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The Role of Biomarkers in the Diagnosis and Management of Pneumonia
Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, soluble triggering receptor expressed on myeloid cells). Biomarkers can differentiate CAP patients who require hospital admission and severe CAP requiring intensive care unit admission. Biomarker-guided antibiotic therapy may limit antibiotic exposure without compromising outcome and thus improve antibiotic stewardship. The authors discuss the role of biomarkers in diagnosin...
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Authors: Sarah Sungurlu, Robert A. Balk Source Type: research

Infectious Pulmonary Diseases
Pneumonia is a lower respiratory tract infection caused by the inability to clear pathogens from the lower airway and alveoli. Cytokines and local inflammatory markers are released, causing further damage to the lungs through the accumulation of white blood cells and fluid congestion, leading to pus in the parenchyma. The Infectious Diseases Society of America defines pneumonia as the presence of new lung infiltrate with other clinical evidence supporting infection, including new fever, purulent sputum, leukocytosis, and decline in oxygenation. Importantly, lower respiratory infections remain the most deadly communicable d...
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Authors: Rachel Rafeq, Lauren A. Igneri Source Type: research

Coronavirus Disease-2019 in the Immunocompromised Host
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 conv...
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Authors: Christopher D. Bertini, Fareed Khawaja, Ajay Sheshadri Source Type: research

Radiographic Imaging of Community-Acquired Pneumonia
The chest radiograph is the most common imaging examination performed in most radiology departments, and one of the more common indications for these studies is suspected infection. Radiologists must therefore be aware of less common radiographic patterns of pulmonary infection if they are to add value in the interpretation of chest radiographs for this indication. This review uses a case-based format to illustrate a range of imaging findings that can be associated with acute pulmonary infection and highlight findings that should prompt investigation for diseases other than community-acquired pneumonia to prevent misdiagno...
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Authors: Lacey Washington, Bryan O ’Sullivan-Murphy, Jared D. Christensen, H. Page McAdams Source Type: research

Viral Pneumonias
Viral pneumonia is usually community acquired and caused by influenza, parainfluenza, respiratory syncytial virus, human metapneumovirus, and adenovirus. Many of these infections are airway centric and chest imaging demonstrates bronchiolitis and bronchopneumonia, With the exception of adenovirus infections, the presence of lobar consolidation usually suggests bacterial coinfection. Community-acquired viral pathogens can cause more severe pneumonia in immunocompromised hosts, who are also susceptible to CMV and varicella infection. These latter 2 pathogens are less likely to manifest the striking airway-centric pattern. Ai...
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Authors: Jennifer Febbo, Jonathan Revels, Loren Ketai Source Type: research

Influenza and Viral Pneumonia
Influenza and other respiratory viruses are commonly identified in patients with community-acquired pneumonia, hospital-acquired pneumonia, and in immunocompromised patients with pneumonia. Clinically, it is difficult to differentiate viral from bacterial pneumonia. Similarly, the radiological findings of viral infection are in general nonspecific. The advent of polymerase chain reaction testing has enormously facilitated the identification of respiratory viruses, which has important implications for infection control measures and treatment. Currently, treatment options for patients with viral infection are limited but the...
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Authors: Rodrigo Cavallazzi, Julio A. Ramirez Source Type: research

Hot Topics In Lung Infections
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Authors: Rachael A. Lee, Helen W. Boucher Source Type: research

Copyright
Elsevier (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Source Type: research

Contributors
HELEN W. BOUCHER, MD, FACP, FIDSA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Source Type: research

Contents
Rachael A. Lee and Helen W. Boucher (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Source Type: research

Forthcoming Issues
Urinary Tract Infection Challenges: Beyond the Basics (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 26, 2024 Category: Infectious Diseases Source Type: research

Respiratory Tract Infections in the Postpandemic Era: A Return to Basics and Call to Action
Respiratory tract infections are a leading cause of death and disability and have remained the world ’s most deadly communicable disease. Although the burden of respiratory infections decreased over the period of 1990-2019, the world encountered unprecedented challenges due to the COVID-19 pandemic, caused by the SARS-CoV-2 virus. Compared with prepandemic years, the United States experienced hig her than usual hospitalizations, numerous shortages in supplies as well as personnel shortages, all of which resulted in increases in patient safety metrics, such as ventilator-associated pneumonia (VAP). (Source: Infectious Dis...
Source: Infectious Diseases Clinics of North America - December 18, 2023 Category: Infectious Diseases Authors: Rachael A. Lee, Helen W. Boucher Tags: Preface Source Type: research

Is Zero Ventilator-Associated Pneumonia Achievable? Updated Practical Approaches to Ventilator-Associated Pneumonia Prevention
Ventilator-associated pneumonia (VAP) remains a significant clinical entity with reported incidence rates of 7% to 15%. Given the considerable adverse consequences associated with this infection, VAP prevention became a core measure required in most US hospitals. Many institutions took pride in implementing effective VAP prevention bundles that combined at least head of bed elevation, hand hygiene, chlorhexidine oral care, and subglottic drainage. Spontaneous breathing and awakening trials have also consistently been shown to shorten the duration of mechanical ventilation and secondarily reduce the occurrence of VAP. (Sour...
Source: Infectious Diseases Clinics of North America - November 30, 2023 Category: Infectious Diseases Authors: Cristina Vazquez Guillamet, Marin H. Kollef Source Type: research

Updates in Cytomegalovirus Prevention and Treatment in Solid Organ Transplantation
The authors summarize recent updates in the prevention and management of cytomegalovirus (CMV) in solid organ transplant (SOT) recipients with a focus on CMV seronegative recipients of organs from seropositive donors (CMV D+/R −) who are at highest risk of CMV infection and disease. They discuss advantages of preemptive therapy for CMV disease prevention in CMV D+/R− liver transplant recipients, letermovir for CMV prophylaxis, and updates in the development of monoclonal antibodies and vaccines as immune-based prevent ative strategies. They review the roles of maribavir and virus-specific T cells for management of res...
Source: Infectious Diseases Clinics of North America - November 20, 2023 Category: Infectious Diseases Authors: Kathleen M. Doss, Madeleine R. Heldman, Ajit P. Limaye Source Type: research

Antimicrobial Stewardship: Where We Have Come And Where We Are Going
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 21, 2023 Category: Infectious Diseases Authors: Sage B. Greenlee, Emily S. Spivak Source Type: research