Difference Between Viral And Bacterial Fever PdfBy Otelo M. In and pdf 25.03.2021 at 16:09 6 min read
File Name: difference between viral and bacterial fever .zip
- What's the difference between Bacteria and Viruses?
- Blood biomarkers differentiating viral versus bacterial pneumonia aetiology: a literature review
- Bacteria and viruses are too tiny to be seen by the naked eye
Please understand that our phone lines must be clear for urgent medical care needs. When this changes, we will update this web site. Please know that our vaccine supply is extremely small. Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi.
What's the difference between Bacteria and Viruses?
Metrics details. The goal of this literature review is to compare current studies regarding the accuracy of different serum markers in differentiating viral from bacterial pneumonia in the pediatric population with what is employed in the medical settings at present. Currently there is still a lack of significant research, that would give us evaluation on biomarkers benefits towards getting a definite diagnosis of pneumonia.
Finding out the potential of biomarkers to differentiate between viral and bacterial pneumonia is also important because knowing the exact pathogen would prevent irrational use of antibiotics. At present, irrational, broad-spectrum antibiotic use and increasing antibiotic resistance in microorganisms are still one of the greatest challenges in clinical settings.
The use of biomarkers in clinical practice would not only facilitate accurate diagnosis, but would also help to reduce the amount of antibiotics overuse. Literature search conducted on Medline and Google Scholar using a combination of terms. Articles that were in English and within ten years of the search date were manually sorted according to inclusion and exclusion criteria. This is because there is overlapping to a varying extent depending on the marker cut-off values, detection methods, analyses, the desired specificity, and sensitivity.
Furthermore, the presence of mixed infection makes almost all markers suboptimal to be used universally. However, to replicate a similar testing condition in a clinical environment may not be practical. Another approach is to make use of more than one marker and combine with clinical signs and symptoms. This may not be cost-effective in many clinical settings; nevertheless, in many studies, marker combination greatly improved the predictive power.
Community-acquired pneumonia CAP is estimated to cause According to the epidemiological data, approximately million cases of CAP are diagnosed every year in children under the age of five worldwide, of which, approximately 10—20 million are severe cases requiring in-patient treatment [ 2 ]. However, there has been a drop in the incidence and mortality of CAP with the introduction of vaccination against Streptococcus pneumoniae and Haemophilus influenzae [ 3 , 4 , 5 ].
Thus, viral pathogens have become significant in causing CAP. However, antimicrobial drug use remains one of the biggest challenges in viral CAP cases [ 7 ], especially in children. In addition, diagnostic limitations in differentiating viral and bacterial pathogen in CAP causes increased antibiotic use and contributes to antibiotic resistence growth [ 8 ].
The biggest challenge remains to differentiate common respiratory viral pathogens from bacterial causes. Clinical signs and symptoms of CAP of viral and bacterial origin overlap significantly [ 9 ]. The uncertainty is further exacerbated by the fact that direct isolation of possible causative agent from the lower respiratory tract is invasive and therefore rarely performed [ 8 ]. Consequently, indirect methods are utilized to isolate the organism.
These include polymerase chain reaction PCR of throat swab, gram stain, and culture of nasopharyngeal aspirate, and blood cultures. However, interpretation can be difficult as children are found to be asymptomatic carriers of a range of organisms and a positive result on PCR may not be indicative of the cause of CAP [ 8 ].
However, the changes observed are not specific to predict causative pathogen. Instrumental diagnostics, such as a chest X-ray is not sensitive or specific and is not recommended in the initial diagnosis of a suspected CAP [ 10 ]. Radiographic changes which show patchy bilateral involvement may suggest a viral aetiology, however, this is not specific [ 10 ]. A great deal of attention, therefore, is given to quantitative changes in different serum markers to make better conclusions.
Owning to the difference in the immunological and inflammatory response induced by bacteria and viruses, the disparity in the levels of specific markers may give an objective value that may equip us with better prediction power regarding aetiology.
Many research studies have explored the different serum markers, but the conclusions are conflicting [ 7 , 11 , 12 , 13 ]. Therefore, an intuitional review is vital to provide enough clarity to bridge the scientific gap. The underlying principle of this research is to summarise literature analysing different biomarkers and provide an overview.
The use of new biomarkers in clinical practice would not only facilitate accurate diagnosis, but would also help to reduce the amount of antibiotics used. We excluded all studies focused on adult CAP. Additionally, all studies analyzing pediatric patients with comorbidities and diagnosed with CAP were excluded from our review.
We also excluded animal studies, literature review, systematic review and metanalysis. Literature was identified by two independent reviewers searching Medline and Google Scholar until the 1st of July After all the primary studies were collected, all the study characteristics were extracted as follows: the author of the study, date of enrolment, where the study was conducted, patient age, type of the study, and target biomarker.
Numerical data extracted included the number of CAP patients in each study and number of viral and bacterial cases. The search returned 13, records up to 1st of July, After activating filters, we selected articles. After duplicate removal, the title and abstracts were manually sorted and matched according to the inclusion and exclusion criteria.
Afterward, details were extracted for each article as described in methods. This information is then summarised in Table 3. In all the studies analysing CRP as a diagnostic marker, the average CRP level was higher in the bacterial group than viral group [ 14 , 20 , 22 , 23 , 25 , 26 , 27 , 28 , 29 ]. In an investigation by Esposito et al. Similarly, in a different study by Esposito et al. The study by Bhuiyan et al. Although the mean levels of CRP were higher in bacterial CAP, there was overlap between viral and bacterial cases leading to issues in fixing a suitable cut-off point that is both sensitive and specific to differentiate between the two.
In the study by Elemraid et al. It is evident that a low reference point for CRP will diagnose almost all cases of bacterial aetiology but will include a significant number of false-positive cases. However, a lower threshold value does not guarantee higher sensitivity.
In a study by Esposito et al. In a study by Naydenova et al. In the same study, the author added Lipocalin-2 Lcn2 to CRP and clinical data which dramatically increased sensitivity to A significant limitation of almost all the studies was the lack of inclusion of primary care patients.
This meant that before hospital admission, many patients might have had exposure to antibiotics which may have altered the level of CRP [ 27 ]. Another drawback was that only one study investigated co-infection viral-bacterial and concluded that CRP level did not correlate with co-infection [ 29 ]. Four studies analysed the diagnostic value of procalcitonin PCT [ 17 , 22 , 24 , 26 ]. PCT is a precursor to calcitonin produced in the parafollicular cells of the thyroid gland by the transcription of CALC-1 gene.
During an infection, CALC-1 gene is activated and upregulated to increase the production of PCT in not only endocrine glands but also many parenchymal tissues [ 30 ]. It is hypothesized that viruses are not able to increase PCT to such a concentration as certain cytokines expressed during viral infection leads to decreased induction of PCT.
This was reflected in the study by Esposito et al. Hoshina et al. The total WBC count fluctuates in the paediatric population, especially in the early period of life. Therefore, the reference values differ between the age groups [ 32 ]. Research by Elemraid et al. Esposito et al. According to Zhu et al. The lack of rise in neutrophil count correlates well with viral causes. In recent years new biomarkers have been tested in children. Of this, MxA1 has shown promising results. Compared to other markers, MxA1 protein tends to rise significantly during viral rather than a bacterial infection.
IFN is classified into three groups depending on the similarities in their amino acid sequence. Type I IFN is called alpha, beta, tau, and -omega and are produced in all cells in the body [ 36 ]. IFN is also elevated in autoimmune conditions and some hematological cancers. The study by Engelmann et al. The author also hypothesized that if a bacterial infection is diagnosed and high levels of MxA1 are detected, this is an indication that bacterial organism preceded a viral cause [ 25 ].
This is because MxA1 stays elevated for approximately ten days after a viral insult in comparison to IFN which has a very short half-life [ 38 ]. The authors also made a correlation with CRP. The study sample size was the biggest drawback of this investigation. Out of children who were enrolled, only 41 had CAP. Moreover, not all cases of CAP were microbiologically confirmed.
Therefore, more studies are needed to confirm the diagnostic value of MxA1. Lcn2 has been studied in the above data. This protein is stored and released by neutrophils which distorts iron transportation within bacteria. This marker is of a high interest in diagnosing aetiological factor of CAP. Two studies involving Lcn2 were carried out in very different settings which may have contributed to the different results. The study by Esposito et al. While Naydenova et al. The latter study was set in a developing nation amongst children with malaria, which is known to affect the concentration of Lcn2 [ 39 ].
According to Huang et al. This protein is elevated during CAP, sepsis and viral-bacterial co-infections, especially bacterial and Influenza virus co-infection [ 40 ]. A study by Zhou et al. It was found that co-infection virus and bacteria can be concluded when HMGB1 expression is greater than 1.
Therefore, HMGB1 seems to be a good marker. However, the need to isolate specific blood cells monocytes and to adopt PCR makes this method prolonged and expensive. Several new markers, such as Syndecan 4 SYN4 , were explored with poor reliability.
Blood biomarkers differentiating viral versus bacterial pneumonia aetiology: a literature review
As you might think, bacterial infections are caused by bacteria, and viral infections are caused by viruses. Perhaps the most important distinction between bacteria and viruses is that antibiotic drugs usually kill bacteria, but they aren't effective against viruses. Bacteria are single-celled microorganisms that thrive in many different types of environments. Some varieties live in extremes of cold or heat. Others make their home in people's intestines, where they help digest food.
Medically reviewed by Carmen Fookes, BPharm. Last updated on April 13, Bacteria are simple, single celled organisms, called prokaryotes, which means their DNA is contained within a certain area of the cell called the nucleoid, but not enclosed. Bacteria are one of the oldest living things on earth, having been in existence for at least 3. A microscope is needed to see them.
between bacterial, viral and mixed aetiology in patients with Use of clinical symptoms and signs to differentiate between bacterial and viral CAP could aid in choosing a phases of infection (separated by at least 2 weeks) were obtained.
Bacteria and viruses are too tiny to be seen by the naked eye
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Metrics details. The goal of this literature review is to compare current studies regarding the accuracy of different serum markers in differentiating viral from bacterial pneumonia in the pediatric population with what is employed in the medical settings at present. Currently there is still a lack of significant research, that would give us evaluation on biomarkers benefits towards getting a definite diagnosis of pneumonia. Finding out the potential of biomarkers to differentiate between viral and bacterial pneumonia is also important because knowing the exact pathogen would prevent irrational use of antibiotics. At present, irrational, broad-spectrum antibiotic use and increasing antibiotic resistance in microorganisms are still one of the greatest challenges in clinical settings.
Родители согласились. Хотя Энсей Танкадо никогда прежде не видел компьютера, он как будто инстинктивно знал, как с ним обращаться. Компьютер открыл перед ним мир, о существовании которого он даже не подозревал, и вскоре заполнил всю его жизнь. Повзрослев, он начал давать компьютерные уроки, зарабатывать деньги и в конце концов получил стипендию для учебы в Университете Досися.
На сей раз голос его прозвучал с несвойственным ему спокойствием: - Директор, если мы введем неверный ключ… - Верно, - прервала его Сьюзан. - Если Танкадо ничего не заподозрил, нам придется ответить на ряд вопросов. - Как у нас со временем, Джабба? - спросил Фонтейн.
По спине Сьюзан пробежал холодок. - Конечно, - чуть слышно сказала. - Танкадо подумал, что раз мы приостановили действие его страхового полиса, то можем приостановить и его. Постепенно она начала понимать. Время сердечного приступа настолько устраивало АНБ, что Танкадо сразу понял, чьих это рук дело, и в последние мгновения своей жизни инстинктивно подумал о мести.
А что это за звездочка? - спросила Сьюзан. - После цифр стоит какая-то звездочка. Джабба ее не слушал, остервенело нажимая на кнопки.
Танкадо ни за что не доверился бы Хейлу. - Коммандер, - напомнила Сьюзан, - Хейл однажды уже чуть не угробил нас - с Попрыгунчиком. Танкадо имел основания ему верить.