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Health Technol Assess 2019 Mar;23(11):1-70

School of Population Health and Environmental Sciences, King's College London, London, UK.

Background: Unnecessary prescribing of antibiotics in primary care is contributing to the emergence of antimicrobial drug resistance.

Objectives: To develop and evaluate a multicomponent intervention for antimicrobial stewardship in primary care, and to evaluate the safety of reducing antibiotic prescribing for self-limiting respiratory infections (RTIs).

Interventions: A multicomponent intervention, developed as part of this study, including a webinar, monthly reports of general practice-specific data for antibiotic prescribing and decision support tools to inform appropriate antibiotic prescribing. Read More

Clin Microbiol Infect 2018 Dec 21. Epub 2018 Dec 21.

Department of Microbiology, Haukeland University Hospital, Bergen, Norway.

Objectives: The view of pleural empyema as a complication of bacterial pneumonia is changing because many patients lack evidence of underlying pneumonia. To further our understanding of pathophysiological mechanisms, we conducted in-depth microbiological characterization of empyemas in clinically well-characterized patients and investigated observed microbial parallels between pleural empyemas and brain abscesses.

Methods: Culture-positive and/or 16S rRNA gene PCR-positive pleural fluids were analysed using massive parallel sequencing of the 16S rRNA and rpoB genes. Read More

Intractable Rare Dis Res 2018 Nov;7(4):283-286

Department of Clinical Laboratory, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan.

A 58-year-old man with a history of diabetes mellitus and end-stage renal disease acquired pneumonia with acute respiratory failure during his stay in an intensive care unit (ICU). Empirical antimicrobial therapy with ceftazidime and vancomycin was initiated, and imipenem replaced ceftazidime 2 days later due to the patients pulmonary condition failed to improve. However, within 5 days, pulmonary consolidation rapidly progressed to necrotizing pneumonia complicated by lung abscess, empyema, pyopneumothorax, and tension pneumothorax, leading to the patient's death. Read More

Praxis (Bern 1994) 2018 Nov;107(23):1283-1287

1 Innere Medizin, Rankweil, Österreich.

Pneumonia: Does Ultrasound Replace Chest X-Ray? Abstract. Pneumonic lung consolidations are characterized by typical changes in terms of sonomorphology: echopoor lesions with blurred margins, bronchoaerograms, regular vascularization, and parapneumonic effusions. Pneumonias may be first discovered at bedside. Read More

Zentralbl Chir 2019 Feb 15;144(1):93-99. Epub 2018 Oct 15.

Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Regensburg.

Introduction: Patients with severe respiratory failure and veno-venous extracorporeal membrane oxygenation (vv-ECMO) often require diagnostic or therapeutic thoracic surgery.

Methods: Retrospective analysis of prospectively collected data (Regensburg ECMO Registry) on all patients requiring vv-ECMO between December 2010 and December 2016 due to acute lung failure (ALF) with diagnostic or therapeutic thoracic surgery. Endpoints were the indications for thoracic surgery as well as postoperative morbidity and in-hospital mortality. Read More

Indian Pediatr 2018 07;55(7):603-604

Department of Paediatrics, CHILDS Trust Medical Research Foundation, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India.

Background: Retained appendicolith following appendicectomy, and can cause recurrent abscess in the abdomen and retroperitoneum.

Case Characteristics: 11-yr-old boy who presented with subpulmonic abscess and pneumonia following appendicectomy for perforated appendicitis.

Observation: Thoracotomy revealed a thick walled subpulmonic abscess surrounding an appendicolith along with a rent in the posterolateral aspect of the diaphragm. Read More

Case Rep Infect Dis 2018 5;2018:4906547. Epub 2018 Apr 5.

Southern Illinois University School of Medicine, Springfield, IL, USA.

Empyema necessitans (EN) is a rare phenomenon that refers to an insidious extension of the empyema through parietal pleura and subsequent dissection into subcutaneous tissue of the chest wall. A 29-year-old man presented to the hospital with fever and chills a few days after an inadvertent needle stick while injecting heroin. His left forearm was warm with an area of fluctuance. Read More

Paediatr Int Child Health 2018 May 23:1-3. Epub 2018 May 23.

c Department of Clinical Radiology , University Hospitals Bristol NHS Foundation Trust , Bristol , UK.

Empyema necessitans is a rare complication of acute bacterial pneumonia, especially in children. It is a complication of empyema characterised by the extension of pus from the pleural cavity into the thoracic wall to form a mass of purulent fluid in the adjacent soft tissue. An inflammatory chest wall mass following pneumonia caused by Streptococcus pneumonia in a six-month-old infant is reported. Read More

Rev Mal Respir 2018 Apr 10;35(4):430-440. Epub 2018 May 10.

Service de réanimation médico-chirurgicale, hôpital Tenon, hôpitaux universitaires de l'Est-Parisien, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Faculté de médecine, Sorbonne université Paris, 75013 Paris, France.

Introduction: Outpatient treatment of community-acquired pneumonia (CAP) patients with non-steroidal anti-inflammatory drugs (NSAIDs) is frequent, although this is not based on clinical recommendations and there is no scientific evidence supporting better symptom relief in comparison to acetaminophen.

State Of The Art: Experimental data suggest that NSAIDs alter the intrinsic functions of neutrophils, limit their locoregional recruitment, alter bacterial clearance and delay the resolution of inflammatory processes during acute bacterial pulmonary challenge. In hospitalized children and adults with CAP, observational data suggest a strong and independent association between the outpatient exposure to NSAIDs and the occurrence of pleuropulmonary complications (pleural empyema, excavation, and abscess). Read More

Case Rep Infect Dis 2018 18;2018:8039803. Epub 2018 Feb 18.

Department of Pulmonary Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.

Empyema thoracis is a serious condition characterized by the accumulation of purulent fluid in the pleural cavity, typically following a pneumonia, subdiaphragmatic abscess, or esophageal rupture. Fungal empyema thoracis is a rare form of this condition with especially high mortality, in which the most frequently isolated fungus is spp. This article presents a 74-year-old female with pneumonia and a complicated hospital course, initially presenting with nausea, vomiting, and dysphagia. Read More

Children (Basel) 2018 Mar 3;5(3). Epub 2018 Mar 3.

Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Rd., Ottawa, ON K1H 8L1, Canada.

Following the introduction of 7-valent pneumococcal vaccine (PCV7), while overall rates of invasive pneumococcal disease and pneumococcal pneumonia in children declined, rates of empyema increased. We examined changes in the incidence of hospitalization for pediatric complicated pneumonia (PCOMP) in Eastern Ontario, Canada, particularly since the introduction of the 13-valent vaccine (PCV13). A retrospective chart review was carried out evaluating previously healthy children admitted with PCOMP, which included empyema, parapneumonic effusion, necrotizing pneumonia, and lung abscess between 2002 and 2015. Read More

BMJ Case Rep 2018 Feb 5;2018. Epub 2018 Feb 5.

Department of Respiratory Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

We report an unusual presentation of pulmonary embolism (PE) where a 58-year-old man first developed symptoms of community-acquired pneumonia. Despite antibiotic therapy, he remained unwell with rising inflammatory markers, general malaise and persistent cough. He developed stony dull percussion and absent breath sounds to his left mid to lower zones. Read More

Chest 2018 Sep 6;154(3):550-556. Epub 2018 Feb 6.

Department of Surgery, Intermountain Medical Center, Murray, UT.

Background: Combined intrapleural therapy with tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) has been shown to reduce the need for surgical intervention for complicated pleural effusion/empyema (CPE/empyema). For patients in whom tPA/DNase is likely to fail, however, receipt of this therapy may simply delay the inevitable. The goal of this study was to identify risk factors for failure of combined intrapleural therapy. Read More

BMC Med 2018 02 8;16(1):13. Epub 2018 Feb 8.

Public Health England, London, UK.

Background: The seven-valent pneumococcal conjugate vaccine (PCV) was introduced in England in September 2006, changing to the 13-valent vaccine in April 2010. PCV impact on invasive pneumococcal disease (IPD) has been extensively reported, but less described is its impact on the burden of pneumonia, sepsis and otitis media in the hospital.

Methods: Using details on all admissions to hospitals in England, we compared the incidence of pneumococcal-specific and syndromic disease endpoints in a 24-month pre-PCV period beginning April 2004 to the 24-month period ending March 2015 to derive incidence rate ratios (IRRs). Read More

Infect Dis Ther 2018 Mar 1;7(1):29-38. Epub 2018 Feb 1.

Faculty of Health Sciences, Soroka University Medical Center, The Infectious Disease Institute, Ben-Gurion University of the Negev, Beersheba, Israel.

Published literature on post-obstructive pneumonia is difficult to find and consists mainly of case reports or small case series. This entity is encountered most often in patients with advanced lung malignancy but is also occasionally seen in patients with community-acquired pneumonia (CAP). There are substantial differences in the manifestations, treatment, and outcomes of post-obstructive pneumonia in these two settings. Read More

BMC Infect Dis 2018 01 15;18(1):40. Epub 2018 Jan 15.

Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.

Background: Transdiaphragmatic extension of pyogenic liver abscess is the rarest cause of pericarditis and pleural empyema. It is a rapidly progressive and highly lethal infection with mortality rates reaching 100% if left untreated. However, the transmission route, treatment methods and prognosis have not been well studied. Read More

Korean J Thorac Cardiovasc Surg 2017 Oct 5;50(5):395-398. Epub 2017 Oct 5.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine.

A 71-year-old man presented with a productive cough and fever, and he was diagnosed as having an esophageal perforation and a mediastinal abscess. He had a history of traumatic hemothorax and pleural drainage for empyema in the right chest and was considered unable to tolerate thoracic surgery because of sepsis and progressive aspiration pneumonia. In order to aggressively drain the mediastinal contamination, we performed internal drainage by placing a Levin tube into the mediastinum through the perforation site. Read More

Cureus 2017 Aug 21;9(8):e1588. Epub 2017 Aug 21.

Internal Medicine, Kettering Medical Center.

Ludwig's angina is a diffuse cellulitis in the submandibular, sublingual, and submental spaces, characterized by its propensity to spread rapidly to the surrounding tissues. Early recognition and treatment for Ludwig's angina are of paramount importance due to the myriad of complications that can occur in association with Ludwig's angina. Known complications of Ludwig's angina include carotid arterial rupture or sheath abscess, thrombophlebitis of the internal jugular vein, mediastinitis, empyema, pericardial effusion, osteomyelitis of the mandible, subphrenic abscess, aspiration pneumonia, and pleural effusion. Read More

Pediatr Radiol 2017 Oct 21;47(11):1431-1440. Epub 2017 Sep 21.

Department of Radiology, Medical University Graz, Graz, Austria.

Diagnostic imaging plays a significant role in both the diagnosis and treatment of complications of pneumonia in children and chest radiography is the imaging modality of choice. Computed tomography (CT) on the other hand, is not currently a first-line imaging tool for children with suspected uncomplicated community-acquired pneumonia and is largely reserved for when complications of pneumonia are suspected or there is difficulty in differentiating pneumonia from other pathology. This review outlines the situations where CT needs to be considered in children with pneumonia, describes the imaging features of the parenchymal and pleural complications of pneumonia, discusses how CT may have a wider role in developing countries where human immunodeficiency virus (HIV) and tuberculosis are prevalent, makes note of the role of CT scanning for identifying missed foreign body aspiration and, lastly, addresses radiation concerns. Read More

J Microbiol Immunol Infect 2017 Sep 2. Epub 2017 Sep 2.

Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan. Electronic address:

Background: Most cases of complicated pneumonia in children are caused by pneumococcal infections. Thomsen-Friedenreich antigen (TA) is present on erythrocytes, platelets and glomeruli, and it can be activated during pneumococcal infection. The aim of this study was to investigate the predictive value of TA activation for pneumococcal infection and association with the severity of complicated pneumonia. Read More

Medicine (Baltimore) 2017 Jul;96(29):e7552

aCHU de Caen, France, Infectious Diseases Department bCHU de Caen, France, Radiology Department cCHU de Caen, France, Nuclear Medicine Department dGroupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie University, UNICAEN Caen, PFRS, 2 rue des Rochambelles, Caen, France.

Rationale: Splenosis is the development of one or more heterotopic splenic tissue autoimplants following rupture of the spleen and remains mostly asymptomatic.

Patient Concerns: We report a case of a 50-year old post-traumatic splenectomized man admitted for a left side community acquired pneumonia resistant to antibiotics.

Diagnoses: The diagnosis of intrathoracic ectopic spleen was suspected because of the history of spleen trauma with diaphragm rupture and the absence of Howell-Jolly bodies. Read More

Tuberk Toraks 2017 Mar;65(1):56-59

Clinic of Pediatric Immunology and Allergy, Dr. Behçet Uz Children Diseases Training and Research Hospital, Izmir, Turkey.

Chronic granulomatous disease (CGD) is a genetically heterogeneous primary immunodeficiency that is characterized by recurrent and life-threatening infections resulting from defects in phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system and granuloma formation due to increased inflammatory response. The most commonly involved organs are the lungs, skin, lymph nodes, and liver due to infection. It may present with recurrent pneumonia, hilar lymphadenopathy, empyema, abscess, reticulonodular patterns, and granulomas due to lung involvement. Read More

BMC Pediatr 2017 04 27;17(1):114. Epub 2017 Apr 27.

Service des Maladies Infectieuses Pédiatriques, Hôpital d'Enfants Abderrahim Harouchi, CHU Ibn Rochd, Casablanca, Morocco.

Background: Simple parapneumonic effusion is a pleural effusion associated with lung infection (i.e., pneumonia). Read More

Asian Cardiovasc Thorac Ann 2017 May 7;25(4):315-317. Epub 2017 Apr 7.

Department of Thoracic Surgery, Nishi-Kobe Medical Center, Hyogo, Japan.

While some cases of nocardial pneumonia develop secondary empyema, tension pyopneumothorax is a very rare and lethal complication. A 74-year-old man who exhibited thrombocytopenia during steroid therapy for autoimmune hepatitis, presented to our department with a nocardial tension pyopneumothorax. He underwent a left lower lobectomy after chest drainage, and was discharged without any complication other than reoperation to remove a postoperative hematoma. Read More

Front Pediatr 2017 27;5:30. Epub 2017 Feb 27.

Pulmonary and Sleep Medicine, Banner Children's Specialists, Banner Medical Group , Phoenix, AZ , USA.

The most common clinical suppurative lung conditions in children are empyema, lung abscess, and bronchiectasis, and to a less often necrotizing pneumonia. Until recently, bronchiectasis was the most common form of persistent suppurative lung disease in children. Protracted bacterial bronchitis is a newly described chronic suppurative condition in children, which is less persistent but more common than bronchiectasis (1). Read More

Handb Clin Neurol 2017 ;140:349-364

Department of Neurology, Center for Infection and Immunity, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address:

Bacterial infections of the central nervous system present as a medical emergency, thus requiring rapid diagnosis and immediate treatment. The most prevalent bacterial infections seen in the intensive care unit can be summarized as acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis, which all commonly involve the brain parenchyma. The infections can either be community-acquired or hospital-acquired, e. Read More

J Vet Emerg Crit Care (San Antonio) 2017 Mar 12;27(2):238-242. Epub 2017 Jan 12.

Departments of Clinical Science and Services.

Objective: To describe a case of successful medical management of subdural intracranial empyema and multifocal pneumonia in a domestic longhaired cat.

Case Summary: A 7-year-and-8-month-old male neutered domestic longhair cat presented with tachypnea, respiratory compromise, vestibular ataxia, obtundation, left-sided head tilt, and multiple cranial nerve deficits. Neuroanatomical localization was multifocal with central vestibular involvement. Read More

Radiologe 2017 Jan;57(1):29-34

Universitätsklinik für Radiologie und Nuklearmedizin, Allgemeines Krankenhaus, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Clinical Issue: Despite a considerable number of antimicrobial agents and interdisciplinary treatment options, lower respiratory tract infections are still associated with high morbidity and mortality rates. Infections of the respiratory tract can lead to severe complications, such as empyema, lung abscesses and acute respiratory distress syndrome (ARDS). Besides intrapulmonary complications pneumonia can also impair other organs due to a systemic inflammatory response. Read More

Radiologe 2017 Jan;57(1):6-12

Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Medizinische Universität Wien, Währinger Guertel 18-20, 1090, Wien, Österreich.

Clinical Issue: The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters.

Standard Radiological Methods: For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. Read More

Cureus 2016 Nov 24;8(11):e896. Epub 2016 Nov 24.

College of Medicine, University of Central Florida ; FM Medical, Inc.

An acute dry cough results commonly from bronchitis or pneumonia. When a patient presents with signs of infection, respiratory crackles, and a positive chest radiograph, the diagnosis of pneumonia is more common. Antibiotic failure in a patient being treated for community-acquired pneumonia requires further investigation through chest computed tomography. Read More

Lung 2017 04 22;195(2):201-208. Epub 2016 Dec 22.

Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France.

Purpose: Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed or used as self-medication in cases of community-acquired pneumonia (CAP). Nevertheless, the consequences of such medication on the risk of pleuroparenchymal complications are not well known. The aim was to investigate whether exposure to NSAIDs prior to hospital admission among patients suffering from CAP is associated with the development of pleural complications or a lung abscess. Read More

BJR Case Rep 2017 7;3(2):20160100. Epub 2016 Nov 7.

Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.

We present the case of a 26-year-old male who was referred to the Emergency department with frank haemoptysis, fever and abdominal pain. He had suffered from an acute splenic rupture secondary to blunt abdominal trauma 3 weeks previously, when he was treated with transfemoral embolisation therapy. On this previous admission his splenic injury was initially not detected owing to CT scanning technique focussed on imaging the thorax rather than the abdomen. Read More

BMC Infect Dis 2016 Oct 18;16(1):574. Epub 2016 Oct 18.

Department of Bacteriology, Amiens University Hospital, Amiens, France.

Background: Aggregatibacter aphrophilus, a commensal of the oro-pharyngeal flora and member of the HACEK group of organisms, is an uncommonly encountered clinical pathogen. It has already been described as the causative agent of brain abscesses, empyema, meningitis, sinusitis, otitis media, bacteriemia, pneumonia, osteomyelitis, peritonitis, endocarditis and wound infections. Herein we report the first case of bartholinitis due to A. Read More

BMC Infect Dis 2016 10 12;16(1):557. Epub 2016 Oct 12.

Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China.

Background: Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; however, central nervous system (CNS) infections are rare. We report here the first case of M. hominis meningitis in China, post neurosurgical treatment for an intracerebral haemorrhage in a 71-year-old male. Read More

Ann Thorac Med 2016 Jul-Sep;11(3):191-6

Division of Pulmonology, Allergy/Immunology, Cystic Fibrosis and Sleep, Children's Healthcare of Atlanta, School of Medicine, Emory University, Atlanta, GA 30322, USA.

Introduction: Pediatric lung abscesses can be primary or secondary, and there is limited data regarding response to treatments and patient outcomes.

Objectives: To assess the clinical and microbiologic profile of pediatric patients with lung abscess and assess the differences in outcomes for patients treated with medical therapy or medical plus surgical therapy.

Methods: A retrospective review of all pediatric patients ≤ 18 years of age that were treated as an inpatient for lung abscess between the dates of August 2004 and August 2014 was conducted. Read More

J Thorac Dis 2016 Jul;8(7):1577-86

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.

Background: Bronchopleural fistula (BPF) is an infrequent but life-threatening complication after lung surgery. Tentative closure of the fistula and irrigation have been the conventional treatments, but are also surgically challenging and associated with a considerable failure rate. This study reports on a conservative practice of this difficult issue, in aim to examine its outcomes. Read More

Case Rep Pulmonol 2016 10;2016:8709347. Epub 2016 Jul 10.

Istishari Hospital, Department of Internal Medicine, Division of Pulmonology, Amman 11183, Jordan.

Amebiasis is a parasitic infection caused by the protozoan Entamoeba histolytica. While most infections are asymptomatic, the disease could manifest clinically as amebic dysentery and/or extraintestinal invasion in the form of amebic liver abscess or other more rare manifestations such as pulmonary, cardiac, or brain involvement. Herein we are reporting a case of a 24-year-old male with history of Down syndrome who presented with severe right side pneumonia complicated with multicystic empyema resistant to regular medical therapy. Read More

Clin Respir J 2018 Jan 25;12(1):253-261. Epub 2016 Jul 25.

Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.

Aim: The aim of this study was to evaluate the factors that could predict the development of local complications (parapneumonic effusion/pleural empyema, necrotizing pneumonia, and lung abscess) in children with community-acquired pneumonia (CAP).

Methods: Demographic, clinical, and laboratory data were prospectively collected and compared in children with noncomplicated and complicated CAP.

Results: Two-hundred and three patients aged from 2 months to 17 years were enrolled. Read More

BMJ 2016 Jul 4;354:i3410. Epub 2016 Jul 4.

Department of Primary Care and Public Health Sciences, King's College London, Guy's Campus, London SE1 1UL, UK.

Objective:  To determine whether the incidence of pneumonia, peritonsillar abscess, mastoiditis, empyema, meningitis, intracranial abscess, and Lemierre's syndrome is higher in general practices that prescribe fewer antibiotics for self limiting respiratory tract infections (RTIs).

Design:  Cohort study.

Setting:  610 UK general practices from the UK Clinical Practice Research Datalink. Read More

Eur J Clin Microbiol Infect Dis 2016 Jul 2;35(7):1177-85. Epub 2016 May 2.

2nd Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Staphylococcus aureus is an infrequent cause of community-associated (CA-SA) pneumonia in children. The aim of this study was to evaluate the clinical, epidemiological, microbiological, and molecular characteristics of CA-SA pneumonia among children hospitalized in two large tertiary care referral centers during an 8-year period. Cases of CA-SA pneumonia admitted between 2007 and 2014 were retrospectively examined through medical record review. Read More

Vaccine 2016 Apr 1;34(15):1847-52. Epub 2016 Feb 1.

Intensive Care Unit, Hospital Clínic Universitari de València. 17, Blasco Ibañez av, 46010 Valencia, Spain.

Introduction: Pneumococcal 13-valent vaccine (PCV-13) has a potential role in preventing bacteraemic pneumococcal pneumonia and its complications, but little is known about its ability to specifically prevent respiratory complications. Our aim were to analyse the pneumococcal serotypes associated with the development of respiratory complications and the potential role of PCV-13 in preventing respiratory complications in bacteraemic pneumococcal pneumonia.

Material And Methods: We analysed demographic characteristics, comorbidities, antibiotic resistances and the outcomes of a cohort of 65 vaccine-naïve bacteraemic pneumococcal pneumonias, stratified by the pneumococcal serotypes included in PCV13 vs. Read More

Klin Padiatr 2016 Jan 14;228(1):29-34. Epub 2016 Jan 14.

HELIOS Klinikum Krefeld, Centre for Paediatric Medicine and Centre for Child and Adolescent Health, Krefeld.

Background: There still is controversy about surgical treatment of pleural empyema in children.

Patients And Methods: Retrospective analysis of treatment strategy, focussing on indication for surgery and outcome of children treated in 2 centres for pleural complications due to primary pneumonia from January 1(st) 2008 to December 31(st) 2012. RESULTS were compared to studies published within the last 10 years. Read More

Paediatr Child Health 2015 Nov-Dec;20(8):441-50

Although immunization has decreased the incidence of bacterial pneumonia in vaccinated children, pneumonia remains common in healthy children. Symptoms of bacterial pneumonia frequently overlap those present with viral infections or reactive airway disease. Optimally, the diagnosis of bacterial pneumonia should be supported by a chest radiograph before starting antimicrobials. Read More

Infection 2016 Aug 30;44(4):539-41. Epub 2015 Nov 30.

Department of Clincal Microbiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.

Tularemia is an emerging zoonotic disease mainly of the Northern Hemisphere caused by the Gram-negative coccobacillus Francisella tularensis. It is affecting a wide range of animals and causes human disease after insect and tick bites, skin contact, ingestion and inhalation. A 66-year-old man presented to our clinic with cavitary pneumonia and distinct pleural effusion. Read More

Hosp Pediatr 2015 Dec 1;5(12):605-12. Epub 2015 Jan 1.

Departments of Pediatrics and

Background: Treatment of pediatric parapneumonic empyema (PPE) requires several weeks of antibiotic therapy that is typically completed in the outpatient setting. The route of outpatient therapy can be oral or intravenous (outpatient parenteral antibiotic therapy [OPAT]). No studies have compared outcomes between oral therapy and OPAT for PPE. Read More

Pediatr Surg Int 2016 Mar 31;32(3):215-20. Epub 2015 Oct 31.

Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 200 First Street SW, Rochester, MN, 55905, USA.

Purpose: The incidence and etiology of empyema with fistula (EWF) in children is unknown. We analyzed a national database to define the epidemiology and diagnoses associated with this condition.

Methods: Discharge data from the Kids' Inpatient Database were reviewed for EWF (ICD-9 diagnosis code 510. Read More

BMC Pulm Med 2015 Oct 26;15:133. Epub 2015 Oct 26.

Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.

Background: The Streptococcus anginosus group (SAG) play important roles in respiratory infections. It is ordinarily difficult to distinguish them from contaminations as the causative pathogens of respiratory infections because they are often cultured in respiratory specimens. Therefore, it is important to understand the clinical characteristics and laboratory findings of respiratory infections caused by the SAG members. Read More

Immunol Allergy Clin North Am 2015 Nov 25;35(4):753-66. Epub 2015 Aug 25.

Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, UHN-67, Portland, OR 97239, USA. Electronic address:

Pulmonary disease, ranging from infectious pneumonia, lung abscess, and empyema to structural lung diseases to malignancy, significantly increase morbidity and mortality in primary immune deficiency. Treatment with supplemental immunoglobulin (intravenous or subcutaneous) and antimicrobials is beneficial in reducing infections but are largely ineffective in preventing noninfectious complications, including interstitial lung disease, malignancy, and autoimmune disease. A low threshold for suspecting pulmonary complications is necessary for the early diagnosis of pulmonary involvement in primary immunodeficiency disorders, before irreversible damage is done, to improve patient outcomes. Read More

BMJ Case Rep 2015 Sep 2;2015. Epub 2015 Sep 2.

National University Health Services, Singapore, Singapore.

A 67-year-old woman with myelodysplastic syndrome (MDS) and transfusional haemosiderosis developed Salmonella empyema caused by direct extension from splenic abscesses. She was successfully treated with antibiotics, pleural decortication and splenectomy. She had presented with fever after being treated for presumed pneumonia and parapneumonic effusion 2 months prior. Read More

Semin Pediatr Surg 2015 Aug 27;24(4):187-95. Epub 2015 Feb 27.

Department of Paediatric Surgery, King׳s College Hospital, Denmark Hill, London SE5 9RS, UK. Electronic address:

Antenatal detection of congenital pulmonary airway malformations (CPAM) has improved immeasurably from its initial application in the 1980s and probably encompasses >80% of all such lesions. Accurate diagnosis still remains less reliable and definitive diagnosis requires detailed anatomical imaging (typically with CT scan) in the post-natal period. About 10% of all lesions will present with symptoms during the neonatal period and the choice of surgical intervention is then easy. Read More