Thorax
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Host- and pathogen-related factors associated with septic shock in pneumococcal pneumonia are not well defined. The aim of this study was to identify risk factors for septic shock and to ascertain patient outcomes. Serotypes, genotypes and antibiotic resistance of isolated strains were also analysed. ⋯ Septic shock is a frequent complication of pneumococcal pneumonia and causes high morbidity and mortality. Current tobacco smoking, chronic corticosteroid treatment and infection caused by serotype 3 are independent risk factors for this complication.
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The nose and paranasal sinuses are contiguous with the lower respiratory tract. Patients with bronchiectasis and cystic fibrosis commonly have sinonasal disease, which is thought to have the same aetiology and pathophysiology as the chronic lung disease. ⋯ In addition to being a common cause of comorbidity, there is evidence suggesting that sinonasal disease may directly influence the bronchial condition. This article reviews sinonasal disease in bronchiectasis and cystic fibrosis and addresses the possible interactions between the health and disease of the upper and lower airways.