clavulanate (100%) was recorded, while moderate resistance to amikacin, vancomycin, cefepime and moxifloxacin was recorded. In Gram-negative bacteria, a high resistance to 3rd g Cephalosporin’s (68.5%) was recorded, while a moderate sensitivity to the other antibiotics tested was recorded. Conclusion: There is a high rate of undiagnosed LRTI in Yemen and this highlights the need for health authorities to develop strategies to diagnose most of the causes of LRTI, including Mycoplasma, Chlamydia, and viral causes. No antibiotics are completely effective in treating LRTI in our area and antibiotic sensitivity should be performed in all cases. Peer Review History: Received 22 April 2019; Revised 4 May; Accepted 9 May, Available online 15 May 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Name: Dr. Michael Otakhor Erhunmwunse Affiliation: St. Philomena Catholic Hospital, Nigeria E-mail: dedoctor4life@gmail.com Name: Dr. Amany Mohamed Alboghdadly Affiliation: Princess Nourah bint abdulrahman university, Riyadh E-mail: amalbgadley@pnu.edu.sa Comments of reviewer(s): Similar Articles: BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY PATTERN AND RISK FACTORS OF MRSA ISOLATED FROM CLINICAL SPECIMENS AMONG MILITARY PATIENTS AT 48 MEDICAL COMPOUND IN SANA'A CITY-YEMEN
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