Guidelines for the management of adult lower respiratory tract infections - Full version

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Abstract

This document is an update of Guidelines published in 2005 and now includes scientific publications through to May 2010. It provides evidence-based recommendations for the most common management questions occurring in routine clinical practice in the management of adult patients with LRTI. Topics include management outside hospital, management inside hospital (including community-acquired pneumonia (CAP), acute exacerbations of COPD (AECOPD), acute exacerbations of bronchiectasis) and prevention. Background sections and graded evidence tables are also included. The target audience for the Guideline is thus all those whose routine practice includes the management of adult LRTI.

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Identification of a Novel Coronavirus in Patients with Severe Acute Respiratory Syndrome

Christian Drosten, Stephan Günther, Wolfgang Preiser … (2003)

The severe acute respiratory syndrome (SARS) has recently been identified as a new clinical entity. SARS is thought to be caused by an unknown infectious agent. Clinical specimens from patients with SARS were searched for unknown viruses with the use of cell cultures and molecular techniques. A novel coronavirus was identified in patients with SARS. The virus was isolated in cell culture, and a sequence 300 nucleotides in length was obtained by a polymerase-chain-reaction (PCR)-based random-amplification procedure. Genetic characterization indicated that the virus is only distantly related to known coronaviruses (identical in 50 to 60 percent of the nucleotide sequence). On the basis of the obtained sequence, conventional and real-time PCR assays for specific and sensitive detection of the novel virus were established. Virus was detected in a variety of clinical specimens from patients with SARS but not in controls. High concentrations of viral RNA of up to 100 million molecules per milliliter were found in sputum. Viral RNA was also detected at extremely low concentrations in plasma during the acute phase and in feces during the late convalescent phase. Infected patients showed seroconversion on the Vero cells in which the virus was isolated. The novel coronavirus might have a role in causing SARS. Copyright 2003 Massachusetts Medical Society

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Avian influenza A (H5N1) infection in humans.

John Beigel, Jeremy Farrar, Aye Han … (2005)

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Mycoplasma pneumoniae and its role as a human pathogen.

Ken B Waites, Deborah F. Talkington (2004)

Mycoplasma pneumoniae is a unique bacterium that does not always receive the attention it merits considering the number of illnesses it causes and the degree of morbidity associated with it in both children and adults. Serious infections requiring hospitalization, while rare, occur in both adults and children and may involve multiple organ systems. The severity of disease appears to be related to the degree to which the host immune response reacts to the infection. Extrapulmonary complications involving all of the major organ systems can occur in association with M. pneumoniae infection as a result of direct invasion and/or autoimmune response. The extrapulmonary manifestations are sometimes of greater severity and clinical importance than the primary respiratory infection. Evidence for this organism's contributory role in chronic lung conditions such as asthma is accumulating. Effective management of M. pneumoniae infections can usually be achieved with macrolides, tetracyclines, or fluoroquinolones. As more is learned about the pathogenesis and immune response elicited by M. pneumoniae, improvement in methods for diagnosis and prevention of disease due to this organism may occur.

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Author and article information

Contributors

M. Woodhead

Journal

Journal ID (nlm-ta): Clin Microbiol Infect

Journal ID (iso-abbrev): Clin. Microbiol. Infect

Title: Clinical Microbiology and Infection

Publisher: European Society of Clinical Infectious Diseases. Published by Elsevier Ltd.

ISSN (Print): 1198-743X

ISSN (Electronic): 1469-0691

Publication date PMC-release: 13 December 2014

Publication date (Print): November 2011

Publication date (Electronic): 13 December 2014

Volume: 17

Pages: E1-E59

Affiliations

[a ]Department of Respiratory Medicine, Manchester Royal Infirmary, Manchester, UK

[b ]Dipartimento Toraco-Polmonare e Cardiocircolatorio, Università degli Studi di Milano, IRCCS Ospedale Maggiore di Milano, Milano, Italy

[c ]Chefarzt der Kliniken für Pneumologie und Infektiologie, Ev. Krankenhaus Herne und Augusta-Kranken-Anstalt, Bergstrasse, Bochum, Germany

[d ]Department of Medicine, Hospital Universitari Mutua de Terrassa, University of Barcelona, Barcelona, Spain

[e ]Pneumologie et Reanimation, Hotel-Dieu de Paris, 1 Place Parvis Notre-Dame, Paris, France

[f ]Microbiology Laboratory, University Hospital Antwerp, Edegem, Belgium

[g ]Department of Communicable Diseases Control and Prevention, Stockholm County, Stockholm, Sweden

[h ]Zentrum für Pneumologie, Diakoniekrankenhaus Rotenburg, Elise-Averdiek-Str. Rotenburg, Germany

[i ]Pulmonary Department, Institut Clinic del Torax, Hospital Clinic de Barcelona, IDIBAPS, CIBERES (Ciber de Enfermedades Respiratorias), Facultad de Medicina. Universitat de Barcelona, Barcelona, Spain

[j ]Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Julius Center, Utrecht, The Netherlands

[k ]Infectious Diseases, Department of Infection and Immunity, Sheffield School of Medicine and Biomedical Science, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK

[l ]General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

Author notes

[* ] Corresponding author: Prof. Mark Woodhead, Department of Respiratory Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK mark.woodhead@ 123456cmft.nhs.uk

Article

Publisher ID: S1198-743X(14)61404-X

DOI: 10.1111/j.1469-0691.2011.03672.x

PMC ID: 7128977

PubMed ID: 21951385

SO-VID: de371182-5a8b-4ef5-b858-e264bd64f97a

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Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Guidelines for the management of adult lower respiratory tract infections - Full version

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Most cited references 516

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Avian influenza A (H5N1) infection in humans.

Mycoplasma pneumoniae and its role as a human pathogen.

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