Non-invasive ventilation in the treatment of severe polymicrobial community-acquired pneumonia

  • Enrico Cinque Intensive Care Unit, Hospital of Lavagna, Lavagna (GE), Italy.
  • Ines Maria Grazia Piroddi Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante (GE), Italy.
  • Cornelius Barlascini Hygiene and Health Medicine Unit, Hospital of Sestri Levante, Sestri Levante (GE), Italy.
  • Alessandro Perazzo Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante (GE), Italy.
  • Antonello Nicolini | antonellonicolini@gmail.com Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante (GE), Italy.

Abstract

Polymicrobial pneumonia may be caused by the combination of respiratory viruses, bacteria and fungi in a host. Colonization by Streptococcus pneumoniae was associated with increased risk of Intensive Care Unit admission or death in the setting of influenza infection, whereas the colonization by methicillin sensible Staphylococcus aureus co-infection was associated with severe disease and death in adults and children. The principal association of pathogens in community-acquired pneumonia (CAP) is bacteria and viral co-infection, and accounts approximately for 39% of microbiological diagnosed cases of CAP. The differential clinical diagnosis between a viral and a bacterial CAP is not easy: no clinical signs or radiological findings help the clinician to suspect to the diagnosis. Patients with polymicrobial infections are more likely to have underlying medical conditions and have more severe outcome. Severe respiratory failure and need of mechanical ventilation occur in several cases. Non invasive ventilation (NIV) use aims to avoid invasive mechanical ventilation. NIV treatment is controversial owing to high reported treatment failure. In this case series we report three cases of severe polymicrobial CAP: all of them required NIV with a good outcome.

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Published
2017-03-15
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Section
Case Reports
Keywords:
Polymicrobial-community-acquired pneumonia, severe respiratory failure, non-invasive ventilation.
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How to Cite
Cinque, E., Piroddi, I. M. G., Barlascini, C., Perazzo, A., & Nicolini, A. (2017). Non-invasive ventilation in the treatment of severe polymicrobial community-acquired pneumonia. Italian Journal of Medicine, 11(1), 57-60. https://doi.org/10.4081/itjm.2017.675