Urgent lung transplantation in acute fibrinous and organizing pneumonia: a sliding door or a new perspective?
- 作者列表："Campisi A","Dell'Amore A","Bertolaccini L","Congiu S","Dolci G","Piccone G","Dal Checco E","Stella F
BACKGROUND:Lung transplantation is nowadays the standard therapy for certain well-defined chronic end-stage lung diseases, even in patients on mechanical ventilation or extracorporeal life support. While these latter techniques have been used worldwide as bridging options to lung transplantation for listed patients, they are not commonly used in previously healthy patients developing acute not-reversible lung failure. METHODS:We will discuss two patients without any relevant medical history developing acute lung failure evolving to irreversible acute fibrinous and organising pneumonia (AFOP), thus listed for urgent lung transplantation. RESULTS:The patients recovered well, and both are still alive. CONCLUSIONS:In the absence of clear guidelines, our approach showed, in these patients, the possible benefits of lung transplantation regarding survival in AFOP.
背景: 肺移植是当今某些明确的慢性终末期肺病的标准治疗方法，即使在机械通气或体外生命支持的患者中也是如此。虽然这些后一种技术已在世界范围内用作所列患者肺移植的桥接选择，但它们并不常用于以前健康的急性不可逆肺衰竭患者。 方法: 我们将讨论两个没有任何相关病史的患者，发展为急性肺衰竭，演变为不可逆的急性纤维素性和机肺炎 (AFOP)，因此被列入紧急肺移植。 结果: 患者恢复良好，且两人均存活。 结论: 在缺乏明确指南的情况下，我们的方法在这些患者中显示了肺移植对AFOP生存率的可能益处。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.