digoxin and Pneumonia

Chronic heart failure may increase risk of pneumonia due to alveoli flooding and reduced microbial clearance. We examined whether chronic heart failure is a risk factor for pneumonia-related hospitalization.. In this large population-based case-control study we identified adult patients with a first-time primary or secondary discharge diagnosis of viral or bacterial pneumonia between 1994 and 2008, using health care databases in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark's Civil Registration System. We used conditional logistic regression to compute relative risk (RR) for pneumonia-related hospitalization among persons with and without pre-existing heart failure, overall and stratified by medical treatment. We controlled for a wide range of comorbidities, socioeconomic markers and immunosuppressive treatment.. The study included 67,162 patients with a pneumonia-related hospitalization and 671,620 population controls. The adjusted OR for pneumonia-related hospitalization among persons with previous heart failure was 1.81 (95% confidence interval (CI): 1.76-1.86) compared with other individuals. The adjusted pneumonia RR was lower for heart failure patients treated with thiazides only (adjusted OR=1.56, 95% CI: 1.46-1.67), as compared with patients whose treatment included loop-diuretics and digoxin as a marker of increased severity (adjusted OR=1.95, 95% CI: 1.85-2.06) or both loop-diuretics and spironolactone (adjusted OR=2.02, 95% CI: 1.90-2.15). The population-attributable risk of pneumonia hospitalizations caused by heart failure in our population was 6.2%.. Patients with chronic heart failure, in particular those using loop diuretics, have markedly increased risk of hospitalization with pneumonia.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cardiotonic Agents; Case-Control Studies; Chronic Disease; Denmark; Digoxin; Diuretics; Female; Heart Failure; Hospitalization; Humans; Logistic Models; Male; Middle Aged; Pneumonia; Risk Factors

A case of serious intoxication with CS tear gas (o-chlorobenzylidene-malononitrile) is reported in a previously healthy male subject of 43 years involving pulmonary edema complicated by pneumonia, signs of heart failure and evidence of hepatocellular damage. Comparison with animal and human exposures supports the etiologic and pathogenetic role of CS tear gas in the present case. The pulmonary edema may have been the consequence of unusual conditions of exposure and/or increased individual susceptibility. The question of the "safety" of CS tear gas is discussed.

Topics: Adult; Chemical and Drug Induced Liver Injury; Digoxin; Furosemide; Heart Failure; Humans; Male; Nitriles; o-Chlorobenzylidenemalonitrile; Pneumonia; Pulmonary Edema; Tear Gases

Topics: Child, Preschool; Digoxin; Female; Heart Diseases; Humans; Infant; Male; Pneumonia

Topics: Acute Disease; Child; Child, Preschool; Chronic Disease; Coronary Disease; Digoxin; Humans; Infant; Infant, Newborn; Myocarditis; Pneumonia; Strophanthins

Topics: Child; Child, Preschool; Digoxin; Drug Evaluation; Heart Defects, Congenital; Heart Failure; Humans; Infant; Pneumonia; Sepsis; Tachycardia, Paroxysmal

Topics: Age Factors; Aged; Bundle-Branch Block; Cellulitis; Diabetic Ketoacidosis; Digoxin; Female; Glucose; Humans; Infusions, Parenteral; Insulin; Penicillins; Pneumonia; Potassium; Streptococcal Infections

Topics: Amphotericin B; Aspergillosis; Aspergillus fumigatus; Blood Bactericidal Activity; Blood Transfusion; Child; Digoxin; Gentamicins; Humans; Leukocytes; Male; Phagocyte Bactericidal Dysfunction; Pneumonia

Topics: Chlorambucil; Chloramphenicol; Cytomegalovirus Infections; Diagnosis, Differential; Digoxin; Electrons; Hodgkin Disease; Humans; Hydrocortisone; Infant; Lung Diseases; Mechlorethamine; Microscopy; Microscopy, Electron; Neoplasms; Pathology; Penicillins; Plasma Cells; Pneumonia; Pneumonia, Pneumocystis; Streptomycin