Necrotizing pneumonia complicated by early and late pneumatoceles

Community-acquired pneumonia generally has a benign course when treated, but can be complicated by pleural effusion, empyema, lung abscesses, necrotizing pneumonia or pneumatoceles. Pneumatoceles can cause cardiorespiratory compromise requiring urgent intervention. A child with a severe necrotizing pneumonia, as well as a large early pneumatocele complicating mechanical ventilation, is presented. While pneumonectomy resulted in transient improvement, the course was further complicated by multiple late occurring pneumatoceles that ultimately led to the patient’s death.     

夫西地酸治疗37例耐甲氧西林金黄色葡萄球菌性呼吸机相关性肺炎临床观察

目的 观察夫西地酸治疗耐甲氧西林金黄色葡萄球菌性呼吸机相关性肺炎临床疗效.方法 选择耐甲氧西林金黄色葡萄球菌性呼吸机相关性肺炎患者37例.应用夫西地酸钠0.5 g加入0.9%氯化钠注射液250 ml中,静脉滴注,1次/8 h,60 min滴入,连用10～14 d,观察其临床疗效、细菌清除率、肝肾功能变化、不良反应.结果夫西地酸治疗耐甲氧西林金黄色葡萄球菌性呼吸机相关性肺炎临床治愈率为67.6%,有效率为86.5%.细菌清除率为62.2%;治疗过程中对肝肾功能无明显影响;无明显不良反应.结论 夫西地酸作为一种安全性较高的药物,对耐甲氧西林金黄色葡萄球菌性呼吸机相关性肺炎效果较好.对于老年和(或)肾功能不良(或潜在不良)患者,可选择该药治疗.     

支原体肺炎的 X 线诊断

报告１１８例经病原学和血清学证实的儿童及青年支原体肺炎的Ｘ线表现，胸部Ｘ线表现明显而临床体征轻。１１８例支原体肺炎按Ｘ线表现分为：①间质性改变５８例，弥漫和局限性分布。②节段性炎症改变５５例，小叶分布为主，大叶分布改变６例。③胸膜及肺门淋巴结病变。支原体肺炎的Ｘ线表现有多种表现形式，要与支气管炎、细菌性肺炎、肺门淋巴结核鉴别，所以Ｘ线检查对支原体肺炎的诊断有指导意义     

感染腺病毒人气管及肺器官组织培养的形态学观察

对感染Ⅲ型腺病毒人气管及肺器官培养组织进行了动态的形态学观察。在接种病毒后8～15天出现了特异性包含体,主要分布在细支气管和呼吸性支气管上皮细胞,也可见于大支气管上皮细胞及腺细胞。与包含体细胞相邻的上皮细胞生长良好,未见腺病毒肺炎时常见的大片坏死,说明单纯腺病毒的直接杀细胞作用不是引起腺病毒肺炎时组织严重坏死的主要机理。     

3种方案治疗老年性肺炎的成本-效果分析

目的：探讨不同药物的治疗方案对同一疾病所产生的经济效果。方法:采用回顾性研究方法，对经确诊 为老年性肺炎的住院患者115例,根据治疗方案不同分为3组,A组: 头孢呋辛+左氧氟沙星；B组: 头孢地嗪；C组:头孢派 酮舒巴坦。应用药物经济学成本-效果分析法进行比较。结果:A,B,C组成本依次为3 073.46元,4 248.96元,4 955.89元 ，有效率分别为84.6%,85.0%,86.1%，敏感性分析结果均与参数改变前的结果基本一致。结论:A组治疗方案优于B组、C 组。     

细菌性肺炎患儿肠道微生态及其与血FOXP3、G-CSF水平的关系

目的研究细菌性肺炎患儿肠道微生态及其与血清转录因子叉头蛋白(FOXP3)、粒细胞-巨噬细胞集落刺激因子(G-CSF)水平的关系。 方法选择细菌性肺炎患儿120例为肺炎组,其中轻度组55例,重度组65例,另选取同期健康体检患儿120例为对照组。比较各组肠道微生物、血清FOXP3、G-CSF水平,分析肠道微生物与FOXP3、G-CSF水平的相关性。 结果肺炎组乳杆菌、双歧杆菌、肠球菌及真杆菌水平低于对照组；重度组乳杆菌、双歧杆菌、肠球菌及真杆菌低于轻度组；肺炎组FOXP3、G-CSF高于对照组,重度组FOXP3、G-CSF高于轻度组(P＜0.05)。双歧杆菌、肠球菌、乳杆菌及真杆菌与FOXP3、G-CSF呈负相关(P＜0.05)。 结论细菌性肺炎患儿肠道微生态与肺炎病情程度有关,且与血清FOXP3、G-CSF呈负相关。     

依替米星联合三代头孢菌素治疗老年社区获得性肺炎的临床研究

目的评价硫酸依替米星联合三代头孢菌素与单独使用三代头孢菌素治疗老年非重症社区获得性肺炎的疗效。方法回顾分析60例老年非重症社区获得性肺炎患者使用依替米星200mg1次／d静点联合应用三代头孢菌素抗炎治疗，对照组54例老年非重症社区获得性肺炎患者单独使用三代头孢菌素治疗，观察两组的治疗效果及不良反应。结果两组有效率分别为83．3％，66．7％，两组住院的平均天数分别为12．51±8．63天和16．25±9．74天，均有显著差别（P〈0．05）。观察组住院费用及药费均少于对照组。观察组发生皮疹2例，不良反应发生率1．6％，未出现肾损害及其他不良反应。结论依替米星联合三代头孢用于治疗老年非重症社区获得性肺炎是安全有效的，同单独应用三代头孢菌素相比可以减少住院时间及医疗费用。     

New insights into pneumococcal disease

Streptococcus pneumoniae (pneumococcus) remains a common cause of disease and death throughout the world. Despite considerable research into various aspects of this infection, there still remain a number of unresolved issues, as well as considerable ongoing controversies, particularly with regard to its optimal management. Among the risk factors for pneumococcal pneumonia, cigarette smoking has been shown to play a major role, more recently among HIV-infected individuals. Considerable recent research has focused on determining the role of the various protein virulence factors in disease pathogenesis. Among the ongoing controversies has been an appreciation of the true impact of antimicrobial resistance on the outcome of pneumococcal infections, as well an understanding of the role of combination antibiotic therapy in the more severely ill hospitalized cases. An important advance in the prevention of pneumococcal infections has been the introduction of the pneumococcal protein conjugate vaccine.     

Acquired Immunodeficiency Syndrome (AIDS)

The Acquired Immunodeficiency Syndrome (AIDS), caused by the human immunodeficiency virus (HIV), also called the human T-lymphotropic virus type III/lymphadenopathy-associated virus [HTLV-III/LAV], has affected over 23,000 people; more than half of those with the disease have died. The actual case fatality rate approaches 100%. AIDS affects all groups and classes of people, although some are at special risk. Distribution of the disease is worldwide. The illness' effects on the body are widespread; of special interest are the ophthalmologic manifestations. The eye may be infected by various viruses (cytomegalovirus, varicella-zoster virus, herpes simples virus or HIV itself), toxoplasma gondii, candida sp, cryptococcus neoformans, M. tuberculosis, or M. avium-intracellulare. Kaposi's sarcoma may affect the eye as well. Retinal vascular abnormalities (e.g., cotton-wool spots, vasculitis) are not uncommon in AIDS. The syndrome may present with neuro-ophthalmologic manifestations. No effective treatment for the illness is currently available, although several hold promise and there is hope for an AIDS vaccine. Prevention of infection through reduction of risks appears to be the only defense against AIDS at this time.