The clinical respiratory journal
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This is a sporadic H7N9 avian influenza case that was the first severe imported case in Beijing and the first case of Hebei province in China. A 61-year-old female who had rapidly progressive pneumonia with respiratory distress and bilateral exduation and consolidation changes on chest X-ray and computerized tomography (CT) scan that did not respond to ordinary antibiotics was diagnosed with influenza A (H7N9) infection in our hospital on July 19, 2013. Intravenous peramivir, veno-venous extracorporeal membrane oxygenation (VV-ECMO) and continuous veno-venous hemofiltration were given on the same day of lab diagnosis because of severe acute respiratory distress syndrome and acute renal failure. ⋯ Twenty-three days after hospitalization, blood stream infection with multidrug-resistant Acinetobacter Baumannii occurred, which lead to septic shock and death. Whether or not the influenza season in north China, the influenza screening should be carried out as a conventional test for the patients who are suspected of viral pneumonia. For the patients who need mechanical ventilation and ECMO support, the lung protective strategy under the guidance of transpulmonary pressure may be helpful for recovering the lung.
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Mycoplasma pneumoniae (MP) is a common childhood pathogen associated with atypical pneumonia (AP). It is often a mild disease and seldom results in paediatric intensive care (PICU) admission. In 2003, World Health Organization (WHO) coined the word SARS (severe acute respiratory syndrome) in patients with severe acute respiratory symptoms (sars) for an outbreak of AP in Hong Kong due to a novel coronavirus. In 2012, another outbreak of coronavirus AP occurred in the Middle East. Confusing case definitions such as MERS (Middle East respiratory syndrome) and SARI (severe acute respiratory infections) were coined. This paper aims to present a case of MP with sars, ARDS, pneumonia and pleural effusion during the MERS epidemics, and review the incidence and mortality of severe AP with MP. ⋯ We urge health organizations to refrain from the temptation of coining unnecessary new terminology to describe essentially the same conditions each and every time when outbreaks of AP occur.
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Randomized Controlled Trial Comparative Study
Electromagnetic navigation-guided TBNA vs conventional TBNA in the diagnosis of mediastinal lymphadenopathy.
Conventional transbronchial needle aspiration (C-TBNA) is a safe method for the diagnosis of hilar and mediastinal lymphadenopathy (MLN). However, diagnostic yield of this technique varies considerably. Electromagnetic navigation bronchoscopy (ENB) is a new technology to increase the diagnostic yield of flexible bronchoscopy for the peripheral lung lesions and MLN. The aim of this prospective study was to compare the diagnostic and sampling success of ENB-guided TBNA (ENB-TBNA) in comparison with C-TBNA while dealing with MLN. ⋯ In this study comparing ENB-TBNA and C-TBNA, the sampling and diagnostic success of ENB-TBNA was found to be superior while dealing with MLN, in all categories studied.
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Comparative Study
Comparison of clinical characteristics of chronic cough due to non-acid and acid gastroesophageal reflux.
Little is known about non-acid gastroesophageal reflux-induced chronic cough (GERC). The purpose of the study is to explore the clinical characteristics of non-acid GERC. ⋯ There are some differences in the clinical manifestations between non-acid and acid GERC, but MII-pH is essential to diagnose non-acid GERC.
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We describe a case of thoracic empyema in a 76-year-old male with complication of diabetes mellitus and hypertension. His chief complaints were fever and chest pain. The patient was diagnosed as pleural infection according to the pulmonary computed tomography (CT) scan and laboratory results. ⋯ On the subsequent 2-month and 6-month follow-up visits, no recurrence has been reported for this patient. Routine microbiological methods are important in diagnosis of pleural infection, but they have limitations in some cases, especially for anaerobe. Molecular assay based on 16S rDNA is helpful in detecting causative organisms of thoracic empyema.