Clinical and Etiological Findings of Viral Pneumonia: A Single Centre Prospective Study

Ambika Prasad Nayak
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Abstract

Introduction: Viral pneumonia is a prominent cause of illness that can occur in all age group throughout the year. Worldwide about 200 million cases of viral community acquired pneumonia occur every year of which 50% cases in children and 50% in adults [1]. Bacterial coinfection found only in 3% of cases [2]. The aim of our study is to find out most common viral pathogen causing pneumonia, most common bacterial co-infection, their typical clinical presentation, common abnormal lab parameters, CT findings, duration of ICU and hospital stay. Materials and Methods: All cases with sign and symptoms of respiratory infections with confirmed diagnosis of viral pneumonia (confirmed by BioFire FilmArray Pneumonia Panel from lower respiratory tract sample, confirmed by microscopy) were included in the study after proper consent. Demographic data, clinical history, laboratory investigations, all routine and radiological investigations are noted and evaluated. Results: Of the total 69 cases Influenza A virus (36%) is the predominant etiological agents followed by human rhinovirus (26%) in these cases. Human Rhinovirus predominate in the early part 2023 but towards end of this year Influenza A virus became the predominant cause for pneumonia. Patients of all age groups are affected but there is definitively a seasonal variation with more in the winter months. Most of the patients have typical respiratory findings like cough (83%) and fever (76%). CT scan showed bilateral ground glass opacity (56%) in most cases, and few had consolidation (29%) features. Blood CRP level (91%) was raised in most of these patients. Haemophilus Influenzae (34%) is the most common associated bacterial co-infection followed by Streptococcus Pneumoniae (26%). All patients responded well to conservative management. Conclusions: Viral pneumonia is not uncommon in the community. Though we found Influenza A followed by Human Rhinovirus are the two most common pathogens in these cases but only 59% of them have bacterial co-infection, so not all patients require antibiotics from the beginning. As most are infected with Haemophilus influenzae so aminopenicillin group is the antibiotics of choice for these patients. Hence as a pulmonologist we must be aware of these cases, their typical presentation and not to over treat these cases with high end antibiotics as most require only symptomatic treatment. Even though it is a single centre study, but it definitely throws a light on the pattern of viral pneumonia in our community
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病毒性肺炎的临床和病因发现:单中心前瞻性研究
简介病毒性肺炎是一种常见病,一年四季各年龄组均可发病。全球每年约有 2 亿例病毒性社区获得性肺炎病例,其中 50%发生在儿童身上,50%发生在成人身上[1]。只有 3% 的病例合并细菌感染 [2]。我们的研究旨在找出导致肺炎的最常见病毒病原体、最常见细菌合并感染、其典型临床表现、常见异常实验室指标、CT 结果、重症监护室和住院时间。材料和方法:所有有呼吸道感染症状和体征并确诊为病毒性肺炎的病例(经下呼吸道样本中的 BioFire FilmArray 肺炎检测板确诊,并经显微镜检查确诊)均在征得适当同意后纳入研究。研究人员记录并评估了人口统计学数据、临床病史、实验室检查、所有常规检查和放射学检查。结果:在总共 69 例病例中,甲型流感病毒(36%)是主要病原体,其次是人类鼻病毒(26%)。人类鼻病毒在 2023 年早期占主导地位,但在今年年底,甲型流感病毒成为肺炎的主要病原体。所有年龄段的患者都会受到影响,但有明确的季节性变化,冬季患者较多。大多数患者有典型的呼吸道症状,如咳嗽(83%)和发烧(76%)。大多数病例的 CT 扫描显示双侧磨玻璃混浊(56%),少数病例有合并症(29%)。大多数患者的血液 CRP 水平(91%)升高。流感嗜血杆菌(34%)是最常见的合并感染细菌,其次是肺炎链球菌(26%)。所有患者均对保守治疗反应良好。结论病毒性肺炎在社区并不少见。虽然我们发现甲型流感和人类鼻病毒是这些病例中最常见的两种病原体,但只有 59% 的患者合并细菌感染,因此并非所有患者一开始就需要使用抗生素。由于大多数患者感染的是流感嗜血杆菌,因此氨青霉素类抗生素是这些患者的首选。因此,作为一名肺科医生,我们必须了解这些病例及其典型表现,不要过度使用高端抗生素治疗这些病例,因为大多数病例只需要对症治疗。尽管这只是一项单中心研究,但它无疑为我们社区的病毒性肺炎模式提供了启示。
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