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Intensive Care Medicine Feb 2020An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading... (Review)
Review
An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading reason for ICU admission. Identifying the cause of ARF increases the chances of survival, but may be extremely challenging, as the underlying disease, treatments, and infection combine to create complex clinical pictures. In addition, there may be more than one infectious agent, and the pulmonary manifestations may be related to both infectious and non-infectious insults. Clinically or microbiologically documented bacterial pneumonia accounts for one-third of cases of ARF in immunocompromised patients. Early antibiotic therapy is recommended but decreases the chances of identifying the causative organism(s) to about 50%. Viruses are the second most common cause of severe respiratory infections. Positive tests for a virus in respiratory samples do not necessarily indicate a role for the virus in the current acute illness. Invasive fungal infections (Aspergillus, Mucorales, and Pneumocystis jirovecii) account for about 15% of severe respiratory infections, whereas parasites rarely cause severe acute infections in immunocompromised patients. This review focuses on the diagnosis of severe respiratory infections in immunocompromised patients. Special attention is given to newly validated diagnostic tests designed to be used on non-invasive samples or bronchoalveolar lavage fluid and capable of increasing the likelihood of an early etiological diagnosis.
Topics: Humans; Immunocompromised Host; Intensive Care Units; Invasive Fungal Infections; Parasitic Diseases; Pneumonia, Bacterial; Respiratory Insufficiency; Respiratory Tract Infections
PubMed: 32034433
DOI: 10.1007/s00134-019-05906-5 -
Indian Journal of Dermatology,... 2018Herpes zoster is a major health burden that can affect individuals of any age. It is seen more commonly among individuals aged ≥50 years, those with immunocompromised... (Review)
Review
Herpes zoster is a major health burden that can affect individuals of any age. It is seen more commonly among individuals aged ≥50 years, those with immunocompromised status, and those on immunosuppressant drugs. It is caused by a reactivation of varicella zoster virus infection. Cell-mediated immunity plays a role in this reactivation. Fever, pain, and itch are common symptoms before the onset of rash. Post-herpetic neuralgia is the most common complication associated with herpes zoster. Risk factors and complications associated with herpes zoster depend on the age, immune status, and the time of initializing treatment. Routine vaccination for individuals over 60 years has shown considerable effect in terms of reducing the incidence of herpes zoster and post-herpetic neuralgia. Treatment with antiviral drugs and analgesics within 72 hours of rash onset has been shown to reduce severity and complications associated with herpes zoster and post-herpetic neuralgia. This study mainly focuses on herpes zoster using articles and reviews from PubMed, Embase, Cochrane library, and a manual search from Google Scholar. We cover the incidence of herpes zoster, gender distribution, seasonal and regional distribution of herpes zoster, incidence of herpes zoster among immunocompromised individuals, incidence of post-herpetic neuralgia following a zoster infection, complications, management, and prevention of herpes zoster and post-herpetic neuralgia.
Topics: Adrenal Cortex Hormones; Antiviral Agents; Electric Stimulation Therapy; Herpes Zoster; Humans; Immunocompromised Host; Incidence; Neuralgia, Postherpetic; Risk Factors; Sex Factors; Treatment Outcome
PubMed: 29516900
DOI: 10.4103/ijdvl.IJDVL_1021_16 -
Radiologic Clinics of North America Sep 2011Pneumonia is an infection of the lung parenchyma caused by a wide variety of organisms in pediatric patients. The role of imaging is to detect the presence of pneumonia,... (Review)
Review
Pneumonia is an infection of the lung parenchyma caused by a wide variety of organisms in pediatric patients. The role of imaging is to detect the presence of pneumonia, and determine its location and extent, exclude other thoracic causes of respiratory symptoms, and show complications such as effusion/empyema and suppurative lung changes. The overarching goal of this article is to review cause, role of imaging, imaging techniques, and the spectrum of acute and chronic pneumonias in children. Pneumonia in the neonate and immunocompromised host is also discussed.
Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunocompromised Host; Infant; Infant, Newborn; Lung; Male; Pneumonia; Tomography, X-Ray Computed; Ultrasonography
PubMed: 21889014
DOI: 10.1016/j.rcl.2011.06.007 -
F1000Research 2021Invasive fungal diseases due to resistant yeasts and molds are an important and increasing public health threat, likely due to a growing population of immunosuppressed... (Review)
Review
Invasive fungal diseases due to resistant yeasts and molds are an important and increasing public health threat, likely due to a growing population of immunosuppressed hosts, increases in antifungal resistance, and improvements in laboratory diagnostics. The significant morbidity and mortality associated with these pathogens bespeaks the urgent need for novel safe and effective therapeutics. This review highlights promising investigational antifungal agents in clinical phases of development: fosmanogepix, ibrexafungerp, rezafungin, encochleated amphotericin B, oteseconazole (VT-1161), VT-1598, PC945, and olorofim. We discuss three first-in-class members of three novel antifungal classes, as well as new agents within existing antifungal classes with improved safety and tolerability profiles due to enhanced pharmacokinetic and pharmacodynamic properties.
Topics: Antifungal Agents; Drug Resistance, Fungal; Fungi; Immunocompromised Host
PubMed: 35136573
DOI: 10.12688/f1000research.28327.2 -
The Lancet. Infectious Diseases Sep 2022
Topics: COVID-19; Drug Combinations; Humans; Immunocompromised Host; Lactams; Leucine; Nitriles; Proline; Ritonavir; SARS-CoV-2
PubMed: 35843259
DOI: 10.1016/S1473-3099(22)00430-3 -
The Journal of Allergy and Clinical... Jul 2022
Topics: Antibodies, Viral; COVID-19; COVID-19 Vaccines; Humans; Immunocompromised Host; SARS-CoV-2; Vaccination
PubMed: 35568078
DOI: 10.1016/j.jaci.2022.05.001 -
Emerging Infectious Diseases Sep 2023We describe a case in Australia of human neural larva migrans caused by the ascarid Ophidascaris robertsi, for which Australian carpet pythons are definitive hosts. We...
We describe a case in Australia of human neural larva migrans caused by the ascarid Ophidascaris robertsi, for which Australian carpet pythons are definitive hosts. We made the diagnosis after a live nematode was removed from the brain of a 64-year-old woman who was immunosuppressed for a hypereosinophilic syndrome diagnosed 12 months earlier.
Topics: Female; Animals; Humans; Middle Aged; Larva Migrans; Australia; Ascaridoidea; Brain; Immunocompromised Host
PubMed: 37610238
DOI: 10.3201/eid2909.230351 -
Ugeskrift For Laeger Mar 2023Norovirus is generally an acute infection causing symptoms such as diarrhea, nausea, and vomiting lasting for 24-48 hours. However, for immunocompromised patients,...
Norovirus is generally an acute infection causing symptoms such as diarrhea, nausea, and vomiting lasting for 24-48 hours. However, for immunocompromised patients, norovirus gastroenteritis can last for several years and result in villous atrophy and lead to severe malnutrition, dehydration, electrolyte imbalance and continuous viral shedding. Several treatment strategies have been suggested in case reports: nitazoxanide, ribavirin and enterally administered immunoglobulin with varying results. Favipiravir is also suggested but not tested on humans, highlighting the need for further research.
Topics: Humans; Gastroenteritis; Norovirus; Diarrhea; Caliciviridae Infections; Immunocompromised Host
PubMed: 36999295
DOI: No ID Found -
Clinical Infectious Diseases : An... Mar 2023The management of patients with prolonged viral shedding and coronavirus disease 2019 symptoms remains unclear. Combining antivirals, as practiced in other infections,...
The management of patients with prolonged viral shedding and coronavirus disease 2019 symptoms remains unclear. Combining antivirals, as practiced in other infections, is theoretically advantageous. We present a case of persistent, symptomatic severe acute respiratory syndrome coronavirus 2 infection and associated organizing pneumonia that was successfully treated with an extended course of combination antiviral therapy.
Topics: Humans; COVID-19; SARS-CoV-2; Organizing Pneumonia; Antiviral Agents; Immunocompromised Host
PubMed: 36281907
DOI: 10.1093/cid/ciac847 -
Clinics in Chest Medicine Jun 2023Immunocompromised hosts, which encompass a diverse population of persons with malignancies, human immunodeficiency virus disease, solid organ, and hematologic... (Review)
Review
Immunocompromised hosts, which encompass a diverse population of persons with malignancies, human immunodeficiency virus disease, solid organ, and hematologic transplants, autoimmune diseases, and primary immunodeficiencies, bear a significant burden of the morbidity and mortality due to coronavirus disease-2019 (COVID-19). Immunocompromised patients who develop COVID-19 have a more severe illness, higher hospitalization rates, and higher mortality rates than immunocompetent patients. There are no well-defined treatment strategies that are specific to immunocompromised patients and vaccines, monoclonal antibodies, and convalescent plasma are variably effective. This review focuses on the specific impact of COVID-19 in immunocompromised patients and the gaps in knowledge that require further study.
Topics: Humans; COVID-19; SARS-CoV-2; COVID-19 Serotherapy; Immunocompromised Host
PubMed: 37085228
DOI: 10.1016/j.ccm.2022.11.012