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重症社区获得性肺炎的临床表现及转归

Clinical presentations and outcome of severe community-acquired pneumonia.

作者信息

Elshamly Mousa, Nour Mohamed O, Omar Abdelmaaboud M M

机构信息

Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Egypt.

Department of Community & Occupational Medicine, Faculty of Medicine, Al-Azhar University (Damietta Branch), Egypt.

出版信息

Egypt J Chest Dis Tuberc. 2016 Oct;65(4):831-839. doi: 10.1016/j.ejcdt.2016.06.002. Epub 2016 Jun 18.

Abstract

BACKGROUND

Severe community-acquired pneumonia (SCAP) represents a frequent and potentially life-threatening condition. About 10% of all hospitalized patients with CAP require admission to the intensive care unit (ICU), and the mortality of these patients reaches 20-50%.

OBJECTIVE

To evaluate the clinical presentation, bacteriological profile and outcome of severe community-acquired pneumonia (SCAP).

PATIENTS AND METHODS

54 patients presented by symptoms and sign of severe community acquired pneumonia who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital from August 2015 to March 2016 were subjected to full clinical examination, chest X ray, complete blood picture, sputum and blood culture, PCR for suspected cases of Influenza H1N1 and MERS-COV, treatment, follow up, data collections and statistical analysis.

RESULTS

The present study included 54 patients 26 males and 28 females with SCAP who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital. The most common comorbidities were diabetes mellitus and hypertension. The most common presentations were fever, cough, dyspnea and hypoxemia. Two patients developed renal failure and 4 patients developed septic shock. The most common isolated organism was , Influenza H1N1, and . Mortality was 24% and it was common in patients with comorbidity than in patients without comorbidities.

CONCLUSION

SCAP occurs more frequently in those with comorbidities. The most frequent isolated causative organism of SCAP is , Influenza H1N1 and . SCAP is associated with significant mortality, early recognition and prompt treatment may improve outcome.

摘要

背景

重症社区获得性肺炎(SCAP)是一种常见且可能危及生命的疾病。所有住院的社区获得性肺炎(CAP)患者中约10%需要入住重症监护病房(ICU),这些患者的死亡率达20% - 50%。

目的

评估重症社区获得性肺炎(SCAP)的临床表现、细菌学特征及预后。

患者与方法

2015年8月至2016年3月期间,入住爱资哈尔大学胡笙医院呼吸科、有重症社区获得性肺炎症状和体征的54例患者接受了全面临床检查、胸部X线检查、全血细胞计数、痰及血培养、针对疑似甲型H1N1流感和中东呼吸综合征冠状病毒病例的聚合酶链反应(PCR)检测、治疗、随访、数据收集及统计分析。

结果

本研究纳入了54例入住爱资哈尔大学胡笙医院呼吸科的重症社区获得性肺炎患者,其中男性26例,女性28例。最常见的合并症是糖尿病和高血压。最常见的表现是发热、咳嗽、呼吸困难和低氧血症。2例患者出现肾衰竭,4例患者发生感染性休克。最常见的分离出的病原体是甲型H1N1流感病毒等。死亡率为24%,合并症患者的死亡率高于无合并症患者。

结论

SCAP在合并症患者中更常见。SCAP最常见的分离致病病原体是甲型H1N1流感病毒等。SCAP与显著的死亡率相关,早期识别和及时治疗可能改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d449/7125902/7944c062b397/gr1.jpg

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