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Journal of Clinical Medicine Dec 2022Extra-pulmonary features sometimes occur in association with atypical bacterial pneumonia and include neurologic manifestations, diarrhea, rashes, altered liver enzymes,... (Review)
Review
BACKGROUND
Extra-pulmonary features sometimes occur in association with atypical bacterial pneumonia and include neurologic manifestations, diarrhea, rashes, altered liver enzymes, or kidney injury, among other conditions. Acute pancreatitis has been associated with atypical pneumonias since 1973.
METHODS
We performed a systematic review of the literature in the Excerpta Medica, National Library of Medicine, and Web of Science databases. We retained 27 reports published between 1973 and 2022 describing subjects with an otherwise unexplained pancreatitis temporally associated with an atypical pneumonia.
RESULTS
The reports included 33 subjects (19 males, and 14 females; 8 children and 25 adults) with acute pancreatitis temporally associated with atypical pneumonia caused by ( = 18), species ( = 14), or ( = 1). Approximately 90% of patients ( = 29) concurrently presented with respiratory and pancreatic diseases. No cases associated with , , or species were found.
CONCLUSIONS
Acute pancreatitis has been associated with various infectious agents. The present review documents the association with atypical pneumonia induced by , species, and .
PubMed: 36498822
DOI: 10.3390/jcm11237248 -
International Journal of Molecular... Nov 2022Guillain-Barré syndrome (GBS) is a rare immune-mediated acute polyradiculo-neuropathy that typically develops after a previous gastrointestinal or respiratory... (Review)
Review
Guillain-Barré syndrome (GBS) is a rare immune-mediated acute polyradiculo-neuropathy that typically develops after a previous gastrointestinal or respiratory infection. This narrative overview aims to summarise and discuss current knowledge and previous evidence regarding triggers and pathophysiology of GBS. A systematic search of the literature was carried out using suitable search terms. The most common subtypes of GBS are acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). The most common triggers of GBS, in three quarters of cases, are previous infections. The most common infectious agents that cause GBS include , , and cytomegalovirus. is responsible for about a third of GBS cases. GBS due to is usually more severe than that due to other causes. Clinical presentation of GBS is highly dependent on the structure of pathogenic lipo-oligosaccharides (LOS) that trigger the innate immune system via Toll-like-receptor (TLR)-4 signalling. AIDP is due to demyelination, whereas in AMAN, structures of the axolemma are affected in the nodal or inter-nodal space. In conclusion, GBS is a neuro-immunological disorder caused by autoantibodies against components of the myelin sheath or axolemma. Molecular mimicry between surface structures of pathogens and components of myelin or the axon is one scenario that may explain the pathophysiology of GBS.
Topics: Humans; Amantadine; Autoantibodies; Axons; Campylobacter jejuni; Guillain-Barre Syndrome
PubMed: 36430700
DOI: 10.3390/ijms232214222 -
The Ocular Surface Apr 2023Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the... (Review)
Review
Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the setting of Mycoplasma infection. Though a clinically distinct disease, MIRM exists on a diagnostic continuum with entities including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and the recently described reactive infectious mucocutaneous eruption (RIME). In this systematic review, we discuss published findings on the epidemiology, clinical manifestations, diagnosis, and management of MIRM, with an emphasis on ocular disease. Lastly, we discuss some of the most recent developments and challenges in characterizing MIRM with respect to the related diagnosis of RIME.
Topics: Humans; Mucositis; Mycoplasma pneumoniae; Stevens-Johnson Syndrome; Eye; Exanthema
PubMed: 36396020
DOI: 10.1016/j.jtos.2022.11.007 -
Brain Sciences Sep 2022(1) Introduction: Tourette syndrome (TS) and chronic tic disorder (CTD) are common neurodevelopmental/-psychiatric disorders. The aetiological factors that contribute to... (Review)
Review
(1) Introduction: Tourette syndrome (TS) and chronic tic disorder (CTD) are common neurodevelopmental/-psychiatric disorders. The aetiological factors that contribute to the pathogenesis of TS/CTD are still poorly understood. The possible risk factors for TS/CTD are considered to be a combination of genetic, immunological, psychological and environmental factors. A comprehensive systematic review was conducted to assess the association between aetiological factors and TS/CTD. (2) Methods: Electronic databases, including PubMed, Embase, Web of Science, Wanfang data, and CNKI, were searched to identify the etiological factors of children and adolescents (≤18 years) with TS/CTD based on a case-control study. Quality assessments were performed according to the Newcastle-Ottawa scale (NOS). (3) Results: According to sample sizes and NOS values, recent evidence may support that genetic factors ( and ), immunological factors (streptococcus and mycoplasma pneumoniae infections), environmental factors (conflict, history of perinatal diseases, and family history of neurological and psychiatric diseases and recurrent respiratory infections) and psychological factors (major life events) are associated with the pathogenesis of TS/CTD. (4) Conclusions: Some risk factors in different categories may be the etiological factors of TS/CTD, but there is a lack of studies on the interaction among the factors, which may require more attention in the future.
PubMed: 36138938
DOI: 10.3390/brainsci12091202 -
Frontiers in Medicine 2022Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, life-threatening immunologic reactions. Prior studies using electronic health records,...
BACKGROUND
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, life-threatening immunologic reactions. Prior studies using electronic health records, registries or reporting databases are often limited in sample size or lack clinical details. We reviewed diverse detailed case reports published over four decades.
METHODS
Stevens-Johnson syndrome and toxic epidermal necrolysis-related case reports were identified from the MEDLINE database between 1980 and 2020. Each report was classified by severity (i.e., SJS, TEN, or SJS-TEN overlap) after being considered a "probable" or "definite" SJS/TEN case. The demographics, preconditions, culprit agents, clinical course, and mortality of the cases were analyzed across the disease severity.
RESULTS
Among 1,059 "probable" or "definite" cases, there were 381 (36.0%) SJS, 602 (56.8%) TEN, and 76 (7.2%) SJS-TEN overlap cases, with a mortality rate of 6.3%, 24.4%, and 21.1%, respectively. Over one-third of cases had immunocompromised conditions preceding onset, including cancer ( = 194,18.3%), autoimmune diseases ( = 97, 9.2%), and human immunodeficiency virus (HIV) ( = 52, 4.9%). During the acute phase of the reaction, 843 (79.5%) cases reported mucous membrane involvement and 210 (19.8%) involved visceral organs. Most cases were drug-induced ( = 957, 90.3%). A total of 379 drug culprits were reported; the most frequently reported drug were antibiotics ( = 285, 26.9%), followed by anticonvulsants ( = 196, 18.5%), analgesics/anesthetics ( = 126, 11.9%), and antineoplastics ( = 120, 11.3%). 127 (12.0%) cases reported non-drug culprits, including infections ( = 68, 6.4%), of which 44 were associated with a mycoplasma pneumoniae infection and radiotherapy ( = 27, 2.5%).
CONCLUSION
An expansive list of potential causative agents were identified from a large set of literature-reported SJS/TEN cases, which warrant future investigation to understand risk factors and clinical manifestations of SJS/TEN in different populations.
PubMed: 36091694
DOI: 10.3389/fmed.2022.949520 -
JAMA Network Open Jul 2022The proportion of macrolide-resistant Mycoplasma pneumoniae (MRMP) infections has changed, and it differs according to geographical region. (Meta-Analysis)
Meta-Analysis
IMPORTANCE
The proportion of macrolide-resistant Mycoplasma pneumoniae (MRMP) infections has changed, and it differs according to geographical region.
OBJECTIVE
To analyze the global patterns, including the temporal trends, regional variations, and variant types, in the proportion of MRMP infections in this systematic review and meta-anaysis.
DATA SOURCES
PubMed, Cochrane Library, and Embase databases were searched for observational studies from inception to September 10, 2021.
STUDY SELECTION
Observational studies reporting the proportion of MRMP infections were screened independently by 2 authors. The presence of MRMP infection was defined as any case of M pneumoniae infection positive for any variants associated with macrolide resistance identified using respiratory samples.
DATA EXTRACTION AND SYNTHESIS
Data were extracted independently and in duplicate by 2 reviewers. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was used. Random-effects meta-analyses were used to estimate the proportion of MRMP infections.
MAIN OUTCOMES AND MEASURES
The global patterns in the proportion of MRMP infections were estimated, and the temporal trends and variant types of MRMP infection with regional differences were investigated.
RESULTS
This study included 153 studies from 150 articles (27 408 samples in 26 countries) in the meta-analysis. The global patterns in the proportion of MRMP infections showed an increasing trend with regional differences. The proportion of MRMP infections was highest in the Western Pacific regions (53.4%; 95% CI, 47.4%-60.3%), followed by the South East Asian region (9.8%; 95% CI, 0.8%-100%), the region of the Americas (8.4%; 95% CI, 6.1%-11.6%), and the European region (5.1%; 95% CI, 3.3%-8.0%). The most commonly identified variant of MRMP infection was A2063G (96.8%; 95% CI, 95.8%-97.7%), followed by A2064G (4.8%; 95% CI, 3.5%-6.7%). The proportion of MRMP infections was the highest in studies including only children (37.0%; 95% CI, 29.8%-46.1%), followed by those including only adults (15.9%; 95% CI, 6.4%-39.7%) and those including both children and adults (16.7%; 95% CI, 10.1%-27.6%).
CONCLUSIONS AND RELEVANCE
This study provides global trends in the proportion of MRMP infections and suggests that strategies to prevent the spread of MRMP infection and to treat MRMP infections are needed to decrease disease burden.
Topics: Adult; Anti-Bacterial Agents; Child; Drug Resistance, Bacterial; Humans; Macrolides; Microbial Sensitivity Tests; Pneumonia, Mycoplasma; United States
PubMed: 35816304
DOI: 10.1001/jamanetworkopen.2022.20949 -
Journal of Immunology Research 2022Mycoplasma pneumoniae is a common pathogen of community-acquired pneumonia (CAP) in children. infection is usually regarded as a self-limiting disease, but in some... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mycoplasma pneumoniae is a common pathogen of community-acquired pneumonia (CAP) in children. infection is usually regarded as a self-limiting disease, but in some special cases, it can also develop into refractory Mycoplasma pneumoniae pneumonia (RMPP). The aim of this study is to analyze the clinical characteristics of CRP (C-reactive protein), LDH (lactate dehydrogenase), ESR (erythrocyte sedimentation rate), , neutrophils (%), lymphocytes (%), and lung consolidation in RMPP and explore their prediction results in the early stage of RMPP, which is important for early treatment.
METHODS
This systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang, and Cqvip, and the date was set until February 23, 2021. For the continuous variables, mean difference (MD) with 95% CI was adopted to evaluate CRP, LDH, ESR, D-dimer, neutrophils (%), lymphocytes (%), and the correlation between lung consolidation and RMPP.
RESULTS
20 studies including 5289 patients were included in the analysis, and the results showed that the CRP of the RMPP group (MD (95% CI): 22.29 (12.20, 32.38), < 0.001), LDH (MD (95% CI): 145.13 (78.62, 211.64), < 0.001), neutrophils (%) (MD (95% CI): 7.27 (0.31, 14.23), = 0.04), and D-dimer (MD (95% CI): 1.79 (-1.17, 4.74), = 0.24) was higher than that of the NRMPP group; the risk of lung consolidation in the RMPP group (OR (95% CI): 14.29 (4.52, 45.12), < 0.001) was higher than that in the NRMPP group, and there was no difference in ESR (MD (95% CI): 8.11 (-1.34, 17.56), = 0.09) and lymphocytes (%) (MD (95% CI): -6.27 (-12.81, 0.27), = 0.06) between the two groups.
CONCLUSION
So, the available evidence indicates that CRP, LDH, neutrophils (%), , and lung consolidation are predictive factors for RMPP.
Topics: Blood Sedimentation; C-Reactive Protein; Child; Humans; L-Lactate Dehydrogenase; Mycoplasma pneumoniae; Pneumonia, Mycoplasma
PubMed: 35795531
DOI: 10.1155/2022/9227838 -
The Journal of Antimicrobial... Aug 2022To determine the prevalence of resistance to macrolides in Mycoplasma pneumoniae worldwide. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To determine the prevalence of resistance to macrolides in Mycoplasma pneumoniae worldwide.
METHODS
Prior to 12 December 2020, PubMed, Web of Science, Scopus and Embase databases were searched for epidemiological studies of M. pneumoniae resistance. Two reviewers independently extracted data from included studies. The extracted data include sampling population, total sampling number, the number of resistant strains and the molecular subtype of resistant strains. The estimate of resistance prevalence was calculated using the random-effects model.
RESULTS
A total of 17 873 strains were obtained from five continents and reported in 98 investigations between 2000 and 2020, with 8836 strains characterized as macrolide resistant. In summary, macrolide-resistant M. pneumoniae was most common in Asia (63% [95% CI 56, 69]). In Europe, North America, South America and Oceania, the prevalence was 3% [2, 7], 8.6% [6, 11], 0% and 3.3%, respectively. Over the last 20 years, the prevalence of macrolide-resistant M. pneumoniae has remained high in China (81% [73, 87]), with a significant increasing trend in South Korea (4% [1, 9] to 78% [49, 93], P < 0.0001). Furthermore, a point mutation at 2063 from A to G was mostly related to M. pneumoniae macrolide resistance. In terms of clinical outcomes, longer cough (mean difference [MD]: 2.93 [0.26, 5.60]) and febrile days (MD: 1.52 [1.12, 1.92]), and prolonged hospital stays (MD: 0.76 [0.05, 1.46]) might be induced by macrolide-resistant M. pneumoniae pneumonia.
CONCLUSIONS
The incidence of macrolide-resistant M. pneumoniae varies globally, with eastern Asia having a greater degree of resistance. However, attention is also required in other areas, and antibiotic alternatives should be considered for treatment in high-prevalence countries.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Humans; Macrolides; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Prevalence; RNA, Ribosomal, 23S
PubMed: 35678262
DOI: 10.1093/jac/dkac170 -
New Microbes and New Infections 2022Stroke is considered as one of the most important concerns in health care centers around the world. By definition there are two types of stroke including ischemic stroke...
BACKGROUND
Stroke is considered as one of the most important concerns in health care centers around the world. By definition there are two types of stroke including ischemic stroke and hemorrhagic stroke. Approximately three-quarters of stroke cases are ischemic strokes, which occur due to several risk factors such as hypertension, obesity, atherosclerosis, diabetes mellitus, osteoarthritis, and inflammatory responses. In recent years, infectious diseases have noticed as a new risk factor for ischemic stroke. Given the importance of the issue, some bacteria that cause chronic infections, especially , , , , and have been considered.
METHODS
In the present meta-analysis, we reviewed 50 case-control studies and assessed the possible association of bacterial infections with the occurrence of ischemic stroke.
RESULTS
We analyzed the information of 33,978 participants in several nested case-control studies, and ultimately showed that bacterial infections could increase the risk of ischemic stroke. Our results suggest that bacterial infections significantly increase in the risk of ischemic stroke (OR: 1.704; 1.57-1.84 with 95% CIs; value = 0.01).
CONCLUSIONS
In this meta-analysis, a significant relationship was observed between infection by three bacteria such as , , and with the occurrence of ischemic stroke. Furthermore, due to the similarity between TLRVYK domain in β2-glycoprotein-I and TLRVYK peptide in various of microorganisms, produced antibodies against pathogens interact with β2-glycoprotein-I, hence the cross-reaction phenomenon increases the positive relationship between infectious diseases and ischemic stroke.
PubMed: 35592534
DOI: 10.1016/j.nmni.2022.100980 -
Journal of Global Health 2022Childhood pneumonia presents a large global burden, though most data and guidelines focus on children less than 5 years old. Less information is available about the...
BACKGROUND
Childhood pneumonia presents a large global burden, though most data and guidelines focus on children less than 5 years old. Less information is available about the clinical presentation of pneumonia in children 5-9 years of age. Appropriate diagnostic and treatment algorithms may differ from those applied to younger children. This systematic literature review aimed to identify clinical features of pneumonia in children aged 5-9 years, with a focus on delineation from other age groups and comparison with existing WHO guidance for pneumonia in children less than 5 years old.
METHODS
We searched MEDLINE, EMBASE and PubMed databases for publications that described clinical features of pneumonia in children 5-9 years old, from any country with no date restriction in English. The quality of included studies was evaluated using a modified Effective Public Health Project Practice (EPHPP) tool. Data relating to research context, study type, clinical features of pneumonia and comparisons with children less than 5 years old were extracted. For each clinical feature of pneumonia, we described mean percentage (95% confidence interval) of participants with this finding in terms of aetiology (all cause vs ), and method of diagnosis (radiological vs clinical).
RESULTS
We included 15 publications, eight addressing all-cause pneumonia and seven addressing . Cough and fever were common in children aged 5-9 years with pneumonia. Tachypnoea was documented in around half of patients. Dyspnoea/difficulty breathing and chest indrawing were present in approximately half of all-cause pneumonia cases, with no data on indrawing in the outpatient setting. Chest and abdominal pain were documented in around one third of cases of all-cause pneumonia, based on limited numbers. In addition to markers of pneumonia severity used in children <5 years, pallor has been identified as being associated with poorer outcomes alongside comorbidities and nutritional status.
CONCLUSIONS
Quality research exploring clinical features of pneumonia, treatment and outcomes in children aged 5-9 years using consistent inclusion criteria, definitions of features and age ranges are urgently needed to better inform practice and guidelines. Based on limited data fever and cough are common in this age group, but tachypnoea cannot be relied on for diagnosis. While waiting for better evidence, broader attention to features such as chest and abdominal pain, the role of chest radiographs for diagnosis in the absence of symptoms such as tachypnoea, and risk factors which may influence patient disposition (chest indrawing, pallor, nutritional status) warrant consideration by clinicians.
PROTOCOL REGISTRATION
PROSPERO: CRD42020213837.
Topics: Child; Child, Preschool; Cough; Fever; Humans; Pneumonia
PubMed: 35356655
DOI: 10.7189/jogh.12.10002