Current opinion in pulmonary medicine
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Ventilator-associated pneumonia (VAP) is the most serious and controversial of the infections of the critically ill patient. The accuracy of standard methods of diagnosis remains under constant scrutiny, and at the same time there is increasing debate about whether it is a preventable disease. This review focuses on the pathophysiology of respiratory tract infection in the ventilated patient, and how the latest advances have grown from our current understanding of its pathogenesis. ⋯ This review will focus on: the current understanding of the pathogenesis of VAT and VAP, modifiable risk factors and new approaches to treatment, and bacterial resistance challenges.
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Cryptococcosis is an important opportunistic fungal infection, especially in the immunocompromised patient. Meningitis is the most common manifestation of cryptococcosis; however, cryptococcal lung disease is probably underdiagnosed, and knowledge of epidemiology, diagnosis, and treatment is necessary. ⋯ Cryptococcal lung disease is an important and probably underdiagnosed infection. Knowledge of the epidemiology, diagnostic methodologies, and treatment is needed to ensure good patient outcomes.
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The review highlights the clinical findings and the management of community-acquired, health-care associated and nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). ⋯ Rapid recognition of possible staphylococcal infection in patients with severe pneumonia is essential. The treatment of MRSA pneumonia must be prompt and effective in order to allow a fast microbiological clearance and to successfully manage the infection.