Hospital-Acquired Pneumonia (Nosocomial Pneumonia) and Ventilator-Associated Pneumonia
Transplanted Lungs Likely Spread Dangerous Legionella Infection To Two Recipients, Study Says - CNN
CNN —
For the first time, an organ transplant is believed to have spread dangerous Legionella bacteria, according to a report published Thursday by the US Centers for Disease Control and Prevention.
The two people who developed Legionnaires' disease received donated lungs from a man who died last year after falling into a river in Pennsylvania. The man, who was in his 30s, had been declared brain-dead after attempts to resuscitate him were unsuccessful.
Doctors were able to transplant his right lung into a woman in her 70s. His left lung went to a man in his 60s. Both eventually developed Legionnaires', a severe form of pneumonia caused by the Legionella bacteria.
People who receive transplanted organ are particularly vulnerable to infections because they have to take a medicine that suppresses their immune system for the rest of their lives to keep it from attacking the donor organ.
In this case, the female patient became ill and tested positive for the Legionella species of bacteria in June 2022, about a month after she received the lung transplant. Doctors treated her with an antibiotic, and she fully recovered.
The male patient had several complications after the transplant and tested positive for the bacteria in June. He initially appeared to recover but died about six months after the transplant surgery due to respiratory failure.
Doctors tested three other people who received organs from the same donor, but they remained free of the bacteria.
After learning about the infections, the Pennsylvania Department of Health went on the hunt for the source of the bacteria.
The department tested the water at the hospital where the transplant operations were done but did not find any evidence of Legionella. Eventually, officials began to suspect that the bacteria came from the drowned organ donor, since Legionella bacteria can be found naturally in fresh water. It's possible that when the man inhaled the water, he picked up the bacteria.
The CDC warns that instances of Legionnaires' disease have increased "substantially" over the past decade. The bacteria thrives in warm water, and as the climate crisis has increased temperatures, there have been many more opportunities for it to grow.
Scientists hope the new report will serve as a warning to health care providers to be on the lookout for potential Legionella infections in organ recipients.
"This cluster highlights the need for increased clinical awareness of possible infection with Legionella in recipients of lungs from donors who drowned in fresh water before organ recovery," says the study, from researchers in Pennsylvania and at the CDC. "Prompt diagnosis and treatment of Legionnaires disease increases the likelihood of a full recovery."
Why Respiratory Infections Are Especially Dangerous For Older Adults, According To A Doctor
(CNN) — After Pope Francis was hospitalized last week for bronchitis, the Vatican has now announced that he has pneumonia in both lungs, with tests continuing to indicate a "complex clinical picture."
Earlier in the week, the Vatican had said the 88-year-old had a "polymicrobial infection of the respiratory tract."
These are the latest in a series of lung-related health concerns that have plagued Francis, and it's a reminder for older adults to take respiratory infections seriously — even if you're not as old as the pontiff.
I asked CNN wellness expert Dr. Leana Wen about the different types of respiratory infections. How are they diagnosed and treated? Why are older adults especially at risk for serious disease due to respiratory infections? And how can everyone reduce their chance of contracting pneumonia and other respiratory infections?
Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore's health commissioner.
CNN: What are different types of common respiratory infections, and what are their symptoms?
Dr. Leana Wen: One way to think about respiratory infections is where they affect the respiratory tract. Upper respiratory tract infections affect the sinuses and throat and would include infections like the common cold and a sinus infection.
Lower respiratory tract infections affect the airways and lungs. They include bronchitis, which is an inflammation of the airway passages leading to the lungs. People with acute bronchitis may cough a lot but generally do not have fever or struggle with breathing; if they do, the concern would be that they also have another condition.
Pneumonia is also a lower respiratory tract infection and is an infection of the lungs themselves. There are a variety of organisms that can cause pneumonia, including viruses, bacteria, fungi and parasites. Individuals with pneumonia can experience a range of symptoms — the common ones being fever, shortness of breath, cough, body aches and fatigue. Some patients may also experience nausea, vomiting, diarrhea, chest pain while breathing, and altered mental status or confusion.
CNN: What does it mean that Pope Francis has a "polymicrobial infection of the respiratory tract"?
Wen: The word polymicrobial means that more than one organism is involved in his illness. So, more than one type of virus, bacteria, fungus or parasite was detected and believed to be the cause of his symptoms.
Since Pope Francis remains hospitalized and his infection is described as complex, it's not a surprise that he was diagnosed with pneumonia. In 2023, he required hospitalization for pneumonia, too. He is also known to have had severe pneumonia in the past and to have had a portion of a lung removed.
CNN: How are lower respiratory tract infections like pneumonia diagnosed and treated?
Wen: Diagnosis is made through a combination of the person's medical history, physical exam and diagnostic tests. The tests could include a chest X-ray or CT scan. They could also include viral swabs through the nose and pharynx and sputum culture in which material is coughed up and tested. Sometimes, patients undergo a bronchoscopy, in which a flexible tube goes into the airways to take samples for testing. Patients who require hospitalization will also receive blood tests, including to assess whether the infection has spread through their bloodstream.
The treatment depends on the type of organism involved. Common causes of bacterial pneumonia include Mycoplasma pneumoniae and Streptococcus pneumoniae. These would be treated with antibiotics. Someone with a fungal pneumonia would receive antifungal treatment. Many viruses can also lead to pneumonia, including Covid-19, influenza, human metapneumovirus, or HMPV, and the respiratory syncytial virus, or RSV. Some of these viruses have specific antivirals that can be given.
CNN: Why are respiratory infections especially concerning in older adults?
Wen: There is no question that respiratory infections present a serious threat to older adults. According to a 2020 study, nearly 1 million older adults are hospitalized for pneumonia every year. Over one-third of those hospitalized die within the next year, that study found.
There are several reasons why older adults are more vulnerable to severe outcomes from these infections. First, they are more likely to have other chronic medical conditions that increase the likelihood of complication, such as chronic obstructive pulmonary disease, emphysema, heart disease, kidney disease and diabetes. Second, they are more likely to have muscle weakness, which makes coughing a challenge. Third, the muscle weakness could lead to swallowing problems. Older individuals are more likely to inhale food or liquid into their lungs, causing aspiration pneumonia.
Fourth, the immune system weakens with age, which means that older individuals would have diminished ability to fight infections. Fifth, some older people may have atypical symptoms — for example, instead of having a high fever and cough, they have worsening confusion or diarrhea. This could lead to a delay in diagnosis until the infection is more severe.
It's important to add that older adults are not the only group for whom respiratory infections can be especially severe. Infants and young children are also very susceptible; globally, pneumonia kills more children under the age of 5 than any other infectious disease. Other vulnerable groups include people who are immunocompromised or who have other serious underlying medical conditions.
CNN: What kinds of complications can occur in people with respiratory tract infections?
Wen: People may experience such difficulty breathing that they need additional respiratory support, including intubation where a machine helps to breathe for the patient and the person has to be under heavy sedation. Bacteria pneumonia can spread to the bloodstream and cause sepsis, which is extremely dangerous and can be quickly fatal. And pockets of pus can form inside or around the lungs, and they may need be drained with surgery.
CNN: Are there steps people can take to reduce their risk of contracting respiratory infections?
Wen: People should receive the vaccines available to them. For instance, everyone 6 months and older should receive the flu shot every year. Children under 5 and adults 50 years and older should receive the pneumococcal vaccine. And people eligible for the RSV vaccine should receive it as well. The CDC recommends it for all adults 75 and older as well as adults ages 60 to 74 who are at increased risk for severe RSV.
Those who smoke or drink alcohol heavily should know that these are risk factors for pneumonia and work to quit smoking and reducing alcohol intake. Eating a healthy diet, exercising regularly and getting adequate sleep can help with strengthening immune response. And people should optimize control of their other underlying medical conditions.
Good hand hygiene can reduce transmission of contagious diseases. Everyone should wash their hands with soap and water, including after touching high-use public spaces.
Those who want to be extra cautious should consider taking additional precautions, including masking in indoor crowded spaces, being sure that those they associate with do not have respiratory symptoms, and reducing time around others during peak respiratory infection season.
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Cladosporium: Allergies, Identification, And More - Healthline
Cladosporium is a common mold that may affect your health. It can cause allergies and asthma in some people. In very rare cases, it can cause infections. Most species of Cladosporium aren't dangerous to humans.
Cladosporium can grow both indoors and outdoors. Spores from the mold can be airborne, which is also how the mold spreads.
This type of mold is more common in areas with humidity, moisture, and water damage.
Reactions to Cladosporium are rare, and are usually an allergic response, but they can be potentially dangerous, causing a fungal infection in the lungs.
It can be difficult to identify Cladosporium in your home without professional help. There are over 500 species of Cladosporium. Many other types of mold can also grow in your home. Cladosporium may appear as brown, green, or black spots.
Not all black mold is the same
Not all black mold is harmful, but there is a toxic mold often found in moist areas like attics. This mold is called Stachybotrys chartarum, and is often found in attics or areas that have consistent moisture. The reason this mold is so dangerous is that it releases mycotoxins that do damage when inhaled. This type of black mold is much darker black to green. The best choice is to find a professional to help you identify if you are dealing with Cladosporium or something else.
Cladosporium is commonly found in the home on:
Cladosporium is more likely to grow in:
You may not be able to identify the mold on your own. Consider hiring a professional mold tester or company to inspect your home, as there are more dangerous black molds than cladosporium.
They can identify the type of mold in your home and help you remove it. Another option is to send mold samples to a professional laboratory for testing.
A professional mold tester can find mold you may not have seen.
Photo of Cladosporium
Exposure to Cladosporium affects people in different ways. Some people may develop an allergic reaction, while others may not.
Symptoms of an allergic reaction vary. It's possible to have symptoms year-round, or only during specific months. Your symptoms may be worse in damp areas or in areas with a higher concentration of mold.
Symptoms of an allergic reaction may include:
An allergic reaction to mold may become serious in some cases. Severe reactions include:
Talk to your doctor about treatment options for allergic reactions and asthma to mold. If you haven't yet, bring in a specialist to diagnose the type of mold to ensure it isn't a more dangerous type.
Limit your exposure to mold and seek help if symptoms continue to get worse. It's important to fix any leaks to prevent pooling of water and have proper ventilation in bathrooms and kitchens. Use a dehumidifier in areas prone to moisture, such as basements.
Your doctor may recommend over-the-counter (OTC) allergy medications first and suggest prescriptions if the OTC drugs don't work.
Medications your doctor may prescribe or recommend include:
Because it increases the risk of severe mental health side effects, montelukast should only be prescribed if there are no other suitable treatment options.
Other treatment options include:
There is no current research to suggest that Cladosporium is dangerous to a fetus during pregnancy. It's possible that exposure to Cladosporium in pregnancy may trigger allergic symptoms or asthma within the mother.
Talk to your doctor about medications that are safe to take during pregnancy.
If possible, you should also identify and remove the mold from your home. Some products used to remove mold may be dangerous to use in pregnancy, and removing the mold may spread it to other areas. Consider hiring a professional mold removal service or have someone else treat the mold.
Cladosporium can be removed from your home, but it's best to hire professional mold removers for this type of job.
The first step is to identify the type of mold growing in your home. It's also important to find out how much mold is in your house and how far it has spread. Next, you can work on removing it.
It's recommended that you get professional help to deal with mold. If you decide to do it alone, you may spread the mold to other areas of your house during the removal process. Mold removal requires special clothing and equipment.
Here are steps you can follow if you decide to try to remove mold on your own:
If antiques or family heirlooms have mold, consider talking them to a specialist who can clean them. You may not want to throw them away, but cleaning them yourself may be risky.
Your insurance company may cover the removal. Talk to your insurance agent to find out the details for mold coverage.
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