Bronchopneumonia

Bordetella bronchiseptica was isolated in pure culture from the lung, abdomen, and intestine of a wild free-ranging southern sea otter ( Enhydra lutris nereis) with severe, suppurative bronchopneumonia. Immunohistochemistry, using antiserum raised to B. bronchiseptica, revealed strong positive staining of bacteria attached to bronchial ciliated epithelia as well as scattered positive staining in affected alveoli. Western blot analysis demonstrated that virulence factors, filamentous hemagglutinin, pertactin, and adenylate cyclase toxin are produced by the sea otter B. bronchiseptica isolate. Ribotype analysis using Pvu II restriction digests indicated that this isolate is most similar to strains commonly obtained in domestic dogs and cats.

BACKGROUND Overuse of antibiotics for children is widespread and contributes to the emergence of antibiotic-resistant bacteria. Moreover, non steroidal antiinflammatory drugs (NSAIDs) are often overprescribed despite of their renal and gastrointestinal side-effects. OBJECTIVES To assess the behaviour and the factors influencing the prescribing practice of family pediatricians for the common upper respiratory diseases of pre-school children in an outpatient setting. METHODS 125 family pediatricians, who provide primary care in an outpatient setting to young children in North-East of Italy (Veneto region), adhered to a survey consisting in a 40-item questionnaire about the factors that could influence their prescribing practice as regards otitis media (OM), pharyngitis (FGT) and broncopneumoniae (BPN) treatment of patients aged 0 to 5 years. Data were collected in November 2002. Descriptive analysis of data was performed using DELPHI TM7 professional Study Program. RESULTS The child&#...

Tobramycin is frequently used for treatment of bronchopneumonia in patients with cystic fibrosis (CF). Variability in tobramycin clearance (CL) is high in this population with few reliable approaches to guide dosing. We sought to evaluate the pharmacokinetics of once-daily intravenous tobramycin in patients with CF and test the influence of covariates on tobramycin CL, including serum creatinine (SCr) and urinary biomarkers: neutrophil gelatinase-associated lipocalin (NGAL), retinol-binding protein (RBP) and kidney injury molecule-1 (KIM-1). This was a prospective, observational cohort study of children/young adults with CF receiving once-daily intravenous tobramycin from October 2012 to May 2014 at Cincinnati Children's Hospital Medical Center. Therapeutic drug monitoring data were prospectively obtained. Population pharmacokinetic analyses were performed using non-linear mixed-effects modelling. Thirty-seven patients (median age 15.3 years, IQR 12.7-19.5) received 62 tobramyci...

Sepsis is a complex immune disorder that is characterized by systemic hyperinflammation. Alarmins, which are multifunctional endogenous factors, have been implicated in exacerbation of inflammation in many immune disorders including sepsis. Here we show that Galectin-9, a host endogenous β-galactoside binding lectin, functions as an alarmin capable of mediating inflammatory response during sepsis resulting from pulmonary infection with Francisella novicida, a Gram negative bacterial pathogen. Our results show that this galectin is upregulated and is likely released during tissue damage in the lungs of F. novicida infected septic mice. In vitro, purified recombinant galectin-9 exacerbated F. novicida-induced production of the inflammatory mediators by macrophages and neutrophils. Concomitantly, Galectin-9 deficient (Gal-9-/-) mice exhibited improved lung pathology, reduced cell death and reduced leukocyte infiltration, particularly neutrophils, in their lungs. This positively correla...

Chronic granulomatous disease (CGD) is a primary phagocyte immunodeficiency. It is often accompanied by an exuberant and aberrant inflammatory response, with granulomata and obstruction of the gastrointestinal and genitourinary tracts and inflammatory bowel disease. Although ...

ABSTRACTBurkholderia pseudomallei, the causative agent of melioidosis, is recognized as a serious health threat due to its involvement in septic and pulmonary infections in areas of endemicity and is recognized by the Centers for Disease Control and Prevention as a category B biothreat agent. An animal model is desirable to evaluate the pathogenesis of melioidosis and medical countermeasures. A model system that represents human melioidosis infections is essential in this process. A group of 10 rhesus macaques (RMs) and 10 African green monkeys (AGMs) was exposed to aerosolizedB. pseudomallei1026b. The first clinical signs were fever developing 24 to 40 h postexposure followed by leukocytosis resulting from a high percentage of neutrophils. Dyspnea manifested 2 to 4 days postexposure. In the AGMs, an increase in interleukin 1β (IL-1β), IL-6, IL-8, gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α) was observed. In the RMs, IL-1β, IL-6, and TNF-α increased. All the RMs...

One hundred eighty children hospitalized for acute respiratory disease were studied in Cali, Colombia. In the majority of patients, pneumonia was the reason for hospitalization and remained the final diagnosis. Fifty-one cases of pneumonia of indeterminate etiology comprised the largest single diagnostic category, followed by 38 cases of pneumonia associated with measles, and 22 cases assocaited with serologic evidence of infection with other viral agents or Mycoplasma pneumoniae. Etiologic diagnosis could be assigned with a reasonable degree of confidence in 116 of the 180 patients (64%). The laboratory procedure found most likely to provide the etiologic diagnosis in this series was paired sera specimens for demonstration of rise in antibody titer against the common viral respiratory pathogens. Those most frequently implicated serologically as etiologic agents in the cases studied were, in order of decreasing frequency, measles, influenza, parainfluenza, and adenoviruses.

Our objective was to construct a population pharmacokinetic model for moxifloxacin disposition in plasma and bronchial secretions in patients with severe bronchopneumonia who were mechanically ventilated. Seventeen patients receiving 400 mg moxifloxacin intravenously daily were enrolled in this multicenter, prospective, open-label study. Blood and bronchial samples were collected on days 1 and 4. The population pharmacokinetic modeling was performed with NONMEM. Moxifloxacin rapidly appeared in bronchial secretions and reached maximum concentrations within 1 to 2 hours. The concentrations achieved in plasma and bronchial secretions showed parallel profiles versus time on days 1 and 4. The pharmacokinetics was best described by a 2-compartment model with a link to bronchial secretions. The population pharmacokinetic parameters were as follows (given as estimate with percent interindividual variability in parentheses except where otherwise indicated): clearance, 14.3 L/h (25%); centra...

Respiratory diseases have a major impact on racehorses in training and are often cited as the second most common reason of horses failing to perform. Cases were submitted by the California Horse Racing Board to the California Animal Health and Food Safety laboratory for postmortem examination between January 1, 2005 and December 31, 2014. We determined the demographics of racehorses with fatal pneumonia, characterized the pathologic findings in animals with a postmortem diagnosis of respiratory infection, and determined the most significant pathogens associated with lower respiratory tract disease. We analyzed autopsy reports from 83 horses with a diagnosis of pneumonia, bronchopneumonia, and/or pleuropneumonia. The most common presentation was pleuropneumonia (71% of cases), with extensive areas of lytic necrosis and abscesses of the pulmonary parenchyma. Streptococcus equi ssp. zooepidemicus, a normal mucosal commensal of the upper respiratory tract of healthy horses, was the most...

The mortality rate in critically ill patients with pneumonia who require invasive vital organ support, including mechanical ventilation, in an intensive care unit (ICU) remains above 50%. The contribution of these costly life support systems to the survival of patients with extensive pneumonia is a matter for debate. The high mortality rate in this group of patients can be attributed in part to the fact that they are frequently referred for ICU care when their condition has already deteriorated to the point of no return. A retrospective study over 18 months of 34 cases of community-acquired pneumonia (17 patients required ventilatory support in the respiratory ICU) was undertaken to identify criteria which would justify early admission to an ICU. These were first-line clinical and biochemical factors, three of which were present in all patients on admission to hospital: (i) bronchopneumonia or lobar pneumonia involving more than two lobes (P less than 0.001); (ii) respiratory rate g...

Title of the paper: Analysis of health traits in different lifetime classes in stationary progeny tested German Fleckvieh bulls The objective of this study was to analyse systematic environmental and genetic effects on the incidence and number of treatments due to bronchopneumonia and other diseases for five different age groups in German Fleckvieh bulls. The data set contained 1775 male calves kept under identical housing and management conditions from the age of about 25 – 50 days to 450 days for a stationary progeny test in growth and carcass traits. The age groups distinguished were from day 10 – 75 (1), 76 – 100 (2), 101 – 150 (3), 151 – 200 (4) and > 200 (5) of age. Fixed environmental effects tested for significance in generalized or general linear models were barn at entry, age at entry, region of origin, season of entry, diagnosis of bronchopneumonia at entry, test group within year of entry and weight at entry. Heritabilities were estimated in linear multivariate animal models using Residual Maximum Likelihood (REML). The multivariately estimated heritabilities for the incidence of bronchopneumonia were between h 2 = 0.22 (first age group) and h 2 = 0.07 (fourth age group). The DEMPSTER and LERNER (1950) transformation resulted in estimates of h 2 = 0.34 for the first and h 2 = 0.13 for the fourth age group. The additive genetic correlations varied from r g =-0.76 (2nd – 5th age group) to r g = 0.78 (1st – 3rd age group). The lowest value of the residual correlation was r e =-0.05 (1st – 4th age group) and the highest value was r e = 0.16 (4th – 5th age group). The multivariately estimated heritabilities for the number of treatments due to bronchopneumonia were highest in the first age group with h 2 = 0.29 and lowest in the fourth age group with h 2 = 0.08. The additive genetic correlations ranged between r g = 0.64 (1st –3rd age group) and r g =-0.33 (2nd – 5th age group). The residual correlations were between r e =-0.11 (1st – 3rd age group) and r e = 0.33 (4th – 5th age group). Genetic differences among animals in resistance to bronchopneumonia are expressed most clearly in the lifetime period between day 40 and 150. Zusammenfassung Ziel der vorliegenden Studie war es, die systematischen und genetischen Einflussfaktoren auf die Inzidenz und Anzahl Behandlungen wegen Bronchopneumonie und anderen Erkrankungen innerhalb von fünf Altersklassen bei Deutschen Fleckviehbullen zu analysieren. Der Datensatz enthielt 1775 männliche Kälber, die im Rahmen der Nachkommenprüfung auf Mast-und Schlachtleistung auf Station mit einem Alter von ca. 25-50 Tagen ein-gestallt und mit 450 Tagen geschlachtet wurden. Die fünf Altergruppen wurden folgendermaßen eingeteilt: 10-75 (1. Altersstufe), 76-100 (2. Altersstufe), 101-150 (3. Altersstufe), 151-200 (4. Altersstufe) und > 200 (5. Al-tersstufe) Tage. Als fixe Umweltfaktoren wurden der Einstellungsstall, das Einstallungsalter, die Herkunftsre-gion, die Einstallungssaison, das Auftreten von Bronchopneumonie bei der Einstallung, das Einstallungsjahr, die Gruppe innerhalb Einstallungsjahr und das Einstallungsgewicht getestet. Anhand eines linearen Tiermodelles wurden sowohl univariat als auch multivariat Heritabilitätsschätzungen für die Inzidenz und Anzahl Behandlun-gen wegen Bronchopneumonie vorgenommen. Die multivariat geschätzten Heritabilitäten für die Inzidenz von Bronchopneumonie lagen zwischen h 2 = 0,22 (Altersklasse 1) und h 2 = 0,07 (Altersklasse 4). Die Heritabilitäts

Fatal starvation is a rare cause of death in industrialised countries. In such cases, investigation of death is never an easy task for forensic pathologists who need to couple autopsy findings with full investigation of the crime scene and family record to establish if death results from deliberate neglect, maltreatment and withholding of food. The present article describes two cases of death caused by child neglect. The first case involved a 16-month-old female who died from starvation with dehydration as a contributing factor. In the second case a 7-year-old girl died from ultimate aspiration of stomach contents that had been vomited during the child's last meal because of the fecal concretions blocking the intestinal passage. In both cases macroscopic and histological findings revealed severe chronic malnutrition; crime scene investigations confirmed stories of child maltreatment and neglect.