Lung Infection In Children Research Articles

Unusual pediatric lung infections: imaging findings

Pediatric lung infections continue to be a leading cause of pediatric morbidity and mortality. Although both pediatric and general radiologists are familiar with typical lung infections and their imaging findings in children, relatively rare lung infections continue to present a diagnostic challenge. In addition, the advances in radiological imaging and emergence of several new lung infections in recent years facilitated the need for up-to-date knowledge on this topic. In this review article, we discuss the imaging findings of pediatric lung infections caused by unusual/uncommon and new pathogens. We review the epidemiological, clinical, and radiological imaging findings of viral (coronavirus disease 2019, Middle East respiratory syndrome, bird flu), bacterial (Streptococcus anginosus, Francisella tularensis, Chlamydia psittaci), and parasitic lung infections (echinococcosis, paragonimiasis, amoebiasis). Additional disorders whose clinical course and imaging findings may mimic lung infections in children (hypersensitivity pneumonitis, pulmonary hemorrhage, eosinophilic pneumonia) are also presented, to aid in differential diagnosis. As the clinical presentation of children with new and unusual lung infections is often non-specific, imaging evaluation plays an important role in initial detection, follow-up for disease progression, and assessment of potential complications.Graphical

Viral and bacterial lung infections in children: algorithms for diagnosis and therapy. A review

Community-acquired pneumonia is among the most common lower respiratory infections. The main etiological factors of lower respiratory infections are bacteria, viruses, and combinations. Pediatricians are increasingly faced with the problem of treating patients with infections caused by multidrug-resistant bacteria and viral lung infections; therefore, differential diagnosis of viral and bacterial lung infections in children is relevant. Significant progress has been made in diagnosing, treating, and preventing pneumonia in children; however, some issues require improvement in approaches to the differential diagnosis of lung infections in children. The paper aims to familiarize healthcare providers with modern principles of differential diagnosis and treatment of lung infections in children.

The Potential Impact of Ayurvedic Traditional Bhasma on SARS-CoV- 2- Induced Pathogenesis

Abstract: In India, the presently ongoing infectious COVID-19 wave is caused by the delta variant of SARS-CoV-2 which has also led thousands of causalities across the globe. The government and healthcare agencies are hovering for effective strategies to counter the pandemic. The application of nanotechnology and repurposing of drugs are found an effective approach, not obsolete but partly in managing the COVID-19 disease. It has also immensely boomed the search of productive, reliable, cost-effective, and bio-assimilable alternative solutions. Since ancient times, the traditionally employed Ayurvedic bhasmas opted for diverse infectious diseases, which are now justified as a nanomedicine that could be applied for managing COVID-19 related health anomalies. Like currently existing engineered metal nanoparticles (NPs), the bhasma nanoparticles (BNPs) are also packed with unique physicochemical properties including multi-elemental nanocrystalline composition, size, shape, dissolution, surface charge, hydrophobicity, multi-pathway regulatory, and modulatory effects. Here, it is hypothesized that due to these conformational- and configurational- based physicochemical advantages, bhasma NPs might have promising potential to manage the COVID-19 pandemic and can reduce the incidence of pneumonia-like common lung infections in children as well as old-age-related inflammatory diseases by immunomodulatory, anti-inflammatory, antiviral, and adjuvant-related characteristics.

Pleuro-pulmonary ultrasound in the diagnosis and follow-up of lung infections in children with cancer: a pilot study

PurposeFebrile neutropenia and lung infections are common and potential fatal complications of pediatric cancer patients during chemotherapy. Lung ultrasound (LUS) has a good accuracy in the diagnosis of pneumonia in childhood, but there is no data concerning its use in the diagnosis and follow-up of pulmonary infection in children with cancer. The goal of this pilot study is to verify the feasibility of lung ultrasonography for the diagnosis and follow up of pneumonia in children and adolescents with cancer.Material and methodsThis is a prospective observational case–control monocentric study conducted in the Pediatric Hematology and Oncology Department of University Hospital of Catania in patients aged < 18 years with cancer. Attending Physician used ultrasonography to detect pneumonia in cancer children with fever. As control group, cancer patients with no infection suspicion were also tested. LUS results were compared to chest X-ray (CXR) and/or chest CT scan, when these imaging techniques were performed, according to clinical indication.ResultsThirty-eight patients were studied. All underwent LUS, 16 underwent CXR, 3 chest CT. Statistical analysis showed LUS specificity of 93% (95% CI 84–100%), and sensitivity of 100%; CXR, instead, showed a specificity of 83% (95% CI 62–100%) and a sensitivity of 50% (95% CI 1–99%).ConclusionThis study shows for the first time that LUS allows physicians to diagnose pneumonia in children and young adults with cancer, with high specificity and sensitivity.

Challenges and Clinical Implications of the Diagnosis of Cytomegalovirus Lung Infection in Children.

Pulmonary cytomegalovirus (CMV) infection is a potential lethal disease in children, but it remains a diagnostic challenge. The differentiation between latent CMV infections with viral shedding and active infections is difficult and may lead to false positives in bronchoalvolar lavage (BAL) PCR detection. This review summarizes current diagnostic approaches for CMV lung infection in children including progress in the identification of underlying immune defects linked to this condition. There is increasing literature supporting that the combined assessment of host risk factors and lung disease pattern is essential for the diagnosis of pulmonary CMV infection in children. The most important host risk factor is an immunecompromised state that has expanded from primary or acquired immunodeficiency (e.g., HIV) to include a myriad of immune-dysregulation syndromes (e.g., CTLA4, PIK3 defects). Newborns, paricularly those born premature, are also a high-risk group. At the pulmonary level, active CMV infection is typically characterized by alveolar compromise leading to hypoxemia, ground-glass opacities, and intra-alveolar infiltrates with CMV inclusions in lung biopsy. The identification of active CMV lung infection should trigger additional evaluation of immune defects (primary or secondary) impairing T and NK cell function or innate antiviral responses as well as other immune dysregulation disorders. Lung CMV infections in children are more prevalent in immunocompromised hosts and premature newborns. Lung CMV infections should prompt further investigation into conditions altering immune mechanisms usually in place to contain CMV infections. Common clinical and radiological patterns such as hypoxemia and ground-glass pulmonary opacities may allow early identification and treatment of CMV lung infection and underlying causes in the pediatric population.

P081 Effect of inhaled ceftazidime on early Burkholderia contaminans lung infection in children with cystic fibrosis

P081 Effect of inhaled ceftazidime on early Burkholderia contaminans lung infection in children with cystic fibrosis

Radiographic Aspects Of Lung Disease During Hiv Infection, Pediatrics At Cnhu / Hkm Cotonou

Objective: To study the radiographic aspects of lung infections in children with HIV in pediatrics at CNHU Cotonou. Patients and methods: The study took place in the medical imaging department and the pediatric ward of CNHU / HKM Cotonou. He acted in a cross-sectional descriptive study retrospective collection which ran from 1 January 2003 to 31 December 2012. The data collection was to take the information from patient records; and proofreading radiographs by two radiologists. Results: The study population consists of 56 children, of which 55.4% boys and 44.6% girls. Children age between 1 year and 6 years old accounted for 46.4%. Only 26.8% of children showed no immune deficiency. Radiographically, the lesions were bilateral in 57.2% of cases. Bronchial syndrome accounted for 42.7% of cases followed by alveolar syndrome with 31.7% of cases. The lesions were scattered in subjects with moderate and severe immune deficiency. It was the same in cases of pneumocystis pneumonia and tuberculosis. We observed a discrepancy between the diagnostic hypotheses and diagnostics retained after completion of the chest radiograph (P = 0.000). Bronchitis and pneumonia were the most common radiographic diagnostic hypotheses with 45% and 33% respectively .The banal germs pneumonia (37.5%), bronchitis (30.3%), Pneumocystis carinii pneumonia (16.1%) and tuberculosis (14.3%). Conclusion: In the majority of cases, chest X-ray to reframe the final diagnosis. In front of pneumonia in children infected with HIV, we should strive to eliminate in the first place, diagnostics such as bacterial pneumonia, Pneumocystis carinii

Can mucoid Pseudomonas aeruginosa be eradicated in children with cystic fibrosis?

Pseudomonas aeruginosa (PsA) is the most common pathogen to cause chronic lung infection in children with cystic fibrosis (CF), and is associated with an increase in both morbidity and mortality. Whilst the non-mucoid strain can be eradicated, it is believed that mucoid PsA is difficult, if not impossible, to eradicate. We hypothesized that with modern and aggressive antibiotic regimes, mucoid PsA can be eradicated in children with CF. We investigated this hypothesis through a retrospective review of respiratory tract cultures of children with CF at The Royal Brompton Hospital, London. Children aged under 16 with a confirmed diagnosis of CF and mucoid PsA on respiratory tract culture during a defined 9-year period were eligible for inclusion. Respiratory tract culture results were followed up for each patient to establish whether children remained infected with mucoid PsA and specifically to identify clearance of infection. Factors which may have been associated with persistence or clearance were also sought. One hundred sixteen children had the minimum dataset, and of these patients 67 (58%) cleared mucoid PsA for more than 1 year. Of the 67 patients who cleared mucoid PsA for more than 1 year, 38 (57%) patients remained clear of mucoid PsA at the last available culture (median 30, range 2-106 clear cultures, and median 55, 12-103 months clear). We conclude that isolation of mucoid PsA does not necessarily equate to lifelong infection. We suggest that trials of eradication of mucoid PsA at first isolation are required.

CFTR: Break a pump, make a channel

Rarely do the two broad motivations propelling molecular biological research—discovery of intricate molecular mechanisms and understanding the underlying causes of human disease—converge in a single system. An example of such convergence is provided by cystic fibrosis (CF), an all-too-common genetic disease characterized by devastating chronic lung infection in children and young adults (1).

Real life evaluation of intravenous antibiotic treatment in a paediatric cystic fibrosis centre: Outcome of home therapy is not inferior

Limited data exist on the efficacy and safety of home intravenous antibiotic (IV-AB) therapy for pulmonary infection specifically in children with cystic fibrosis (CF). We report on the outcome of IV-AB in the home vs hospital setting based on retrospective single centre patient data from 1999 to 2004 (age >5 and <18 years). Treatment location was chosen based on estimation of competence, adherence, social background and patient preference. Primary outcome parameter was change in FEV(1). Secondary outcome parameters were weight and IgG as well as occurrence of complications. One hundred and thirty-one treatment observations (TOs) were analysed for 47 patients. Mean age was 13.32 (+/-2.9) years and mean FEV(1) 65 (+/-19) % predicted. Fifty-four (41%) TO's were home and 77 (59%) were hospital treatments. Percent change in FEV(1) and weight gain was comparable in the 2 settings. Complications were rare in both groups. The outcome of IV-AB therapy for lung infection in children with CF was not inferior in the home compared to the hospital setting. In our centre, home IV-AB treatment is a valuable treatment option for children with CF.

Magnetic resonance imaging of lung infections in children

The advantages and limitations of MRI in lung infections in children have not been well established. This article illustrates the MRI findings in children with pneumonia caused by Mycoplasma pneumoniae, Streptococcus pneumoniae, and other pathogens. Lung parenchymal, pleural, and lymph node abnormalities are well characterized by MRI. Loculation of pleural fluid is detected in children with empyema. Contrast enhancement may be useful in the differentiation of active inflammation from noninflammatory changes. MRI can be particularly useful in the follow-up of children with chronic pulmonary diseases.

Chronic lung infection in children

Tuberculosis and aspergillosis are two of the most common chronic lung infections that occur in children. They both present in a variety of ways, acutely or insidiously. Tuberculosis is increasing in incidence due to increased immigration and the HIV pandemic. Symptoms can range from subclinical to acute sepsis with respiratory distress requiring intensive care support. Aspergillus is an important pathogen, particularly in patients who are immunocompromised either due to organ impairment such as cystic fibrosis or due to primary or secondary suppression of the immune system. Aspergillosis can also present with mild to fulminant symptomatology. Imaging is often the cornerstone of diagnosis. This article concentrates on the wide range of radiological features that these two organisms can cause.

Lung infections in children.

Airway infections in children is a considerably broad topic. This discussion focuses on several common nonbacterial causes of lower respiratory tract infection in children, including respiratory syncytial virus, Mycoplasma pneumoniae, and Chlamydia pneumoniae. In addition, the occurrence of two important bacterial causes of lower respiratory illness (Bordetella pertussis and Mycobacterium tuberculosis) is increasing. This review focuses on current information on the prophylaxis, treatment, and diagnosis of these agents. Finally, consideration is given to infections in immunocompromised children: the effects of respiratory syncytial virus infections in immunosuppressed transplant patients, and prevention and diagnosis of opportunistic infections (including Pneumocystis carinii) in children with human immunodeficiency virus.

19 PULMONARY DEFENSES AGAINST “PSEUDOMAS AERUGINOSA” “(Ps.a.)” AS A FUNCTION OF AGE IN A POSSIBLE ANIMAL MODEL FOR CYSTIC FIBROSIS (CF)

CF is one of the most important causes of Ps.a. lung infection in children, and there is no much knowledge about the mechanisms involved in the lung clearance of this microorganism. The aim if this study was to evaluate the Ps.a. lung clearance in mice with cribriform degeneration, which have been indicated as a possible animal model for CF. Male and female 15-150 days old mice of the DBA/2J-cri inbred strain, genotypes cri/cri and +/? were submitted to an infective aerosol containing Ps.a. Half of the animals were killed immediately and the others 4 hs. after exposure, the lungs were excised, homogenized and cultured quantitatively. Correlation between Ps.a. lung clearance and age was observed as well as an overlapping of the values from both genotypes in mice of the same age. Furthermore, the young animals appear to be more susceptible to Ps.a. infection before weaning than the adult do. The results suggest the existence of a slower maturation of a mechanism involved in the lung defense against Ps.a. infection.