| Theme | Dialysis Therapy and Respiratory Systems | |
|---|---|---|
| Title | Respiratory infection, pneumonia | |
| Publish Date | 1997/12 | |
| Author | Noriaki Yorioka | Second Department of Internal Medicine, Hiroshima University School of Medicine |
| Author | Kenichiro Shigemoto | Ichiyokai Harada Hospital |
| [ Summary ] | This study assessed the diagnosis and treatment of various respiratory infections in patients on dialysis. With respect to pneumonia, outpatients on dialysis are commonly infected with Streptococcus pneumoniae or Haemophilus influenzae, while inpatients on dialysis often suffer opportunistic infections with Gram-negative bacilli such as Pseudomonas aeruginosa. Enterobacter, and Serratia. When administering antibiotics, the dose and interval must be determined from the blood half-time and the rate of dialysis (depending on the excretion route). Among the viral pneumonias, cytomegalovirus is important. For diagnosis, detection of circulating antigen is useful, and ganciclovir is administered after dialysis for treatment. Respiratory mycoses include. Candida, Aspergillus, Cryptococcus, Nocardia and others. For diagnosis, the (1-3)-β-D-glucan level is useful, while amphotericin B, flucytosine, miconazole, or fluconazole are administered for treatment. Pneumocystis carinii pneumonia is also an important opportunistic infection in patients on dialysis. It presents with a dry cough, rapidly progressive dyspnea, bilateral interstitial infiltrates on chest X-ray films, and severe hypoxemia. DNA detection by PCR is useful for making the diagnosis. An ST mixture or pentamidine isetionate is administered as treatment. Respiratory infections in patients on dialysis are prone to become complicated and serious. Thus, it is important to treat them as promptly as possible. |
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