• Title/Summary/Keyword: Respiratory tract Infections

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Refractory Achilles Tendinopathy and Multiple Pain on the Tendon and Tendon Attachment Site of the Foot Related to Intermittent Levofloxacin Usage: A Case Report (간헐적 Levofloxacin 약제 사용과 관련된 난치성 아킬레스건병증과 족부의 다발성 건 및 건 부착부 통증: 증례 보고)

  • Seung Jun Park;Jin Soo Suh;Jun Young Choi
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.3
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    • pp.103-107
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    • 2023
  • Quinolone antibiotics are frequently prescribed for suspected respiratory or urinary tract infections because of their effectiveness and generally perceived safety profile. On the other hand, some studies have raised concerns regarding the potential association between quinolone use and Achilles tendinopathy or tendon rupture. There is a lack of reports on the link between quinolone use and multiple tendon and tendon attachment site pain in the foot and ankle joints; hence, this study examined this issue further. This paper presents a case report of a patient with persistent Achilles tendinopathy and multiple tendon and tendon attachment site pain in the foot who did not respond adequately to conservative treatments. In particular, the discontinuation of quinolone use resulted in favorable clinical outcomes. This report offers valuable insights into the potential risks associated with quinolone antibiotics and highlights the importance of vigilance when managing patients with tendon-related complaints. A comprehensive review of the relevant literature is also presented to contextualize these findings.

Role of biomarkers in antimicrobial stewardship: physicians' perspectives

  • Hyeri Seok;Dae Won Park
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.413-429
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    • 2024
  • Biomarkers are playing an increasingly important role in antimicrobial stewardship. Their applications have included use in algorithms that evaluate suspected bacterial infections or provide guidance on when to start or stop antibiotic therapy, or when therapy should be repeated over a short period (6-12 h). Diseases in which biomarkers are used as complementary tools to determine the initiation of antibiotics include sepsis, lower respiratory tract infection (LRTI), COVID-19, acute heart failure, infectious endocarditis, acute coronary syndrome, and acute pancreatitis. In addition, cut-off values of biomarkers have been used to inform the decision to discontinue antibiotics for diseases such as sepsis, LRTI, and febrile neutropenia. The biomarkers used in antimicrobial stewardship include procalcitonin (PCT), C-reactive protein (CRP), presepsin, and interleukin (IL)-1β/IL-8. The cut-off values vary depending on the disease and study, with a range of 0.25-1.0 ng/mL for PCT and 8-50 mg/L for CRP. Biomarkers can complement clinical diagnosis, but further studies of microbiological biomarkers are needed to ensure appropriate antibiotic selection.

Clinical Analysis of Acute Respiratory Tract Infections by Influenza Virus in Children (인플루엔자 바이러스에 의한 소아 급성 호흡기 감염증의 유행 및 임상 양상)

  • Kwon, Min Kyoung;Kim, Mi Ran;Park, Eun Young;Lee, Kon Hee;Yoon, Hae Sun;Kim, Kwang Nam;Lee, Kyu Man
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1519-1527
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    • 2002
  • Purpose : Although influenza virus is one of the most important causes of acute respiratory tract infections(ARTIs) in children, virus isolation is not popular and there are only a few clinical studies on influenza in Korea. We evaluated the epidemiologic and clinical features of ARTIs by influenza virus in children. Methods : From February 1995 to August 2001, nasopharyngeal aspirations were obtained and cultured for the isolation of influenza virus in children admitted with ARTIs. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Respiratory viruses were isolated in 997(22.0%) out of 4,533 patients examined, and influenza virus was isolated in 164 cases(3.6%). Influenza virus was isolated year after year mainly from December to April of next year. The ratio of male and female was 1.9 : 1 with a median age of 15 months. The most common clinical diagnosis of influenza virus infection was pneumonia, and fever and cough developed in most patients. There was no difference between influenza A and B infection in clinical diagnoses and symptoms. All patients recovered without receiving antiviral treatment except for one patient diagnosed with pneumonia who had underlying disease of Down syndrome with ventricular septal defect. Conclusion : ARTIs caused by influenza virus developed every winter and spring during the period of study. Because fatal complication can develop in the high risk group, prevention, early diagnosis and proper management of influenza should be emphasized.

Parental concerns about their premature infants' health after discharge from the neonatal intensive care unit: a questionnaire survey for anticipated guidance in a neonatal follow-up clinic

  • Cho, Ji-Yun;Lee, Ju-Young;Youn, Young-Ah;Kim, Soon-Ju;Kim, So-Young;Sung, In-Kyung
    • Clinical and Experimental Pediatrics
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    • v.55 no.8
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    • pp.272-279
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    • 2012
  • Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

A Case of Pulmonary Trichomoniasis in a Young Healthy Male (건강한 젊은 남성에서 발생한 폐트리코모나스증 1예)

  • La, Sung Soo;Kong, Jae Hwan;Bang, Chang Seok;Hahn, Sung Hwhan;Myong, Na-Hye;Kim, Doh Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.387-391
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    • 2008
  • Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.

Effects of Liriope muscari Water Extracts on the Cell Death and Inflammatory Cytokine Expression of Poly I:C-treated Lung Carcinoma Cells (맥문동 열수 추출물이 Poly I:C를 처리한 폐암세포주의 사멸 및 염증성 사이토카인 발현에 미치는 영향)

  • Kang, Dayeon;Cho, Namjoon;Renchinkhand, Gereltuya;Lee, Bo-Hee;Kim, Eun-Mi;Nam, Myoung Soo;Kim, Keekwang
    • The Korea Journal of Herbology
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    • v.36 no.1
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    • pp.97-102
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    • 2021
  • Objectives : Virus infection through the respiratory tract causes various inflammatory diseases such as pneumonia, cystic fibrosis, and obstructive pulmonary disease, causing enormous social damage. Therefore, it is very important to develop a treatment and prevention of infectious diseases. In this study, we investigated the effect of water extracts of Liriope muscari (WELM), known to improve lung function, on the inflammatory response of lung carcinoma cell line A549 cells induced by the viral double stranded RNA mimetic Polyinosinic:polycytidylic acid (Poly I:C). Methods : The cell viability by WELM treatment was analyzed using MTS assay in A549 cells. After inducing an inflammatory response to WELM-treated A549 cells with Poly I:C, the degree of apoptosis was confirmed through bright field microscopy. Interferon beta (IFN-β) mRNA expression level in A549 cells was analyzed by quantitative reverse transcription PCR (qRT-PCR). Results : WELM treatment has no significant effect on cell viability of A549 cells. We confirmed that pre-treatment of WELM effectively reduces the Poly I:C-induced apoptotic cell death in A549 cells. In addition, it was confirmed that the mRNA expression level of IFN-β, a pro-inflammatory cytokine increased by Poly I:C treatment, was significantly suppressed by WELM treatment in A549 cells. Conclusions : These results provide the evidence that WELM is effective at inhibiting inflammation on respiratory viral infections and suggest that Liriope muscari might be a valuable natural substance in the prevention and treatment of infectious diseases.

Serotype Distribution of Human Respiratory Adenovirus Isolated in Gyeonggi Province (경기도내에서 분리한 호흡기아데노바이러스의 혈청형 분포특성)

  • Lee, Hyun-Kyung;Lee, Myung-Jin;Mun, Su-Kyoung;Kim, Woon-Ho;Cho, Han-Gil;Yoon, Mi-Hye;Lee, Jong-Bok;Cheong, Hyang-Min
    • Korean Journal of Microbiology
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    • v.48 no.3
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    • pp.175-179
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    • 2012
  • Adenoviruses are an important cause of respiratory tract infections, particularly in infants, young children, and immuno-compromised patients. In this study, we investigated the characteristics of adenoviruses isolated from outpatients with acute respiratory illness in Gyeonggi province of South Korea during 2009-2011. Adenoviruses were detected in 102 of 1,622 (6.3%) specimens by using PCR or real-time PCR with viral specific primers. 76 isolates were obtained from 102 specimens using the A549 cells. Serotypic distributions of isolated adenovirus were analyzed by sequencing of hexon gene. Six different serotypes were identified, which included adenovirus serotypes 1-6. Adenovirus 3 (n=40, 52.6%) was the predominant serotype. The predominant types of adenovirus every year were serotypes 1 and 3 in 2009, serotype 3 in 2010, and serotype 5 in 2011, respectively. Adenoviruses 1, 2, 4, 5, and 6 were isolated sporadically throughout the study period. Adenovirus 3 was present both during outbreaks and in sporadic cases. These results indicate that adenovirus 3 played major causative agent of adenovirus outbreaks in Gyeonggi province of South Korea during 2009-2011. Continuous surveillance for specific serotypes of adenovirus that can cause outbreaks is important.

Effect of severe acute respiratory syndrome coronavirus 2 infection during pregnancy in K18-hACE2 transgenic mice

  • Byeongseok, Kim;Ki Hoon, Park;Ok-Hee, Lee;Giwan, Lee;Hyukjung, Kim;Siyoung, Lee;Semi, Hwang;Young Bong, Kim;Youngsok, Choi
    • Animal Bioscience
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    • v.36 no.1
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    • pp.43-52
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    • 2023
  • Objective: This study aimed to examine the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on pregnancy in cytokeratin-18 (K18)-hACE2 transgenic mice. Methods: To determine the expression of hACE2 mRNA in the female reproductive tract of K18-hACE2 mice, real-time polymerase chain reaction (RT-PCR) was performed using the ovary, oviduct, uterus, umbilical cord, and placenta. SARS-CoV-2 was inoculated intranasally (30 μL/mouse, 1×104 TCID50/mL) to plug-checked K18-hACE2 homozygous female mice at the pre-and post-implantation stages at 2.5 days post-coitum (dpc) and 15.5 dpc, respectively. The number of implantation sites was checked at 7.5 dpc, and the number of normally born pups was investigated at 20.5 dpc. Pregnancy outcomes, including implantation and childbirth, were confirmed by comparison with the non-infected group. Tissues of infected mice were collected at 7.5 dpc and 19.5 dpc to confirm the SARS-CoV-2 infection. The infection was identified by performing RT-PCR on the infected tissues and comparing them to the non-infected tissues. Results: hACE2 mRNA expression was confirmed in the female reproductive tract of the K18-hACE2 mice. Compared to the non-infected group, no significant difference in the number of implantation sites or normally born pups was found in the infected group. SARS-CoV-2 infection was detected in the lungs but not in the female reproductive system of infected K18-hACE2 mice. Conclusion: In K18-hACE2 mice, intranasal infection with SARS-CoV-2 did not induce implantation failure, preterm labor, or miscarriage. Although the viral infection was not detected in the uterus, placenta, or fetus, the infection of the lungs could induce problems in the reproductive system. However, lung infections were not related to pregnancy outcomes.

Sequence and Phylogenetic Analysis of Respiratory Syncytial Virus Isolated from Korea (국내에서 유행한 Respiratory Syncytial 바이러스의 염기서열 및 계통분석)

  • Kwon, Soon-Young;Choi, Young-Ju;Kim, So-Youn;Song, Ki-Joon;Lee, Yong-Ju;Choi, Jong-Ouck;Seong, In-Wha
    • The Journal of Korean Society of Virology
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    • v.26 no.1
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    • pp.9-22
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    • 1996
  • Respiratory Syncytial virus (RSV) is an important cause of acute lower respiratory tract infections in human, with infants and young children being particularly susceptible. In the temperate zones, sharp annual outbreaks of RSV occur during the colder months, in both the northern and the southern hemisphere. RSV is unusual in that it can repeatedly reinfect individuals throughout life and infect babies in the presence of maternal antibody. RSV isolates can be divided into two subgroups, A and B, on the basis of their reactions with monoclonal antibodies, and the two subgroups are also distinct at the nucleotide sequence level. The specific diagnosis of RSV infection was best made by isolation of virus in tissue culture, identification of viral antigen, or by specific serologic procedures. Recently, rapid detection of RSV and analysis of RSV strain variation became possible by development of methods of reverse transcription and polymerase chain reaction amplification. In this study, to determine the genetic diversity of RSV found in Korea, 173 bp and 164 bp spanning selected regions of the RSV F and SH genes were enzymatically amplified and sequenced, respectively. Eight for F gene and three for SH gene were detected in 66 nasopharyngeal swap samples tested. Two major antigenic subgroups, A and B were confirmed from Korean samples (seven for subgroup A and one for subgroup B). At the nucleotide level of the F gene region, Korean subgroup A strains showed 95-99% homologies compared to the prototype A2 strain of subgroup A and 93-100% homologies among Korean subgroup A themselves. For the SH gene region, Korean subgroup A strain showed 97.5% homology compared to the prototype A2 strain of subgroup A, and Korean subgroup B strain showed 97% homology compared to the prototype 18537 strain of subgroup B. Most of base changes were transition and occured in codon position 3, which resulted in amino acid conservation. Using the maximum parsimony method, phylogenetic analysis indicated that Korean RSV strains formed a group with other RSV strains isolated from the United States, Canada, the Great Britain and Australia.

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The Clinical Manifestation of Pulmonary Infection in AIDS Patients (국내 일개 대학병원에서 경험한 AIDS 환자의 폐 감염성 질환의 임상적 특성)

  • Jung, Jae Woo;Chung, Jin Won;Song, Ju Han;Jeon, Eun Ju;Lee, Young Woo;Choi, Jae Cheol;Shin, Jong Wook;Park, In Whon;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.554-561
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    • 2006
  • Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.