Pneumonia case study

Numerous case studies have described death following the accidental ingestion of kerosene by children (usually under the age of 5 but as old 15 years). The deaths are usually attributed to lipoidal pneumonia (Morrison and Sprague 1976 Santhanakrishnan and Chithra 1978 Zucker et al. 1986) that was probably induced by the aspiration of the kerosene. Specific respiratory effects associated with death from kerosene ingestion include pneumothorax (Mahdi 1988 Zucker et al. 1986), emphysema (Mahdi 1988), and pneumonitis (Singh et al. 1981). Cardiac arrhythmia was reported as the cause of death in one child however, it was suspected that myocarditis and pulmonary edema may have been the cause of the rapid deterioration and death of the child (Dudin et al. 1991). 

Beebe, like Case and Lea, set up three groups mustard gas casualties, pneumonia cases, and those with leg wounds the latter two series excluded any who might possibly have had contact with H. Sample size was set at 2,500 each, but the restrictions left Beebe with groups of 2,718 H casualties, 1,855 cases of pneumonia, and 2,578 men with leg wounds. All in the H group had evidence of H injury to skin, eyes, and respiratory tract. All were born between 1888 and 1893 and were alive on January 1, 1919. Records in the Veterans Administration files enabled Beebe to follow the men up to January 1956. In a followup study of lung-cancer mortality,... 

Kirkpatrick et al. (2005) carried out a study to determine whether there was an increase in respiratory diagnosis emergency room admissions to a Florida hospital, in Sarasota, during the period of a toxic red tide. The rates of admission were compared for a three-month time period when there was an onshore red tide in 2001 and during the same three-month period in 2002 when no red tide bloom occurred. There was no significant increase in the total number of respiratory admissions between the two time periods. However, there was a 19% increase in the rate of pneumonia cases diagnosed... 

Exposure to the Legionella bacteria doesn t necessarily lead to infection. According to some studies, an estimated 5-10% of the American population show serologic evidence of exposure, the majority of whom do not develop symptoms of an infection. Legionella bacteria account for 2-15% of the total number of pneumonia cases requiring hospitalization in the United States. 

A single case study was located which described the death of a male worker exposed to an undetermined concentration of hydrazine once a week for 6 months (Sotaniemi et al. 1971). Death was attributed to hydrazine exposure, resulting in severe lesions of the kidneys and lungs with complicating pneumonia. 

Death. Data regarding the lethal effects of hydrazines in humans are limited to a single case study involving inhalation exposure to hydrazine. Death was reported in a male worker exposed to an undetennined concentration of hydrazine once a week for 6 months (Sotaniemi et al. 1971). Death in this case was due to lesions of the kidneys and lungs with complicating pneumonia. The effects on the kidneys and lungs, as well as effects in other tissues, were comparable to those observed in animals exposed to hydrazine. Therefore, death in this case is most likely attributed to hydrazine exposure. 

Acidosis occurs when the pH of blood falls below about 7.35. In respiratory acidosis, impaired respiration increases the concentration of dissolved CO2 and lowers the blood s pH. The condition is common in victims of smoke inhalation and patients with asthma, pneumonia, and emphysema. The most efficient treatment consists of placing the patient in a ventilator. Metabolic acidosis is caused by the release of large amounts of lactic acid or other acidic by-products of metabolism (Case study 43), which react with bicarbonate ion to form carbonic acid, thus lowering the blood s pH. The condition is common in patients with diabetes and severe burns. 

Systematic reviews A systematic review witir mete-analysis was conducted to assess the association between PPIs with community-acquired pneumonia. This study used nine case-control and cohort observational studies with 120,863 cases of pneumonia. Current use of PPIs (odds ratio 1.39 95% confidence interval 1.09-1.76) as well as therapy with PPIs for less than 30 days (odds ratio 1.65 95% confidence interval 1.25-2.19), high-dose of PPIs (odds ratio 1.50 95% confidence interval 1.33-1.68) or low-dose of PPIs (odds ratio 1.17 95% confidence interval 1.11-1.24) were all found to be significantly associated with community-acquired pneumonia. There was no significant association between community-acquired pneumonia and use of PPIs over 180 days (odds ratio 1.10 95% confidence interval 1.00-1.21) [35 ]. 

Almirall, J. et al., Risk factors for community-acquired pneumonia in adults a population-based case-control study, Eur. Respir. J., 13, 349, 1999. 

Caution Tularemia has long been a weapon of war used and/or studied by the Japanese, the Russians, and the United States. Chemoprophylaxis is not recommended following potential natural exposures (tick bite, and/or rabbit or other animal exposures). Inhalation tularemia can lead to fulminant pneumonia with a case fatality rate of 30 to 60 percent without treatment. 

Gulmez SE, Holm A, Frederiksen H et al. (2007) Use of proton pump inhibitors and the risk of community-acquired pneumonia a population-based case-control study. Arch Intern Med 167(9) 950-955... 

Clough, A. R., Z. Wang, R. S. Bailie, C. B. Burns, and B. ]. Currie. Case-control study of the association between kava use and pneumonia in eastern Arnhem and Aboriginal communities (Northern Territory, Australia). Epidemiol Infect 2003 131(1) 627-635. 

Fernandez-Aviles F, Batlle M, Ribera JM, Matas L, Sabria M, Feliu E. Legionella sp pneumonia in patients with hematologic diseases. A study of 10 episodes from a series of 67 cases of pneumonia. Haematologica 1999 84(5) 474-5. 

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