• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.397-404
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• 2011

Background: To evaluate chest CT findings of pandemic influenza A/H1N1 pneumonia without co-infection. Methods: Among 56 patients diagnosed with pandemic influenza A/H1N1 pneumonia, chest CT was obtained in 22 between October 2009 and Februrary 2010. Since two patients were co-infected with bacteria, the other twenty were evaluated. Predominant parenchymal patterns were categorized into consolidation, ground glass opacity (GGO), and mixed patterns. Distribution of parenchymal abnormalities was assessed. Results: Median age was 46.5 years. The CURB-65 score, which is the scoring system for severity of community acquired pneumonia, had a median of 1. Median duration of symptoms was 3 days. All had abnormal chest x-ray findings. The median number of days after the hospital visit that Chest CT was performed was 1. The reasons for chest CT performance were radiographic findings unusual for pneumonia (n=13) and unexplained dyspnea (n=7). GGO was the most predominant pattern on CT (n=13, 65.0%). Parenchymal abnormalities were observed in both lungs in 13 cases and were more extensive in the lower lung zone than the upper. Central and peripheral distributions were identified in ten and nine cases, respectively. One showed diffuse distribution. Peribronchial wall thickening was found in 16 cases. Centrilobular branching nodules (n=7), interlobular septal thickening (n=4), atelectasis (n=1), pleural effusion (n=5), enlarged hilar and mediastinal lymph nodes (n=6 and n=7) were also noted. Conclusion: Patchy and bilateral GGO along bronchi with predominant involvement of lower lungs are the most common chest CT findings of pandemic influenza A/H1N1 pneumonia.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.147-151
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• 2008

Non-resolving or slowly resolving pulmonary infiltrates in spite of administering adequate antimicrobial therapy are a clinical diagnostic challenge for physicians. The rate of radiographic resolution varies with the patients' age, the underlying comorbidities, the extent of radiographic involvement, the functional status and the causal pathogens. It is important to differentiate non-resolving or slowly resolving bacterial pneumonia from other uncommon infectious pneumonias or malignancies that require invasive diagnostic techniques to confirm the diagnosis. Bronchioloalveolar carcinoma can present with various clinical and radiographic features. Unfortunately, the radiographic similarity of consolidative BAC to pneumonia often leads to an incorrect diagnosis of pneumonia and possibly significant delays in obtaining appropriate diagnostic studies. We describe here a case of a mixed adenocarcinoma and bronchioloalveolar carcinoma that was initially diagnosed as pneumonia due to the consolidation pattern on the radiography and the patient's initial improvement with antibiotic treatment.

• Journal of the Korean Society of Radiology
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• v.5 no.6
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• pp.391-400
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• 2011

Pneumonia is an infection of the lungs and respiratory system and can be classified by a variety of factors such as infectious agents, etiology, infection area, and other criteria. From a 46-year-old male, who was suspected of being infected with atypical pathogen pneumonia and underwent such tests as serological testing, examination of sputum, urine examination, parasite examination, bronchoscopy, needle biopsy and so on, no significant abnormality was found. This patient also showed no specific symptoms like auscultatory abnormalities, high fever, nonproductive cough, muscle stiffness, sputum production, dyspnea. Prescription of broad-spectrum oral antibiotics and ant-parasitic didn't seem to be effective against bacterial and atypical pathogen. The patient's condition alternately repeated between natural cure and recurrence. The average healing process during which scarring, nodule recurrence and disappearance on the lungs happened was about 20 days. Chest radiography and chest high resolution computerized tomographic scans(HRCT scan) was performed to depict parenchymal aberrations and demarcate the extent and distribution of atypical pathogen pneumonia. As a result, chest radiography did not show the specific symptoms, whereas areas of opacity (seen as white) which represent consolidation were revealed in chest HRCT scan. This indicates that only chest radiography is not that useful for early diagnosis of atypical pathogen pneumonia in patients, since it can't show exactly what the symptom is because of the barriers such as diaphragm, liver, and spine. Therefore, it is desirable that chest HRCT should be used in the diagnosis to compare with the results of chest radiography. Here, report with literature investigations the case of recurrent atypical pathogen pneumonia.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.146-151
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• 2017

Purpose: We analyzed the risk factors affecting readmission of children with pneumonia. Methods: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. Results: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. Conclusions: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.

• Tuberculosis and Respiratory Diseases
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• v.63 no.6
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• pp.515-520
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• 2007

Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of pneumonia in older children and young adults. Normally, it does not progress to a condition requiring hospitalization but improves spontaneously or has a mild clinical course. We report two cases of M. pneumoniae pneumonia with different clinical manifestations from the normal course. The patients were young healthy individuals. The diagnoses were made by serology. However, it could not be determined beforehand that they had M. pneumoniae pneumonia. Based on the empirical treatment strategy of severe community acquired pneumonia, the patients were treated with broad-spectrum antibiotics including cephalosporin, quinolone and macrolide. After administering the antibiotics, they showed a gradually favorable clinical course and recovered without residual complications. A M. pneumoniae infection should be considered as a cause of severe community acquired pneumonia, and empirical treatment targeting this organism might be helpful in treating patients with the severe manifestation.

• Tuberculosis and Respiratory Diseases
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• v.61 no.5
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• pp.479-483
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• 2006

Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of prominent intra-alveolar fibrin and organizing pneumonia, with out hyaline membranes or prominent eosinophilia. The clinical manifestations of AFOP resemble those of acute lung injury such as acute interstitial pneumonia (AIP). However, the classic histological patterns of AFOP differ from diffuse alveolar damage (DAD), bronchiolitis obliterans with organizing pneumonia (BOOP) or acute eosinophilic pneumonia (AEP). The characteristic intra-alveolar fibrin ball and lack of classic hyaline membrane are the predominant histological features of AFOP. Although some reports suggest that its clinical course is less catastrophic than DAD, the clinical entity that distinguishes AFOP from DAD has not been established. We present a case of pathologically demonstrated AFOP in a 79-year-old man. The radiological findings of our case were similar to those of DAD, presented with diffuse bilateral lung infiltrations. However, despite the rapid development of respiratory failure, the patient had a better response and outcome to steroid therapy than what would be expected for DAD.

• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.547-554
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• 2021

In order to quickly and accurately diagnose pneumonia on a chest X-ray image, different batch sizes of 4, 8, 16, and 32 were applied to the same Xception deep learning model, and modeling was performed 3 times, respectively. As a result of the performance evaluation of deep learning modeling, in the case of modeling to which batch size 32 was applied, the results of accuracy, loss function value, mean square error, and learning time per epoch showed the best results. And in the accuracy evaluation of the Test Metric, the modeling applied with batch size 8 showed the best results, and the precision evaluation showed excellent results in all batch sizes. In the recall evaluation, modeling applied with batch size 16 showed the best results, and for F1-score, modeling applied with batch size 16 showed the best results. And the AUC score evaluation was the same for all batch sizes. Based on these results, deep learning modeling with batch size 32 showed high accuracy, stable artificial neural network learning, and excellent speed. It is thought that accurate and rapid lesion detection will be possible if a batch size of 32 is applied in an automatic diagnosis study for feature extraction and classification of pneumonia in chest X-ray images using deep learning in the future.

• Journal of Sasang Constitution and Immune Medicine
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• v.17 no.3
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• pp.172-178
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• 2005

1. Objectives pneumonia is the infection of the lungs. The typical symptoms of is cough, sputum, fever, chest pain, infiltration of chest X-ray. We have tried researching effect of herbal medicine Soeumin Doksampalmulkeunja-tang(獨蔘八物君子湯). 2. Methods This patient with serious fever, sputum which were caused by aspiration pneumonia was treated by Doksampalmulkeunja-tang(獨蔘八物君子湯), who was diagnosed as Soeumin 3. Results Doksampalmulkeunja-tang(獨蔘八物君子湯) is effective against the fever. sputum symptom of Soeumin. The chest PA test were improved. 4. Conclusions The consitutional treatment with herb-medicine may have effect on fever symptom of Soeumin. Soeumin Exterior febrile Disease must be treated by raising the stagnant yang qi. Further study on Soeumin Exterior febrile Disease is needed.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.101-103
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• 2016

Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.484-488
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• 1999

Massive lung gangrene is a rare but very rapidly progressing fatal complication of lobar pneumonia. Etiologic agents are Klebsiella pneumoniae, Pneumococcus and Aspergillus, etc. Chest X-ray shows firm consolidation of the involved pulmonary lobe and bulging fissure due to the volume expansion of involved lung. CT-scan shows extensive lung parenchymal destructions with multiple small cavitary lesions. Recommended treatment is the early surgical intervention combined with antibiotics. Without surgical intervention, lung gangrene is known to progress toward sepsis, multiorgan failure, and high mortality. We report two cases of rapidly progressing massive lung gangrene by Klebsiella pneumonia treated by the resectional surgery.