We report a case of an infected pneumatocele in the course of anaerobic pneumonia in an adult. To the best of our knowledge, anaerobic pneumonia complicated by a pneumatocele in an adult has not previously been described. The pneumatocele occurred on the fifth day of hospitalization, and rapidly increased in size, with the development of a subsequent mixed anaerobe infection. A pig-tail catheter was inserted and the pus drained. The bacterial culture from the pus was positive for three anaerobes: Bacteroid species, Peptostreptococcus asaccharolyticus and Fusobacterium species. Intravenous antibiotics and percutaneous catheter drainage resulted in a successful treatment.
Pneumonia, Bacterial/*complications/microbiology ; Pneumocephalus/*complications/microbiology ; Middle Aged ; Male ; Humans ; Gram-Negative Anaerobic Bacteria/isolation & purification

Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.
Actinomycosis/*complications ; Aged ; Aneurysm, Infected/*etiology/*radiography/therapy ; Embolization, Therapeutic ; Human ; Male ; Pneumonia, Bacterial/*complications ; *Pulmonary Artery ; Treatment Outcome

OBJECTIVETo investigate the etiology and clinical manifestation of hemoptysis in children.

METHODA retrospective analysis was performed for 106 cases of hemoptysis who were admitted to The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from January 2005 to December 2014.The clinical information including laboratory tests and image data were collected and analyzed.

RESULTA total of 106 patients (50 males and 56 females) were identified. The median age was 9.1 years (range 2 months to 18 years). Pneumonia (35, 31.1%) was the most common etiology of hemoptysis, which included bacterial pneumonia (27 cases), mycoplasmal pneumonia(4 cases), chlamydial pneumonia (3 cases), and influenza pneumonia(1 case). Other causes included bronchitis(15, 14.2%), pulmonary tuberculosis (11, 10.4%), bronchiectasis (11, 10.4%), diffuse alveolar hemorrhage (8, 7.5%), idiopathic pulmonary hemosiderosis(6, 5.7%), cardiovascular dysplasia(6, 5.7%), pulmonary contusion (4, 3.8%), foreign body in bronchus (2, 1.9%), allergic bronchopulmonary aspergillosis (2, 1.9%). Eighty-six patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and eleven patients, respectively. Pneumonia accounted for 33.7% of mild hemoptysis and 45.5% of massive hemoptysis were due to bronchiectasis; 80.2% were treated with antibiotics and 41.5% were given hemostatic agents; 8.5% received lobectomy. Ninety-six patients (90.6%) were cured and parents gave up treatment in 4 cases (3.8%). Six patients (5.7%) suffered from recurrent hemoptysis.

CONCLUSIONHemoptysis mainly occurred in children who were older than 6 years, the most common cause of hemoptysis was respiratory tract infection. In most cases, the amount of hemoptysis was small and the overall prognosis was good.

Adolescent ; Bronchiectasis ; complications ; Bronchitis ; complications ; Child ; Child, Preschool ; Female ; Foreign Bodies ; complications ; Hemoptysis ; diagnosis ; etiology ; therapy ; Hemosiderosis ; complications ; Humans ; Infant ; Influenza, Human ; complications ; Lung Diseases ; complications ; Lung Injury ; complications ; Male ; Pneumonia, Bacterial ; complications ; Prognosis ; Retrospective Studies ; Tuberculosis, Pulmonary ; complications

PURPOSE: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. METHODS: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for χ2 test, t-test and ANCOVA. RESULTS: Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). CONCLUSION: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.
Anti-Bacterial Agents* ; Hematoma ; Hospitalization* ; Hysterectomy* ; Injections, Intravenous ; Medical Records ; Medication Errors ; Pneumonia ; Pneumoperitoneum ; Postoperative Complications* ; Retrospective Studies ; Wound Infection

OBJECTIVETo study the effect of β-lactamase (BLs) detection and β-lactam/β-lactamase inhibitor (BL/BLI) on the incidence of antibiotic-associated diarrhea (AAD) in children with severe bacterial pneumonia.

METHODSThe clinical data of the children with bacterial severe pneumonia were retrospectively studied. Of all the patients, 248 using amoxicillin/clavulanate but without BLs detection and 323 using amoxicillin (BLs negative) or amoxicillin/clavulanate (BLs positive) were used as the amoxicillin group; 208 patients using piperacillin/tazobactam but without BLs detection and 291 patients using piperacillin (BLs negative) or piperacillin/tazobactam (BLs positive) were used as the piperacillin group; and 191 patients using cefoperazone/sulbactam but without BLs detection and 341 patients using cefoperazone (BLs negative) or cefoperazone/sulbactam (BLs positive) were used as the cefoperazone group. The incidence and clinical symptoms of AAD between the undetected and detected BLs patients were compared.

RESULTSThe incidences of AAD in the amoxicillin, piperacillin and cefoperazone groups without BLs detection groups were significantly higher than those in the corresponding groups with negative or positive results of BLs detection (P<0.01). The durations of diarrhea, antibiotic use and hospitalization stay in AAD patients receiving BLs detection were shorter than in those without receiving BLs detection (P<0.01).

CONCLUSIONSIt is very important to detect BLs for reducing the incidence and relieving symptoms of AAD in children with severe bacterial pneumonia.

Adolescent ; Anti-Bacterial Agents ; adverse effects ; Child ; Child, Preschool ; Diarrhea ; chemically induced ; epidemiology ; prevention & control ; Humans ; Incidence ; Infant ; Pneumonia, Bacterial ; complications ; beta-Lactamases ; analysis

The study was purposed to evaluate synergistic effect of beta-lactam antibiotics in drug-induced hemolysis. The general information, including primary diseases, therapeutic drugs, infection pathogens in 6 patients with pulmonary infection and unknown reason anemia were integrated and analyzed. The leukocyte and reticulocyte counts, total bilirubin (TB), direct bilirubin (DB), fasting blood glucose (Glu in peripheral blood) were all determined by conventional method. At the same time, the erythrocyte direct antiglobulin test (DAT), complement fixation test (CFT), cell culture and smear examination were carried out. The antibodies in plasma were also detected by indirect antiglobulin test (IAT). The result showed that levels of WBC, TB, DB, Glu and reticulocyte in six patients treated with beta-lactam antibiotics were raised remarkably. DAT was strongly positive, but no RBC antibodies were detected in the plasma by IAT. The binding of red cells by monocytes or lymphocytes was great, and the hemolysis of red cells by alexin not appeared. After stopping above-mentioned beta-lactam antibiotic administration, patient's WBC, TB, DB, and Glu levels returned to normal values. Furthermore, DAT test result turned to negative. It is concluded that beta-lactam antibiotics lead to drug-induced hemolysis by non-specific adsorption of some proteins onto RBC surface, and their proteins may be considered as direct cause for this hemolysis.
Aged ; Anemia, Hemolytic ; chemically induced ; etiology ; Anti-Bacterial Agents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Bacterial ; complications ; drug therapy ; beta-Lactams ; adverse effects

Although gemifloxacin has low in vitro activity against Mycobacterium tuberculosis, the effect of gemifloxacin on the delay of tuberculosis (TB) treatment has not been validated in a clinical setting. The study group included patients with culture-confirmed pulmonary TB who initially received gemifloxacin for suspected community-acquired pneumonia (CAP). Two control groups contained patients treated with other fluoroquinolones or nonfluoroquinolone antibiotics. Sixteen cases were treated with gemifloxacin for suspected CAP before TB diagnosis. Sixteen and 32 patients were treated with other fluoroquinolones and nonfluoroquinolones, respectively. The median period from the initiation of antibiotics to the administration of anti-TB medication was nine days in the gemifloxacin group, which was significantly different from the other fluoroquinolones group (35 days). The median times for the nonfluoroquinolone group and the gemifloxacin group were not significantly different. There were no significant differences between the gemifloxacin and other fluoroquinolone group in terms of symptomatic and radiographic improvements. However, the frequency of radiographic improvement in the other fluoroquinolones group tended to be higher than in the gemifloxacin group. Gemifloxacin might be the preferred fluoroquinolone for treating CAP, to alleviate any concerns about delaying TB treatment.
Adult ; Aged ; Anti-Bacterial Agents/*therapeutic use ; Case-Control Studies ; Fluoroquinolones/*therapeutic use ; Humans ; Middle Aged ; Naphthyridines/*therapeutic use ; Pneumonia/complications/diagnosis ; Tuberculosis/complications/*drug therapy/radiography

OBJECTIVETo explore the risk factors of ventilator-associated pneumonia (VAP) in patients admitted in an intensive care unit (ICU) for pulmonary tuberculosis (TB).

METHODSThe clinical data of 143 patients admitted in the ICU at our center between January, 2014 and June, 2015 were reviewed. The patients with VAP and those without VAP were analyzed for risk factors of VAP in the setting of an ICU for pulmonary TB and compared for the duration of ventilation and hospital stay.

RESULTSThe patients with pulmonary TB showed a significantly higher incidence of VAP in the ICU than those without TB. Univariate analysis suggested that the occurrence of VAP was significantly correlated with the duration of mechanical ventilation, invasive examination, pulmonary tuberculosis, lung structure changes, use of multiple antibiotics, diabetes, tracheal incision, indwelling gastric tube, APACHE II score, and coma (P<0.05). Multivariate logistic regression analysis showed that pulmonary TB, duration of mechanical ventilation, APACHE II score, invasive operation, and use of multiple antibiotics were independent risk factors for VAP (P<0.05). The patients who developed VAP had a prolonged duration of mechanical ventilation and ICU stay (P<0.05).

CONCLUSIONPatients admitted in tuberculosis ICU are exposed to a high risk of VAP with a high mortality rate as the result of multiple interacting risk factors. Pulmonary TB, prolonged mechanical ventilation, an APACHE II score >15, invasive operation, and use of multiple antibiotics are all independent risk factors for VAP in tuberculosis ICU.

APACHE ; Anti-Bacterial Agents ; adverse effects ; Humans ; Incidence ; Intensive Care Units ; Length of Stay ; Pneumonia, Ventilator-Associated ; complications ; Respiration, Artificial ; adverse effects ; Risk Factors ; Time Factors ; Tuberculosis, Pulmonary ; complications

OBJECTIVETo explore etiology, clinical manifestation and immunological changes of infectious pneumonia of neonates in Chengdu area.

METHODSSerum specimens were collected from 111 infants with infectious pneumonia. Eight viral and mycoplasmal specific serum IgM antibodies were detected by enzyme linked immunosorbent assay (ELISA); C reactive protein (CRP), total IgG and its subclasses, IgA and IgM were determined by rate scattered nephelometry; T lymphocyte subpopulations were detected by biotin-streptavidin-peroxidase method, and clinical and other laboratory data were analyzed.

RESULTS(1) Etiological agents: specific serum IgM antibodies were positive in 40 of 111 cases (36.0%) with pneumonias. All the 30 control infants were negative for the specific serum IgM antibodies. Among 111 infants with infectious pneumonia, 20.7% had single viral or mycoplasmal infection, 40.5% had bacterial infection, 15.3% had viral and mycoplasmal infection with bacterial infection; 23.4% had infection with unknown agents. (2) The most common clinical manifestations were tachypnea and cyanosis. The next were cough, milk choking, rales, retractions of the supraclavicular, intercostal and subcostal areas. Roentgenographic examination commonly revealed vague opacities, increased density and patchy infiltration. (3) Immune status: (1) CD(3), CD(4) cell counts of infants with pneumonias were lower than those of the controls while their serum IgA, IgM concentrations were higher than those of the control. (2) The CD(3) and CD(4) cell counts of the group with bacterial infection were lower than those of the control group. (3) The serum IgA concentration of the group with viral and mycoplasmal infection was higher than those of the control group and the group with unknown infection. (4) The serum IgM concentration of the group with bacterial infection was higher than those of the control group. (5) There were no significant differences in CD(8) cell counts, CD(4)/CD(8), concentration of serum IgG and IgG(1 - 4) between pneumonia group and the control group, and among various infectious groups and the control.

CONCLUSIONPathogens of neonatal infectious pneumonia in Chengdu area included single viral or mycoplasmic infection or bacterial infection, viral and mycoplasmal infection with bacterial infection, and unknown infection. Immunological changes of newborn infants suffered from infectious pneumonia included declined CD(3) and CD(4) cell counts, particularly in bacterial infection.

Antibodies, Bacterial ; blood ; Antibodies, Viral ; blood ; Bacterial Infections ; complications ; C-Reactive Protein ; analysis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin M ; blood ; Infant, Newborn ; Male ; Pneumonia ; diagnosis ; etiology ; immunology ; T-Lymphocyte Subsets ; immunology ; metabolism ; Virus Diseases ; complications

OBJECTIVE: To compare single-dose prophylactic antibiotics after cord clamping with multi-dose postoperative antibiotics in operative complications after elective cesarean section. METHODS: Forty-five women undergoing elective cesarean section had 1g cefazolin administration after umbilical cord clamping. Forty-five women was control group who had antibiotics administration postoperatively 4 times 1 g cefazolin and 5 days more per oral. Postoperative complication including febrile morbidity, wound infection, endometritis, urinary tract infection, pneumonia were recorded, as were the duration of hospital stay and the need for therapeutic antibiotics. RESULTS: Postoperative complication incuding febrile morbidity, wound infection, endometritis, urinary tract infection, pneumonia had no difference between two groups significantly. Also, their hospital stay had no difference significantly. CONCLUSION: Single-dose prophylactic antibiotics administration after cord clamping in elective cesarean section is considered to have no difference in comparison with multi-dose post-operative administration. Single-dose prophylactic antibiotics administration after cord clamping will reduce side effect of drugs and resistance. Also it will provide better cost effectiveness.
Anti-Bacterial Agents* ; Cefazolin ; Cesarean Section* ; Constriction* ; Cost-Benefit Analysis ; Endometritis ; Female ; Humans ; Length of Stay ; Pneumonia ; Postoperative Complications ; Pregnancy ; Umbilical Cord ; Urinary Tract Infections ; Wound Infection