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Problematic Patterns

Pneumonia, an inflammatory condition of the lung, primarily affects the alveoli, which fill with fluid and pus. This manifests in a variety of symptoms and limits oxygen intake. The causes include bacteria, viruses or fungi (1). Pneumonia classification involves healthcare-associated (otherwise called hospital-acquired) or communityacquired (CAP); when not acquired in a hospital or other medical institution. Symptoms manifest in cough (with or without sputum), fever, pleuritic chest pain and dyspnea. If untreated, pneumonia can result in bacteraemia, septic shock, lung abscesses, pleural effusion, empyema and pleurisy and respiratory or renal failure (2).

Pneumonia remains a major cause of illness and death, affecting mostly young children and the elderly. Pneumonia is the world’s leading cause of death among children under five and accounts for 15% of all deaths of children at this age (3). According to the WHO, 5% of overall mortality was caused in 2015 by lower respiratory tract infections, including pneumonia (4).

Misdiagnosis

Physicians must differentiate pneumonia from upper respiratory tract infections and other conditions (eg congestive heart failure) that share similar clinical features. Pulmonary embolism (PE) is known as ‘the great masquerader’; it presents a diagnostic dilemma and is most often mistaken for pneumonia. Dyspnea is the most common symptom of PE, and tachypnea is the most frequent sign. Patients with severe pneumonia may be very short of breath (5).

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Daniella Bajzath, PharmD, Safety Officer at PSI CRO AG, is a graduate of Pharmaceutical Faculty, Semmelweis University, Hungary. Before joining PSI in 2016, she had worked for four years in public pharmacies in Hungary and Germany. She has experience in preparing and handing out prescription and OTC drugs and in advising patients on medical subjects in several indications.

Maxim Belotserkovskiy MD, PhD, MBA, holds the position of Head of Medical Affairs at PSI CRO AG. He has board certifications in internal medicine, rheumatology, anesthesiology, intensive care and hemodialysis. Maxim is also a certified Associate Professor of pathological physiology. He has more than 25 years of experience in clinical research as an investigator and research professional. Maxim is also the author/co-author of more than 150 publications.

Maxim Kosov MD, PhD, is a director of medical monitoring and consulting at PSI CRO, US. He is a board-certified physician in paediatrics, anaesthesiology and intensive care. Maxim is a member of American Society Clinical Oncology. He has more than 12 years of experience in clinical research industry and has experience across a board range of indications. He is also the author/co-author of more than 40 publications.

John Riefler MD, MS, is a director of medical monitoring and consulting at PSI CRO, US. His MS is in microbiology, and his clinical training is in internal medicine and infectious diseases. John is a fellow of the Infectious Disease Society of America and the American Heart Association. He has 29 years’ experience in clinical development in Big Pharma and CROs. John is also the author/co-author of 22 publications.
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Daniella Bajzath
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Maxim Belotserkovskiy
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Maxim Kosov
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John Riefler
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