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Atypical pneumonia (Review).

Atypical pneumonia encompasses diverse pathogens, such as Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella species, which differ from typical bacterial pneumonia in their extrapulmonary manifestations. Clinical differentiation relies on systemic involvement rather than on standalone symptoms. Despite challenges in distinct diagnosis, syndromic approaches and weighted point systems aid in accurate presumptive diagnoses. Antibiotic treatment, often non-β-lactams due to the unique cell structures of atypical pathogens, targets intracellular processes. Macrolides, tetracyclines, quinolon…

Unusual Pneumonia Mimic.

UNLABELLED: Disease in atypical organ locations can mimic other pathologies, hampering the right diagnosis. Such conditions may even be emergencies, like appendicitis. Subhepatic appendix is a very rare entity which may be caused by caecum dehiscence failure. The authors present the case of a 55-year-old immunocompetent man admitted to the Emergency Department with sepsis and severe hypoxaemia. Chest x-ray showed right lower lobe infiltrate, and community-acquired pneumonia was diagnosed. The patient was started on broad-spectrum antibiotics, but he continued to deteriorate and after 3 days de…

Community-Acquired Pneumonia.

Community-acquired pneumonia is one of the most common infections seen in emergency department patients. There is a wide spectrum of disease severity and viral pathogens are common. After a careful history and physical examination, chest radiographs may be the only diagnostic test required. The first step in management is risk stratification, using a validated clinical decision rule and serum lactate, followed by early antibiotics and fluid resuscitation when indicated. Antibiotics should be selected with attention to risk factors for multidrug-resistant respiratory pathogens. Broad use of pne…

Lymphocytic Interstitial Pneumonia.

Lymphocytic interstitial pneumonia (LIP) is a rare lung disease on the spectrum of benign pulmonary lymphoproliferative disorders. LIP is frequently associated with connective tissue diseases or infections. Idiopathic LIP is rare; every attempt must be made to diagnose underlying conditions when LIP is diagnosed. Computed tomography of the chest in patients with LIP may reveal ground-glass opacities, centrilobular and subpleural nodules, and randomly distributed thin-walled cysts. Demonstrating polyclonality with immunohistochemistry is the key to differentiating LIP from lymphoma. The 5-year …

Acute eosinophilic pneumonia.

We report the case of an 18-year-old woman who presented to an outside hospital in respiratory distress and was found to have pulmonary eosinophilia. She remained profoundly hypoxaemic despite maximal ventilatory strategies and underwent cannulation for veno-venous extra corporeal membrane oxygenation (ECMO). The respiratory failure improved with time, using corticosteroids, and the veno-venous ECMO helped in stabilisation of the patient in the setting of profound hypoxaemia.

Acute eosinophilic pneumonia.

Acute eosinophilic pneumonia is a severe and rapidly progressive lung disease that can cause fatal respiratory failure. Since this disease exhibits totally different clinical features to other eosinophilic lung diseases (ELD), it is not difficult to distinguish it among other ELDs. However, this can be similar to other diseases causing acute respiratory distress syndrome or severe community-acquired pneumonia, so the diagnosis can be delayed. The cause of this disease in the majority of patients is unknown, even though some cases may be caused by smoke, other patients inhaled dust or drugs. Th…

[Hydroxyurea-induced pneumonia].

INTRODUCTION: Hydroxyurea is an antimetabolite drug used in the treatment of myeloproliferative disorders. Common adverse effects include haematological, gastrointestinal cutaneous manifestations, and fever. Hydroxyurea-induced pneumonitis is unusual. CASE REPORT: A female patient was treated with hydroxyurea for polycythemia vera. She was admitted 20 days after commencing treatment with a high fever, productive cough, clear sputum and nausea. A chest CT-scan showed diffuse ground-glass opacities. Microbiological investigations were negative. The symptoms disappeared a few days after disconti

Cryptogenic organizing pneumonia.

Organizing pneumonia (OP) is a pathological pattern defined by the characteristic presence of buds of granulation tissue within the lumen of distal pulmonary airspaces consisting of fibroblasts and myofibroblasts intermixed with loose connective matrix. This pattern is the hallmark of a clinical pathological entity, namely cryptogenic organizing pneumonia (COP) when no cause or etiologic context is found. The process of intraalveolar organization results from a sequence of alveolar injury, alveolar deposition of fibrin, and colonization of fibrin with proliferating fibroblasts. A tremendous ch…

[Chronic eosinophilic pneumonia].

Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare disorder of unknown cause, associated with intense and abnormal eosinophilic lung infiltration. Most cases occur in patients with prior history of atopy and asthma. It is characterized by subacute or chronic presentation, alveolar and blood eosinophilia and peripheral pulmonary infiltrates on chest imaging, which are sometimes migratory. All treated patients show good and rapid response to systemic corticosteroid therapy and favourable prognosis, however relapses are frequent after weaning or stopping treatment. By this reason, in abou…

Community-acquired pneumonia

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… pneumonia. … should be considered as it can lead to primary viral pneumonia or to secondary bacterial pneumonia. …

Asthma and pneumonia.

Chest pain remains a common complaint among children seeking care in the United States. Asthma and lower respiratory tract infections such as pneumonia can be significant causes of chest pain. Children with chest pain caused by either of these pulmonary etiologies generally present with associated respiratory symptoms, including cough, wheezing, tachypnea, respiratory distress, and/or fever. Although analgesic medications can improve chest pain associated with pulmonary pathologies, the mainstay of therapy is to treat the underlying etiology; this includes bronchodilator and/or steroid medicat…

Pneumonia complicating pregnancy.

Community-acquired pneumonia (CAP) can affect pregnancy, posing risks to mother and fetus. CAP is the most common fatal nonobstetric infectious complication and a common cause of hospital readmission. Risk factors of pneumonia in pregnancy relate to anatomic and physiologic respiratory changes and immune changes. Aspiration can occur during labor, can cause life-threatening disease, and is more common in cesarean deliveries. Influenza pneumonia can cause severe disease, increasing the risk of preterm delivery, abortion, cesarean section, maternal respiratory failure, and death. CAP treatment r…

Q fever pneumonia.

Q fever is a disease found in both humans and animals, caused by the bacterium Coxiella burnetii. The epidemiology of Q fever is that of the animal reservoirs of the infection including both direct and indirect contact and use of a variety of products from such animals as cattle, sheep, and goats. Pneumonia is the major manifestation of Q fever in some countries. It is mild to moderate in severity, and mortality is unusual. It can occur as sporadic or outbreak cases.

[Exogenous lipoid pneumonia].

The aspiration of lipoid material following the accidental ingestion of lipid formulations is the most frequent cause of exogenous lipoid pneumonia in paediatrics. The presence of cough, increasing dyspnea and chest pain, together with alveolar infiltrates in the chest radiography and the previous accidental intake of a lipid substance and vomiting should make us suspect this diagnosis. We present two cases of aspiration lipoid pneumonia in paediatric patients, with a different clinical presentation and radiological outcome, pointing out in one of them the appearance of pneumatoceles as a cons…