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Introdução: a pneumonia é uma infecção nos pulmões, provocada pela penetração de microrganismos. Outras infeções respiratórias, incluindo a SARS-COV-2, podem agravar a clínica do paciente. Por sua vez, esta é uma doença sistêmica, com foco pulmonar que pode gerar complicações respiratórias, dentre elas a pneumonia. Neste seguimento, estudos evidenciam que 15% dos pacientes com COVID-19 podem apresentar pneumonia leve e 5% evoluir para pneumonia grave. Objetivo: comparar a ocorrência de morbimortalidade por pneumonia no Estado da Bahia, no período pré e durante a pandemia de COVID-19. Metodologia: trata-se de um estudo ecológico, quantitativo, com dados públicos, disponíveis no Sistema Informações em Saúde da plataforma DataSUS/ TABNet, referentes ao Estado da Bahia, no período de jan./2018 a dez./2021. Foram selecionados os dados: internamentos, média de internamento, óbitos e taxa de mortalidade. Os dados foram analisados através da estatística descritiva, frequência relativa, e estatística analítica com o teste de frequências relativas U de Mann-Whitney. Resultados: o Estado da Bahia, registrou um total de 48 mil internações por pneumonia, com média de taxa de permanência de internamento de 6,4 dias e um total de 8 mil óbitos, com média de taxa de mortalidade de 16,91% ao ano. Observa-se que ocorreu redução nas internações e óbitos, e aumento na taxa de mortalidade por pneumonia, no período estudado (P<0,001). Conclusão: contudo, verificou-se que no Estado da Bahia durante o período da pandemia de COVID-19, ocorreram redução no número de internados e óbitos, e aumento na taxa de mortalidade por pneumonia, comparando-se ao mesmo período pré pandemia.
Introduction: pneumonia is an infection in the lungs, caused by exposure to microorganisms. Other respiratory infections, including SARS-COV-2, may aggravate the patient's health condition. In turn, this is a systemic disease, with a pulmonary focus that can lead to respiratory complications, including pneumonia. In this area, studies show that 15% of patients with COVID-19 may have mild pneumonia and 5% progress to severe pneumonia. Objective: to compare the occurrence of morbidity and mortality from pneumonia in the State of Bahia, in the period before and during the COVID-19 pandemic. Methodology: this is an ecological, quantitative study, with public data, available in the Health Information System of the DataSUS/TABNet platform, referring to the State of Bahia, from Jan./2018 to Dec./2021. Selected data: hospitalizations, average hospitalization, deaths and mortality rate. Data were analysed using descriptive statistics, relative frequency, and analytical statistics with the Mann-Whitney U relative frequency test. Results: the State of Bahia recorded a total of 48,000 hospitalizations for pneumonia, with an average hospitalization stay rate of 6.4 days and a total of 8,000 deaths, with an average mortality rate of 16.91% per year. It is observed that there was a reduction in hospitalizations and deaths, and an increase in the mortality rate due to pneumonia, in the studied period (P<0.001). Conclusion: however, it was found that in the State of Bahia during the period of the COVID-19 pandemic, there was a reduction in the number of hospitalizations and deaths, and an increase in the mortality rate due to pneumonia, compared to the same pre-pandemic period.
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Humanos , Masculino , Feminino , Pneumonia , Infecções Respiratórias , Sistema Único de Saúde , Indicadores de Morbimortalidade , COVID-19 , Broncopneumonia , Estudos Ecológicos , Estudos de Avaliação como AssuntoRESUMO
Abstract Objective: To investigate the clinical implications of Golgi glycoprotein 73 (GP73) and granulocyte colony-stimulating factor (G-CSF) in children with bronchopneumonia (BP). Methods: Seventy-two children with BP (observation group) and 81 healthy children (control group) consecutively brought to the present study's hospital between June 2019 and October 2020 were enrolled. GP73 and G-CSF levels were determined to analyze their diagnostic value for pediatric BP. High-sensitivity C-reactive protein (hs-CRP) was also measured. The clinical implications of GP73 and G-CSF in pediatric BP complicated with respiratory failure and their connections with the inflammatory response were discussed. Results: GP73 and G-CSF levels were remarkably higher in the observation group (p< 0.05). The sensitivity and specificity of combined detection (GP73+G-CSF) in predicting pediatric BP were 72.22% and 86.42%, respectively (p < 0.001 ). GP73 and G-CSF, which are closely related to X-ray classification and complications in the observation group, decreased after treatment and were positively correlated with hs-CRP (p < 0.05), especially in children complicated with respiratory failure. Regression analysis identified the independence of the course of the disease, hs-CRP, X-ray classification, GP73, and G-CSF as influencing factors of respiratory failure in children with BP (p < 0.05). Conclusion: GP73 and G-CSF, with elevated levels in children with BP, are strongly linked to disease progression and are independent influencing factors of respiratory failure, which may be the key to diagnosing and treating pediatric BP in the future.
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OBJECTIVE: To investigate the clinical implications of Golgi glycoprotein 73 (GP73) and granulocyte colony-stimulating factor (G-CSF) in children with bronchopneumonia (BP). METHODS: Seventy-two children with BP (observation group) and 81 healthy children (control group) consecutively brought to the present study's hospital between June 2019 and October 2020 were enrolled. GP73 and G-CSF levels were determined to analyze their diagnostic value for pediatric BP. High-sensitivity C-reactive protein (hs-CRP) was also measured. The clinical implications of GP73 and G-CSF in pediatric BP complicated with respiratory failure and their connections with the inflammatory response were discussed. RESULTS: GP73 and G-CSF levels were remarkably higher in the observation group (p < 0.05). The sensitivity and specificity of combined detection (GP73+G-CSF) in predicting pediatric BP were 72.22% and 86.42%, respectively (p < 0.001). GP73 and G-CSF, which are closely related to X-ray classification and complications in the observation group, decreased after treatment and were positively correlated with hs-CRP (p < 0.05), especially in children complicated with respiratory failure. Regression analysis identified the independence of the course of the disease, hs-CRP, X-ray classification, GP73, and G-CSF as influencing factors of respiratory failure in children with BP (p < 0.05). CONCLUSION: GP73 and G-CSF, with elevated levels in children with BP, are strongly linked to disease progression and are independent influencing factors of respiratory failure, which may be the key to diagnosing and treating pediatric BP in the future.
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Broncopneumonia , Fator Estimulador de Colônias de Granulócitos , Proteínas de Membrana , Criança , Humanos , Proteína C-Reativa , Progressão da Doença , Fator Estimulador de Colônias de Granulócitos/análise , Proteínas de Membrana/análiseRESUMO
Pulmonary atelectasis is a disease characterized by the collapse of the pulmonary alveoli, leading to partial or total loss of function in the affected lung, and is mostly described in older dogs. It occurs due to chronic inflammatory and obstructive processes such as pneumonia. In infants who do not feed directly from the mother, it is common to develop aspiration pneumonia due to inhalation of a milk replacer. Once aspirated, food generates an inflammatory process in the airway that alters the function of the pulmonary surfactant, increases mucus production, and causes consequent airway obstruction, which may progress to alveolar and bronchial collapse. The aim of the present study was to report a case of a 4-month-old canine with pulmonary atelectasis secondary to bronchopneumonia and the outcome of the clinical case. The patient presented with cough, exercise intolerance, tachypnea, and progressive weight loss. Thoracic radiographic examination was performed to identify displacement of the mediastinum and heart overlapping the collapsed lung, interstitial-alveolar pattern associated with atelectasis of the middle lobe of the right lung, and a diffuse interstitial bronchial pattern throughout the other lung fields. Pulmonary support treatment was administered with antibiotics, bronchodilators, mucolytics, and inhaled corticosteroids, with resolution of clinical and radiographic symptoms after 60 days of treatment. Therefore, adequate treatment of chronic bronchopneumonia is effective in resolving pulmonary atelectasis and its associated clinical complications.
A atelectasia pulmonar é uma enfermidade caracterizada pelo colapso dos alvéolos pulmonares levando a perda de função parcial ou total do pulmão acometido, sendo mais frequente em cães mais velhos. Ocorre devido a processos inflamatórios crônicos e obstrutivos como as pneumonias. Em filhotes que não se alimentam diretamente da mãe, é comum o desenvolvimento de pneumonia aspirativa devido à inalação de fórmula de leite. Uma vez broncoaspirado, o alimento gera um processo inflamatório que altera a função do surfactante pulmonar, aumento na produção de muco e consequente obstrução das vias aéreas, podendo progredir para colapso de alvéolos e brônquios. O objetivo do presente estudo foi relatar um caso de um canino, de 4 meses de idade, com atelectasia pulmonar secundária a broncopneumonia e a evolução do caso clínico. O paciente apresentava sinais de tosse, intolerância a exercícios, taquipneia e emagrecimento progressivo. Realizado exame radiográfico de tórax, identificou-se deslocamento de coração sobrepondo-se ao pulmão colapsado, padrão interstício-alveolar associado a atelectasia do lobo médio do pulmão direito, além de padrão intersticial brônquico difuso pelos demais campos pulmonares. O tratamento de suporte pulmonar foi realizado com antibióticos, broncodilatadores, mucolíticos e corticosteroides inalatórios, com resolução dos sintomas clínicos e radiográficos após 60 dias de tratamento. Portanto, o tratamento adequado para broncopneumonia crônica foi eficaz na resolução da atelectasia pulmonar e suas complicações clínicas.
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Background: India accounts for the highest number of TB cases globally (almost one-fifth of the global burden and almost two-thirds of the cases in South East Asia. Furthermore, the development of drug resistance of varying levels such as multi-drug resistant TB (MDR-TB), extensively-drug resistance TB (XDR-TB) and total-drug resistant TB (TDR-TB) has been on the increase, and now India also features in the 27 high-MDRTB-burden countries. Almost parallel to these developments, in the last few years, we have been encountering less common morphological forms of pulmonary TB (PTB) at autopsies. With these less common manifestations of the disease, we undertook this study to examine the changing trends in the morphological pattern of pulmonary TB over the recent years. Methods: In this 3-year retrospective study, adult autopsy cases of PTB (that significantly contributed to the final cause of death) were studied in detail. HIV-positive cases were excluded from the study. The clinical details, gross appearances of the pulmonary lesions, microscopic pattern and Ziehl-Neelsen (ZN) staining were studied. Extrapulmonary involvement and causes of death were documented. Results: Pulmonary tuberculosis as a cause of death at autopsy was seen in 130 adult patients over 3 years. The age range was between 12 to 70 years. Anti-tuberculous therapy had been administered in 33 of them, but only one patient had taken complete therapy. Dyspnea was the commonest respiratory symptom seen in 51 cases (39.2%). Tuberculous bronchopneumonia was the commonest lesion (45.3%), miliary lesions (including localized miliary) accounted for 26% while fibrocavitary lesions (including the ones not involving apex) were seen in 13% cases. Other morphologies included nodular forms of TB (13%), localized miliary lesions (11.9%), and fibrocavitary lesions, not necessarily involving the apex (11.7% of all fibrocavitary cases), and predominant pleuritis with underlying lung involvement by TB in 1 case. Many cases of TB bronchopneumonia had a bronchocentric pattern of distribution (14.7%). On microscopy, caseating granulomas were seen in 93% cases, only caseation necrosis was seen in 4.6% cases, and necrotizing granulomas with abscess-like reaction in 11.5% cases. ZN staining was positive in 92 cases (70.7%). All the extrapulmonary lesions showed caseating granulomas histologically. The final cause of death was found to be primarily tuberculous in 106 cases (81.5%), whereas in 24 cases (19.5%) pulmonary TB was attributed to the secondary cause of death. Conclusion: The typical apical involvement of secondary TB was not seen in most of our cases. This could indicate a difference in the morphology and the pattern of lung involvement in recent years. The difference in gross morphology does not affect the pattern of involvement of the lung. In our study, we have observed both; a change in morphology, i.e., more cases of TB bronchopneumonia, and a change in the pattern of involvement like nodular forms, localized miliary forms, and fibrocavitary lesions not necessarily involving the apex. We postulate that this less common manifestation of pulmonary TB is closely related to the development of multi-drug and microbial resistance posing serious medical challenges.
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Introducción: La infección nosocomial o intrahospitalaria constituye un importante problema de salud en todos los hospitales del orbe. Objetivo: Describir las características clínicas y epidemiológicas de pacientes con infecciones intrahospitalarias. Métodos: Se realizó un estudio descriptivo y transversal de 57 pacientes con infecciones intrahospitalarias, ingresados en el Servicio de Medicina Interna del Hospital Provincial Docente Clínico-Quirúrgico Saturnino Lora de Santiago de Cuba, de octubre a diciembre de 2019, para lo cual se analizaron las variables edad, enfermedades asociadas, factores predisponentes, tipo de infección y gérmenes aislados. Resultados: En la serie sobresalieron el grupo etario de 60-69 años y la hipertensión arterial como enfermedad crónica concomitante (26,0 %). Entre los factores predisponentes resultó más frecuente el tabaquismo (32,8 %) y el tipo de infección preponderante fue la bronconeumonía bacteriana (47,0 %), cuyo germen causal en la mayoría de los casos (35,1 %) fue la Klebsiella pneumoniae. Conclusiones: Las infecciones intrahospitalarias aquejaron principalmente a pacientes de edad avanzada con enfermedades crónicas asociadas, como la diabetes mellitus y la hipertensión arterial. Cabe destacar la importancia de conocer la flora microbiana existente en el servicio donde se adquiere la infección, a fin de lograr tanto la prevención como el diagnóstico oportuno y el tratamiento adecuado.
Introduction: The cross or hospital infections constitute an important health problem in all the hospitals of the world. Objective: To describe the clinical and epidemiological characteristics of patients with hospital infections. Methods: A descriptive and cross-sectional study of 57 patients with hospital acquired infections was carried out. They were admitted to the Internal Medicine Service of Saturnino Lora Clinical-surgical Teaching Provincial Hospital of Santiago de Cuba, from October to December, 2019, for which the variables age, associated diseases, predisposing factors, type of infection and isolated germs were analyzed. Results: In the series the 60-69 years age group and hypertension as concomitant chronic disease (26.0 %) were notable. Among the predisposing factors nicotine addiction (32.8 %) was more frequent and the preponderant type of infection was the bacterial bronchopneumonia (47.0 %) whose causal germ in most of the cases (35.1 %) was the Klebsiella pneumoniae. Conclusions: The hospital acquired infections mainly afflicted patients of advanced age with associated chronic diseases, as diabetes mellitus and hypertension. It is necessary to highlight the importance of knowing the existent microbial flora in the service where the infection is acquired, in order to achieve boththe prevention, the opportune diagnosis and the appropriate treatment.
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Infecção Hospitalar , Klebsiella pneumoniae , BroncopneumoniaRESUMO
The Cuvier's beaked whale (CBW; Ziphius cavirostris) is a cosmopolitan marine mammal found in deep tropical and temperate waters of all oceans. CBW strandings have been recorded sporadically in Brazil; however, there is lack of information available regarding their causes of stranding and/or death. Herein, we report the epidemiologic, pathologic, morphologic parasitologic features and molecular identification of arterial and renal crassicaudiasis by Crassicauda sp. in three geographically and chronologically distant CBW stranded off Brazil. CBW-1 was an adult male stranded dead in Rio Grande do Sul State. CBW-2 was an adult female that stranded alive in Sergipe State and died shortly after. CBW-3 was and adult male that stranded dead in Santa Catarina State. The most relevant pathologic findings in these three CBW were severe, chronic proliferative mesenteric and caudal aortic endarteritis and chronic granulomatous and fibrosing interstitial nephritis with renicular atrophy and loss, and numerous intralesional Crassicauda sp. nematodes. Furthermore, CBW-1 had concomitant gram-negative bacterial pneumonia and pulmonary and hepatic thromboembolism. Morphologic analysis of renal adult nematodes identified Crassicauda sp. in the three CBW. Molecular analyses targeting the 18S and ITS-2 ribosomal loci of renal nematodes in CBW-2 and CBW-3 identified C. anthonyi. It is believed that severe arterial and renal crassicaudiasis likely resulted or contributed significantly to morbidity and death of these animals. These results expand the known geographical range of occurrence of crassicaudiasis in CBW. Specifically, the present study provides the first accounts of arterial and renal crassicaudiasis in CBW off the southern hemisphere, specifically in CBW off Brazil, and to the authors' knowledge, it is the first record of C. anthonyi in the southern Atlantic Ocean.
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The bovine respiratory disease (BRD) complex is a multietiological and multifactorial disease associated with a wide range of viral and bacterial pathogens. This study evaluated the contribution of specific infectious disease agents in the development of BRD in cattle from Brazil and determined if a virus within the malignant catarrhal fever virus (MCFV) group and Mycoplasma bovis, acting individually or in conjunction, can be associated with the development of BRD. Formalin-fixed paraffin-embedded pulmonary sections were used in immunohistochemical assays to determine the intralesional presence of six antigens associated with BRD: bovine alphaherpesvirus 1 (BoHV-1), bovine parainfluenza virus 3 (BPIV-3), bovine viral diarrhea virus (BVDV), bovine respiratory syncytial virus (BRSV), MCFV, and M. bovis. Pneumonia was diagnosed in 82.7% (120/145) of all cattle evaluated. Interstitial pneumonia (60%, 72/120) and suppurative bronchopneumonia (25.8%, 31/120) were the most frequent patterns of pneumonia identified. Intralesional antigens of MCFV (53.3%, 64/120) were the most frequently associated with BRD, followed by M. bovis (47.5%, 57/120), BVDV (42.5%, 51/120), BoHV-1 (28.3%, 34/120), BRSV (24.2%, 29/120), and BPIV-3 (8.3%, 10/120). Additionally, antigens of BVDV, MCFV, and M. bovis were the most frequently identified agents associated with singular and concomitant infections. The MCFV identified during this study is more likely to be ovine gammaherpesvirus 2 (OvHV-2), since OvHV-2 is the only MCFV identified within the geographical region of this study. Interstitial pneumonia with proliferative vascular lesions may be a useful histologic feature to differentiate MCFV-induced pneumonia from other viral pneumonias of cattle. These results demonstrate that MCFV and M. bovis, in single or mixed infections, can produce pneumonia in cattle and should therefore be considered as primary agents in the development of BRD.
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Extremely low birth weight (ELBW) infants are at particularly high risk for infection due to an immature immune system, invasive procedures such as endotracheal intubation, intravascular catheterization, and other factors. Neonatal infections in this population are associated with a high mortality, poor growth, and neurodevelopmental outcomes. Pseudomonas aeruginosa (P. aeruginosa) infection is an uncommon but potentially devastating cause of pneumonia and sepsis in the ELBW population. P. aeruginosa is an important cause of healthcare-associated infections (HAI) or nosocomial infections. P. aeruginosa can perceive unfavorable environmental changes and orchestrate adaptations by developing plasmid-mediated and adaptive resistance to antibiotics. We describe an ELBW infant born at 26 weeks' gestation who succumbed at 13 days of life to P. aeruginosa infection. Some of the factors related to the pathogenesis and multidrug resistance are described.
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Introducción: La enfermedad respiratoria aguda es la entidad más frecuente en la vida del ser humano y las enfermedades respiratorias agudas se encuentran entre las causas de muerte. La autopsia es el mejor método del estudio del enfermo y su realización es una fortaleza del sistema de salud cubano. Objetivo: Determinar las características demográficas y morfológicas que se encontraron en las autopsias de fallecidos con enfermedad respiratoria aguda. Método: Se realizó un estudio descriptivo y de corte transversal, de los fallecidos a quienes se realizó autopsia, en el periodo de 1986 al 2019. Se estudiaron las variables edad, sexo, comorbilidades, causas de muerte y relación clínico - patológica. Resultados: La población quedó conformada por 390 autopsias que presentaban estas afecciones (2,5 por ciento). El grupo de edades entre 65 a 84 años fue el más afectado en ambos sexos. En las causas directas de muerte predominó la bronconeumonía bacteriana. Se destaca la elevada coincidencia en las causas directas de muerte y las discrepancias en las causas básicas. La línea de tendencia indica el incremento progresivo en el transcurso de los años estudiados. Conclusiones: Las características demográficas muestran que todos los grupos de edades están afectados, con predominio de 65 a 84 años, en ambos sexos. El pulmón fue el órgano más afectado en las causas directas de muerte, con predominio de la bronconeumonía, mientras que la mayoría presenta enfermedad respiratoria aguda como causa básica de muerte, con elevada discrepancia en su relación clínico patológica(AU)
Introduction: Acute respiratory disease is the most frequent entity in human life and acute respiratory diseases are among the causes of death. The autopsy is the best method of studying the patient and it is a strength of the Cuban health system. Objective: To determine the demographic and morphological characteristics found in the autopsies of the deceased with acute respiratory diseases. Method: A descriptive and cross-sectional study was carried out of the deceased who underwent autopsy, in the period from 1986 to 2019. The variables age, sex, comorbidities, causes of death and clinical-pathological relationship were studied. Results: The population was made up of 390 autopsies with these conditions (2.5 percent). The 65 to 84 age group was the most affected in both sexes. In direct causes of death, bacterial bronchopneumonia predominated. The high coincidence in the direct causes of death and the discrepancies in the basic causes stand out. The trend line indicates the progressive increase in the course of the years studied. Conclusions: The demographic characteristics show that all age groups are affected, with a predominance of 65 to 84 years, in both sexes. The lung was the most affected organ in direct causes of death, with a predominance of bronchopneumonia, while the majority had acute respiratory disease as the basic cause of death, with a high discrepancy in its clinical-pathological relationship(AU)
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Humanos , Doenças Respiratórias , Autopsia , Broncopneumonia , Causa Básica de Morte , Estudos Transversais , Causalidade , Grupos EtáriosRESUMO
Extremely low birth weight (ELBW) infants are at particularly high risk for infection due to an immature immune system, invasive procedures such as endotracheal intubation, intravascular catheterization, and other factors. Neonatal infections in this population are associated with a high mortality, poor growth, and neurodevelopmental outcomes. Pseudomonas aeruginosa (P. aeruginosa) infection is an uncommon but potentially devastating cause of pneumonia and sepsis in the ELBW population. P. aeruginosa is an important cause of healthcare-associated infections (HAI) or nosocomial infections. P. aeruginosa can perceive unfavorable environmental changes and orchestrate adaptations by developing plasmid-mediated and adaptive resistance to antibiotics. We describe an ELBW infant born at 26 weeks' gestation who succumbed at 13 days of life to P. aeruginosa infection. Some of the factors related to the pathogenesis and multidrug resistance are described.
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Humanos , Masculino , Recém-Nascido , Pseudomonas aeruginosa , Broncopneumonia , Recém-Nascido de Baixo Peso , Infecção Hospitalar , Sepse NeonatalRESUMO
RESUMEN Existen pocos estudios acerca de la epidemiología de las infecciones respiratorias agudas graves tanto en la literatura mundial como en el país, los estudios se centran fundamentalmente en la epidemiologia y comportamiento de las IRA sin especificar que ocurre con las formas graves. Con la presente publicación se pretende caracterizar el comportamiento de las infecciones respiratorias agudas graves en la provincia Granma, marzo-mayo 2020. Para ello se realizó un estudio descriptivo, retrospectivo y transversal, teniendo en cuenta las siguientes variables: grupos de edad, sexo, municipio de residencia, antecedentes patológicos personales y diagnóstico. Obteniendo como resultados que el periodo que se describe resultaron hospitalizados 175 pacientes con IRAG. La tasa de incidencia de la provincia fue de 21,4 por 100 mil habitantes. Se notificaron casos en todos los municipios, el 62,9 % de los casos de IRAG se registraron en hombres y los de 65 y más años representaron el mayor porcentaje de casos. Se concluye que Bayamo el municipio de mayor tasa de incidencia, predominó el sexo masculino, las edades de 65 y más años, la hipertensión arterial fue la comorbilidad más referida y dentro de las formas clínicas la bronconeumonía.
ABSTRACT There are few studies on the epidemiology of severe acute respiratory infections in both world literature and the country, studies focus primarily on the epidemiology and behavior of undified IRAs that occur with severe forms. This publication is intended to characterize the behavior of severe acute respiratory infections in Granma province, March-May 2020. For this purpose, a descriptive, retrospective and transversal study was carried out, taking into account the following variables: age groups, sex, municipality of residence, personal pathological history and diagnosis. Obtaining as results that the period described was hospitalized 175 patients with IRAG. The incidence rate of the province was 21.4 per 100 thousand inhabitants. Cases were reported in all municipalities, 62.9% of IRAG cases were recorded in men and those in 65 and over accounted for the highest percentage of cases. It is concluded that Bayamo, the municipality with the highest incidence rate, dominated the male sex, the ages of 65 and older, high blood pressure was the most referred comorability and within the clinical forms bronchopneummony.
RESUMO Há poucos estudos sobre a epidemiologia de infecções respiratórias agudas graves tanto na literatura mundial quanto no país, os estudos focam principalmente na epidemiologia e comportamento de IRAs indignos que ocorrem com formas graves. Esta publicação pretende caracterizar o comportamento de infecções respiratórias agudas graves na província de Granma, março a maio de 2020. Para isso, foi realizado um estudo descritivo, retrospectivo e transversal, levando-se em conta as seguintes variáveis: faixas etárias, sexo, município de residência, histórico patológico pessoal e diagnóstico. Obtendo como resultados que o período descrito foi hospitalizado 175 pacientes com IRAG. A taxa de incidência da província foi de 21,4 por 100 mil habitantes. Os casos foram notificados em todos os municípios, 62,9% dos casos de IRAG foram registrados em homens e aqueles em 65 anos ou mais representaram o maior percentual de casos. Conclui-se que Bayamo, município com maior taxa de incidência, dominou o sexo masculino, com idades a 65 anos ou mais, a pressão alta foi a mais referida comorability e dentro das formas clínicas de broncopneummonia.
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Se describe el caso clínico de un adolescente de 18 años de edad con antecedentes patológicos personales de hipertensión arterial crónica esencial y obesidad de grado II, que fue atendido en el Hospital Pediátrico Provincial José Martí Pérez de Sancti Spíritus por presentar tos húmeda ocasional, fiebre y falta de aire. Inicialmente se diagnosticó neumonía en la base del pulmón derecho, que luego evolucionó a bronconeumonía. Durante su hospitalización se recibió el resultado de la prueba de reacción en cadena de la polimerasa en tiempo real, que fue positivo en el coronavirus SARS-CoV-2. Se logró estabilizar el cuadro clínico del paciente, el cual tuvo una evolución favorable; se le dio el alta hospitalaria tras cumplir el periodo de vigilancia epidemiológica.
The case report of an 18 years teenager with a personal pathological history of chronic essencial hypertension and grade II obesity, who was assisted in José Martí Provincial Pediatric Hospital from Sancti Spiritus due to occasional humid cough, fever and lack of air. Initially pneumonia was diagnosed at the base of the right lung, which became a bronchopneumonia later. During his hospitalization, the result of the polymerase reaction test in real time was received, which was positive in the coronavirus SARS-CoV-2. It was possible to stabilize the patient clinical pattern, which had a favorable clinical course; he was discharged after fulfilling the surveillance period.
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Broncopneumonia , Infecções por Coronavirus , Betacoronavirus , Adolescente , Hipertensão , ObesidadeRESUMO
Community-acquired pneumonia (CAP) diagnosis remains a challenge in paediatrics. Chest radiography is considered gold standard for definition of pneumonia, however no previous study assessed the relationship between immune response and radiographic-confirmed-pneumonia. We assessed association between cytokines/chemokines levels and radiographic abnormalities in children with CAP. Children < 5-years-old hospitalized with CAP were investigated in a prospective study at the Federal University of Bahia Hospital, Brazil. On admission, clinical data and biological samples were collected to investigate 20 aetiological agents and determine serum cytokines/chemokines levels; chest radiographs were performed. Among 158 patients, radiographic diagnosis of pneumonia was confirmed in 126(79.7%) and 17(10.8%) had pleural effusion. Viral, bacterial and pneumococcal infection were detected in 80(50.6%), 78(49.4%) and 37(23.4%) cases. By comparing the median concentrations of serum cytokines/chemokines between children with or without pleural effusion, interleukin(IL)-6 was higher (26.6[18.6-103.7] vs 3.0[0.0-19.8]; p < 0.001) among those with pleural effusion; and between children with or without radiographic-confirmed-pneumonia, IL-6 was higher in the first subgroup (4.5[0.0-23.4] vs 0.0[0.0-3.6]; p = 0.02) after having excluded cases with pleural effusion. Stratified analyses according to aetiology showed IL-6 increase in the radiographic-confirmed-pneumonia subgroup inside the pneumococcal infection (28.2[5.9-64.1] vs 0.0[0.0-0.0]; p = 0.03) subgroup. By multivariable analysis, with IL-6 as dependent variable, pneumococcal infection and pleural effusion showed independent association with IL-6 elevation [respective OR: 5.071 (95%CI = 2.226-11.548; p < 0.001) and 13.604 (95%CI = 3.463-53.449; p = 0.0001)]. Considering the cases without pleural effusion, the area under the curve of IL-6 to predict pneumococcal infection was 0.76 (95%CI = 0.66-0.86; p < 0.001). IL-6 increase is a potential biomarker of pneumococcal infection among children with CAP without pleural effusion upon admission.
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Quimiocinas/sangue , Citocinas/sangue , Pneumonia Pneumocócica/sangue , Biomarcadores/sangue , Brasil , Pré-Escolar , Infecções Comunitárias Adquiridas/sangue , Feminino , Hospitalização , Humanos , Lactente , Masculino , Infecções Pneumocócicas/sangue , Estudos Prospectivos , Radiografia/métodosRESUMO
BACKGROUND: Pertussis is a highly contagious disease of public health interest caused by the bacterium Bordetella pertussis. Although its incidence has decreased substantially after the introduction of a vaccination, the burden of the disease remains high. Although the paroxysmal phase is highly disabling, complications are uncommon and more prevalent in children than in adults. The most frequent neurological complication is encephalopathy, but seizures, paresis, paraplegia, ataxias, aphasias, and decerebration postures have also been described. The complication of decerebration postures has not been previously reported in adults. CASE PRESENTATION: We present a video case of an adult HIV patient with severe coughing paroxysms, post-tussive emesis and syncope, whose workup confirmed the diagnosis of a B. pertussis respiratory infection. During hospitalization, he had fluctuant encephalopathy and post-tussive decerebration postures following paroxysms. He was treated with antibiotic therapy and finally sent home without residual neurological deficits. CONCLUSION: This case illustrates the biological plausibility of neurologic complications of pertussis in adults, which, albeit rare, can cause important morbidities. Future research should explore whether there are differences in the clinical presentation, risk factors and pathophysiology of the disease among adults or interventions aimed at preventing or treating pertussis encephalopathy.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Bordetella pertussis/genética , Encefalopatias/complicações , Estado de Descerebração/complicações , HIV , Coqueluche/complicações , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/virologia , Antibacterianos/uso terapêutico , Bordetella pertussis/isolamento & purificação , Encefalopatias/tratamento farmacológico , Encefalopatias/microbiologia , Estado de Descerebração/tratamento farmacológico , Estado de Descerebração/microbiologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Fatores de Risco , Resultado do Tratamento , Coqueluche/tratamento farmacológico , Coqueluche/microbiologiaRESUMO
A dictiocaulose é uma afecção respiratória causada por helmintos do gênero Dictyocaulus spp., considerada potencial causa de queda na produtividade e morte de bovinos no Brasil e em outros países do mundo. Este trabalho descreve o relato de infecção por Dictyocaulus viviparus e dictiocaulose em bovinos no município de Londrina, PR. A associação das condições ambientais, nutricionais e imunológicas, juntamente com controle parasitário inadequado favoreceu o desenvolvimento da doença, ressaltando a importância da afecção no diagnóstico diferencial de doenças respiratórias dos bovinos na Região Sul do Brasil.(AU)
Dictyocaulosis is a respiratory disease caused by helminths of the genus Dictyocaulus spp., considered a potential cause of decline in the productivity and death of cattle in Brazil and in other countries of the world. This work describes a report of infection by Dictyocaulus viviparous and dictyocaulosis in cattle in Londrina, PR. The association of environmental, nutritional and immunological conditions, along with an inadequate parasitic control favored the development of the disease, emphasizing the importance of the disease as a differential diagnosis of the bovine respiratory diseases in the Southern Region of Brazil.(AU)
Dictiocaulosis es una enfermedad respiratoria causada por helmintos del género Dictyocaulus spp., considerada una causa potencial de declive en la productividad y muerte del ganado en Brasil y en otros países del mundo. Este trabajo describe el reporte de infección por Dictyocaulus viviparus y dictiocaulose en bovinos en Londrina, PR. La asociación de condiciones ambientales, nutricionales e inmunológicas, junto con un control parasitario inadecuado, favoreció el desarrollo de la enfermedad, destacando la importancia de la enfermedad como diagnóstico diferencial de enfermedades respiratorias bovinas en la Región Sur de Brasil.(AU)
Assuntos
Animais , Bovinos , Infecções por Dictyocaulus/diagnóstico , Infecções por Dictyocaulus/etiologia , Infecções por Dictyocaulus/patologia , Dictyocaulus/isolamento & purificação , Broncopneumonia/parasitologia , Complexo Respiratório Bovino , Brasil , Pneumopatias Parasitárias/veterináriaRESUMO
A dictiocaulose é uma afecção respiratória causada por helmintos do gênero Dictyocaulus spp., considerada potencial causa de queda na produtividade e morte de bovinos no Brasil e em outros países do mundo. Este trabalho descreve o relato de infecção por Dictyocaulus viviparus e dictiocaulose em bovinos no município de Londrina, PR. A associação das condições ambientais, nutricionais e imunológicas, juntamente com controle parasitário inadequado favoreceu o desenvolvimento da doença, ressaltando a importância da afecção no diagnóstico diferencial de doenças respiratórias dos bovinos na Região Sul do Brasil.
Dictyocaulosis is a respiratory disease caused by helminths of the genus Dictyocaulus spp., considered a potential cause of decline in the productivity and death of cattle in Brazil and in other countries of the world. This work describes a report of infection by Dictyocaulus viviparous and dictyocaulosis in cattle in Londrina, PR. The association of environmental, nutritional and immunological conditions, along with an inadequate parasitic control favored the development of the disease, emphasizing the importance of the disease as a differential diagnosis of the bovine respiratory diseases in the Southern Region of Brazil.
Dictiocaulosis es una enfermedad respiratoria causada por helmintos del género Dictyocaulus spp., considerada una causa potencial de declive en la productividad y muerte del ganado en Brasil y en otros países del mundo. Este trabajo describe el reporte de infección por Dictyocaulus viviparus y dictiocaulose en bovinos en Londrina, PR. La asociación de condiciones ambientales, nutricionales e inmunológicas, junto con un control parasitario inadecuado, favoreció el desarrollo de la enfermedad, destacando la importancia de la enfermedad como diagnóstico diferencial de enfermedades respiratorias bovinas en la Región Sur de Brasil.
Assuntos
Animais , Bovinos , Dictyocaulus/isolamento & purificação , Infecções por Dictyocaulus/diagnóstico , Infecções por Dictyocaulus/etiologia , Infecções por Dictyocaulus/patologia , Brasil , Broncopneumonia/parasitologia , Complexo Respiratório Bovino , Pneumopatias Parasitárias/veterináriaRESUMO
RESUMEN Introducción: las infecciones respiratorias agudas representan una de las primeras causas de atención médica en todo el mundo, tanto en la consulta ambulatoria como en la internación y se encuentran entre las primeras causas de mortalidad. Objetivo: caracterizar infecciones respiratorias agudas en pacientes ingresados en cuidados intensivos del Hospital Pediátrico Provincial Docente "Pepe Portilla", en el período de marzo 2016 a marzo de 2018. Métodos: se realizó un estudio observacional descriptivo y de corte transversal. La muestra quedó conformada por todos los pacientes que ingresaron con alguna infección respiratoria aguda en el período estudiado (n=261), seleccionados a partir de un muestreo no probabilístico. Para el procesamiento de la información obtenida se emplearon las técnicas de estadística descriptiva. Resultados: predominaron los pacientes del sexo masculino y menores de cinco años (43,3 %). La bronconeumonía (48,5 %) en menores de cinco años y la neumonía (39,2 %) en niños de seis a 10 años, fueron las formas clínicas más frecuentes. El abandono de la lactancia materna, la corta edad, el tabaquismo pasivo y la convivencia con animales, constituyeron los factores de riesgo de mayor incidencia. El derrame pleural paraneumónico fue la complicación intratorácica más representada (51,8 %). Conclusiones: los infantes masculinos y menores de cinco años son propensos a infecciones respiratorias graves, donde la neumonía resulta la forma clínica de mayor incidencia. Estas son un problema de salud en la provincia, que genera a su vez, altos costos hospitalarios.
ABSTRACT Introduction: acute respiratory infections represent one of the leading causes of medical care worldwide, both in outpatient and inpatient settings and are among the leading causes of mortality. Objective: to characterize acute respiratory infections in patients admitted the intensive care unit at "Pepe Portilla" Provincial Pediatric Teaching Hospital from March 2016 to March 2018. Methods: a descriptive, cross-sectional and observational study was conducted. The sample consisted of all patients admitted with an acute respiratory infection in the period studied (n=261), chosen from a non-probability sample. Descriptive statistical techniques were applied to process the information collected. Results: predominantly male patients under 5 years of age (43,3 %). Bronchopneumonia (48,5 %) in children younger than 5 years old and pneumonia (39,2 %) in children from 6 to 10 years were the most frequent clinical types. Weaning from breastfeeding, young age, passive smoking and cohabitation with animals were the risk factors with the highest incidence. Parapneumonic pleural effusion was the most represented intrathoracic complication, identifying the 51,8 %. Conclusions: male infants and children under 5 years of age are prone to severe respiratory infections, where pneumonia is the clinical type with the highest incidence. Severe respiratory infections in pediatric patients continue to be a health problem in the province, creating high hospital costs.
RESUMO
Background: Newborn calves are born immunosuppressed, hypogammaglobulinemic, immunologically immature, and therefore more vulnerable to many infectious diseases. During pregnancy, the fetal-placental environment is regulated by Th2-type cytokines that neutralize Th1 responses, an important factor for immune defense against viral agents. The ingestion and absorption of colostral immunoglobulins enhance the immunity of the neonate. However, the presence of maternal antibodies might negatively affect the success of parental vaccination in the first two months of life. This study aimed to evaluate the effecacy of parenteral vaccination in newborn calves with high titers of maternal antibodies against respiratory viruses. Materials, Methods & Results: Twenty-eight Holstein calves were allocated to the vaccinated group (VAC, n = 18) or an unvaccinated control group (NVAC, n = 10). The initial vaccination with 5 mL of a commercial vaccine occurred around the 14th day of life (D14) and the booster at D35. Respiratory and diarrhea symptoms were evaluated at D12, D14, D16, D20, D31, D36, D45, D53, and D60. Blood samples were taken for leukogram, haptoglobin, and seroneutralization of BVDV, BoHV-1, BRSV, and BPI3V, at the time of vaccination at D14 (T1), at booster (D35, T2), and 21 days after the booster (D56, T3). Despite the increased prevalence of BRD during the period of the study, no calves from either group exhibited respiratory disease at D12 or D14. In subsequent assessments, the frequency of BRD increased over time in the VAC group until it reached a maximum prevalence of 38.9% (7/18) at D31. In the NVAC group, the maximum prevalence observed was 40% at D45 and D60. A comparison of the frequencies for BRD cases showed a statistical trend at D36 (P = 0.07), with a higher prevalence for the NVAC group (30%) in relation to the VAC group (5.6%). For the NVAC group, a greater number of total...
Assuntos
Animais , Recém-Nascido , Bovinos , Animais Recém-Nascidos/imunologia , Broncopneumonia/imunologia , Broncopneumonia/veterinária , Complexo Respiratório Bovino/imunologia , Complexo Respiratório Bovino/prevenção & controle , Imunidade Materno-Adquirida , ColostroRESUMO
Background: Pasteurellosis is a common disease of cattle, pigs, and poultry, which rarely affects humans. In rabbits, therespiratory presentation of the disease is frequently reported. Clinical signs related to bronchopneumonia include sneezing, lung stertors, oculonasal discharge, dyspnea and cyanosis. Infection may lead to otitis, conjunctivitis, abscesses andsepsis. Furthermore, Pasteurella multocida infection may lead to sudden death without clinical manifestations. Reports ofpasteurellosis in rabbits are scarce in Brazil. Therefore, the objective of this article is to describe an outbreak of pasteurellosis with high mortality in a rabbity in the State of Santa Catarina, Brazil.Cases: Two adult rabbits were submitted for necropsy at the Veterinary Pathology Laboratory of the Instituto Federal Catarinense- Campus Concórdia, within an interval of twenty days. Herd was represented by 40 animals, of which six fattening rabbits andthree breeders died. Animals were kept in suspended cages with slatted floor. Clinical signs were represented by prostration,sneezing, and mucopurulent nasal discharge. In addition, wounds were observed in the distal portion of the limbs. Death occurredup to two days after the onset of clinical signs. Necropsies were performed and tissue samples were collected for histopathologic,immunohistochemical and microbiologic (bacterial culture and antibiogram) exams. At the necropsy, severe diffuse fibrinousexudate covering the pericardium sac, visceral and parietal pleural surfaces was noted, as well as multiple diaphragm adhesions.In addition, the lungs presented diffuse red coloration and showed multiple abscesses ranging from 0.3 to 1cm in diameter. Thenasal sinus and the tracheal mucosa showed diffuse reddening (rabbits 1 and 2). Abscesses up to 2 cm in diameter were observedin the mammary glands (rabbit 1), heart and kidneys (rabbit 2). The urinary bladder...(AU)