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    Tytuł:
    Diagnostic difficulties with COVID-19 in a patient after total laryngectomy
    Trudności diagnostyczne w rozpoznaniu COVID-19 u pacjenta po laryngektomii całkowitej
    Autorzy:
    Czech, Joanna
    Burduk, Paweł
    Wierzchowska, Małgorzata
    Powiązania:
    https://bibliotekanauki.pl/articles/1399027.pdf
    Data publikacji:
    2021-06-22
    Wydawca:
    Index Copernicus International
    Tematy:
    COVID-19
    laryngectomy
    lower respiratory tract
    SARS-CoV-2
    upper respiratory tract
    dolne drogi oddechowe
    górne drogi oddechowe
    laryngektomia
    Opis:
    Coronavirus disease (COVID-19) is caused by the SARS-CoV-2 virus and often presents with flu-like symptoms that can have varying degrees, which may subsequently lead to acute respiratory distress (ARDS). The genetic material of the virus in samples of respiratory secretions is identified by way of basic diagnostic tests. Due to the altered course of the respiratory tract, patients after total laryngectomy require special attention in the diagnosis of SARS-CoV-2 infection. We present a case of a patient after laryngectomy who obtained different results of COVID-19 tests depending on the site of sampling.
    Choroba COVID-19 wywoływana jest przez wirusa SARS-CoV-2 i często manifestuje się objawami grypopodobnymi, które mogą przebiegać z różnym nasileniem. W dalszej kolejności może prowadzić do ostrej niewydolności oddechowej (ARDS). Podstawowe testy diagnostyczne identyfikują materiał genetyczny wirusa w próbkach wydzielin z dróg oddechowych. Chorzy po laryngektomii całkowitej z uwagi na zmieniony przebieg dróg oddechowych wymagają szczególnej uwagi pod względem diagnostyki w kierunku zakażenia SARS-CoV-2. W naszej pracy przedstawiamy przypadek pacjenta po laryngektomii, u którego uzyskano różne wyniki testów w kierunku COVID-19 w zależności od miejsca pobrania próbek. Słowa kluczowe: SARS-CoV-2, laryngektomia, drogi oddechowe
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2021, 10, 2; 44-47
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The role of bronchoscopy in the diagnosis of lower respiratory tract infections
    Autorzy:
    Mierzejewski, Michał
    Krenke, Rafał
    Powiązania:
    https://bibliotekanauki.pl/articles/1401689.pdf
    Data publikacji:
    2016
    Wydawca:
    Index Copernicus International
    Tematy:
    bronchoscopy
    lower respiratory tract infections
    bronchoalveolar lavage
    opportunistic infections
    tuberculosis
    pulmonary mycoses
    Opis:
    Bronchoscopy was introduced into clinical practice over 100 years ago. Due to technological advances, diagnostic capabilities of current bronchoscopy are not limited to the trachea and proximal bronchi but also include the peripheral airways as well as various anatomical structures located outside the bronchi. A wide range of available techniques that include bronchoalveolar lavage, protected microbiological brush, transbronchial biopsy of the lungs and mediastinal lymph nodes makes bronchoscopy useful in diagnosing various lower respiratory tract infections. For example, the collection of high quality biological samples for microbiological examination plays a crucial role when treating patients with nosocomial pneumonia. Bronchoscopy may provide the samples directly from the site of infection. In immunocompromised hosts bronchoscopy is routinely used as the diagnostic tool in lower respiratory tract infections. Due to implementation of novel therapies, the number of immunocompromised patients is steadily increasing, hence there are growing needs for effective diagnosis of opportunistic pulmonary infections. In the specific group of lung transplant recipients, bronchoscopy play a crucial role in monitoring the rejection process and also in differentiating between the rejection and pulmonary infections. Bronchoscopy is also useful in diagnosing tuberculosis or nontuberculous pulmonary infections. This particularly refers to patients who are unable to produce sputum for microbiological examination.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2016, 5, 3; 1-6
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The utility of a modified technique for lower respiratory tract sampling in COVID-19 ICU and review of diagnostic approaches in suspected ventilator associated pneumonia
    Autorzy:
    Anokar, Anita
    Jedge, Prashant
    Shah, Jignesh
    Chougale, Samruddhi
    Powiązania:
    https://bibliotekanauki.pl/articles/1918273.pdf
    Data publikacji:
    2021-09-30
    Wydawca:
    Towarzystwo Pomocy Doraźnej
    Tematy:
    Closed suction system
    ventilator-associated pneumonia
    COVID-19
    lower respiratory tract sampling
    Opis:
    INTRODUCTION: Lower respiratory tract (LRT) sampling is an aerosol generating procedure. In COVID 19 pandemic, guidelines have advocated caution against all aerosol generating procedures. However, microbial cultures on tracheobronchial aspirates are important to guide antibiotic usage in ventilator-associated pneumonia (VAP). MATERIAL AND METHODS: In our tertiary care COVID-19 intensive care unit (ICU), a protocol was set for using closed suction system for timely LRT sampling in VAP and to reduce the risk of exposure to respiratory secretions. Timing of sample collection was as per intensivist discretion following CDC VAP definition. This prospective study was conducted between June to November 2020, to assess the utility of this technique in diagnosis of suspected VAP. Microbiological and clinico-radiological parameters were documented. Heavy growth (>105 cfu/mL) on semiquantitative culture was taken as significant. RESULTS: Total 69 samples generated from 63 patients were analyzed. Mean age 54.48 years and 77.78% of patients had one or more comorbidities. Average duration of invasive ventilation prior to the first culture was 7.14 ± 4.36 days. Progressive radiological worsening at the time of sample collection was in 92.75% (64 of 69 episodes). Microbiological diagnosis of VAP was confirmed in 76.81%. Culture reports guided antibiotic change. Insignificant culture growth in 13.06%. The positivity rate for early and late (>4days) samples were 69.56% and 80.43% respectively. 95% of culture isolates were Gram negative microorganisms. Most common being Acinetobacter baumannii (41.67%) and Klebsiella pneumoniae (31.66%) in both early and late VAP. Around 85% were multidrug resistant organisms. There were no significant adverse events related to sampling technique. CONCLUSIONS: Lower respiratory tract sampling using closed suction system is easy to execute and minimizes procedure related risk to both patient and health care workers in COVID-19 ICU. Gram negative MDR pathogens are prevalent in both early and late VAP. Need further comparative study to understand effectiveness of this technique against other conventional techniques in VAP diagnosis.
    Źródło:
    Critical Care Innovations; 2021, 4, 3; 1-14
    2545-2533
    Pojawia się w:
    Critical Care Innovations
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
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