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Query: UMLS:C0002895 (sickle cell disease)
 11,747 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pneumococcal and mycoplasma infection of the lung or pleura, infarction of lung or pleura, local abscess below the diaphragm, and heart, kidney, or pancreas involvement are among the many causes of pleural effusion. Several of these have an increased likelihood of occurrence in sickle cell disease as a direct consequence of sicklemia or of the functional asplenia which develops. A patient is presented in whom many of these considerations arose.
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PMID:Pleural effusion in sickle cell disease. 90 10

Children with sickle cell disease and acute chest syndrome were investigated for infection with Chlamydia pneumoniae and Mycoplasma pneumoniae. Of 30 patients who had 32 episodes of acute chest syndrome, four (13%) had C. pneumoniae isolated from the nasopharynx; two of these also had serologic evidence of acute infection, and one had positive nasopharyngeal isolates on two subsequent occasions during the course of 1 year with stable, elevated titers of anti-C. pneumoniae IgG, suggesting chronic infection. Two patients with negative cultures had serologic evidence of infection with C. pneumoniae. None of 32 cultures for M. pneumoniae were positive, and although anti-M. pneumoniae IgM developed in two patients, one of these patients had evidence of C. pneumoniae infection (positive culture and seroconversion). We conclude that C. pneumoniae infection is prevalent in our sickle cell population with acute chest syndrome. Until further studies clarify the pathophysiologic significance of C. pneumoniae infection, we believe that early inclusion of erythromycin as antimicrobial therapy for acute chest syndrome seems reasonable.
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PMID:Role of Chlamydia pneumoniae in acute chest syndrome of sickle cell disease. 189 50

Aplastic and hypoplastic crises are well recognised complications of sickle cell disease. Recent evidence has shown that most of these crises are caused by parvovirus infection. Five cases of aplastic or hypoplastic crises in patients born and living in this country were studied. Three patients had clear evidence of parvovirus infection, while in two evidence of parvovirus infection was lacking. One patient had evidence of concurrent parvovirus and Mycoplasma pneumoniae infection. Recurrent crises may occur, and reticulocyte monitoring during infection in patients with chronic haemolytic states is therefore important.
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PMID:Aplastic and hypoplastic episodes in sickle cell disease and thalassaemia intermedia. 300 72

Mycoplasma pneumoniae, which usually causes mild infections in normal children, has been shown to cause isolated cases of severe pneumonia in children with sickle cell disease. We recently observed an outbreak of Mycoplasma pneumonia in three sisters with homozygous sickle cell disease. Two of them required hospitalization, and one progressed to respiratory failure requiring prolonged ventilatory assistance. All eventually recovered without long-term pulmonary complications. Familial outbreaks are not uncommon in Mycoplasma infection, but they have not been described previously in siblings with sickle cell disease. It is assumed that local or systemic host defense abnormalities predispose patients with sickling syndromes to more severe courses of Mycoplasma infections.
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PMID:Severe Mycoplasma pneumonia in three sisters with sickle cell disease. 315 38

Reports in the 1970s suggested that acute chest syndrome (ACS) in children with sickle cell disease is usually due to bacterial infection. Studies in adults and more recently in children, however, showed that proved bacterial infection occurs in a minority of these patients and that vascular occlusion is the main pathologic process. In a retrospective study of 32 episodes of ACS in children, a definite bacterial infection was found in 3% (one patient), possible bacterial infection in 11% (four patients), and a possible mycoplasma in 13% (five patients). With the intent to dilute sickle cells, 23 patients received blood transfusion within 24 hours after hospital admission; all showed a dramatic clinical and roentgenographic improvement. Of the nine patients who did not receive a transfusion after hospital admission, the conditions of five patients deteriorated but improved after "late" transfusion; three patients showed slow improvement, and only one patient improved within 48 hours. From this we conclude that vascular occlusion might be the main process in ACS and that early blood transfusion may be valuable in shortening the course and decreasing mortality. The low hemoglobin value at presentation in our patients makes dilution of sickle cells possible by packed red blood cell transfusion rather than exchange transfusion.
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PMID:Beneficial effect of blood transfusion in children with sickle cell chest syndrome. 334 20

Cytomegalovirus (CMV) pneumonia frequently occurs in immunocompromised hosts. Unlike encapsulated bacteria and Mycoplasma, CMV pneumonia has not been reported in sickle cell disease. We describe a case of a healthy young man with sickle cell thalassemia who died with CMV pneumonia.
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PMID:Cytomegalovirus pneumonia in sickle cell disease. 608 44

M. pneumoniae is a common cause of pneumonia. The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell count is normal or only slightly elevated, and the Gram stain of the sputum (if any can be obtained) reveals polymorphonuclear leukocytes and few bacteria. The diagnosis is more difficult when the patient presents with symptoms not suggestive of pneumonia including lethargy, dyspnea, and a 1- to 4-week history of shortness of breath without cough or fever in association with diffuse reticulonodular or interstitial pulmonary infiltrates. The disease in the previously healthy host is usually benign and self-limiting. However, the course is shortened by the administration of tetracycline derivatives or erythromycin. M. pneumoniae pneumonia can occur in association with other diseases including sickle cell anemia, sarcoidosis, systemic lupus erythematosus, Hodgkin's disease, and various other immunodeficiency states. In these patients mycoplasma pneumonia can be very serious. Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients.
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PMID:Mycoplasma pneumonia. 676 79

Pneumococcal sepsis and/or meningitis are major causes of morbidity and mortality in young children with sickle cell disease. Abnormal complement activity, poor splenic function and a lack of type-specific pneumococcal antibody are responsible for the severity and frequency of these infections. A program consisting of early institution of antibiotic therapy for febrile episodes, antimicrobial prophylaxis, and administration of pneumococcal vaccine may be effective in reducing the incidence of pneumococcal disease. Specific guidelines for infection prevention are presented. Other infections that are more frequent or more severe in children with sickle cell disease (e.g., Salmonella, Haemophilus and mycoplasma infections) are also discussed.
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PMID:Infections in children with sickle cell anemia. Special reference to pneumococcal and salmonella infections. 716 89

Acute pulmonary complications of sickle cell anemia are sickle cell lung disease and bacterial pneumonias. Chronic abnormalities in lung function include a restrictive ventilatory defect and perhaps increased venous admixture to the pulmonary circulation. Coexisting sarcoidosis may complicate sickle cell anemia and interact to potentiate sickling. Sickle cell lung disease, or acute "chest syndrome," occurs with greatest frequency in adults, is due primarily to pulmonary infarction, and may lead to cor pulmonale. On the other hand, bacterial pneumonia due to Streptococcus pneumoniae occurs with greater frequency in infancy and childhood. Mycoplasma and other organisms may also cause pneumonia with protracted illness and slow resolution. Bacteremia and meningitis may be further complications, particularly in children. Precise diagnosis of the acute febrile pulmonary episode is often difficult. In adults the illness is commonly self-limited. However, a vigorous diagnostic approach is warranted in all severely ill patients.
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PMID:The lung in sickle cell disease: a clinical overview of common vascular, infectious, and other problems. 746 92

Mycoplasma pneumoniae, a gram-negative bacteria, is an important cause of lower respiratory tract infection in children (20% of cases). The infection tends to be endemic and is punctuated by epidemic episodes every 4 to 7 years. Its frequency seems to be higher in children between 5 and 9 years of age, but is probably underestimated before 5 years. M.pneumoniae may cause multisystem infection. Diagnosis is established upon clinical data and laboratory findings. Usually, the infection is associated with leucocyte count under 15,000/mL and C-reactive protein under 50 m/L. Detection of M. pneumoniae DNA in clinical samples appears to have advantages over serological tests. Severe infections have been described in patients with humoral and cellular immunodeficiencies, sickle cell disease, cystic fibrosis. Treatment with macrolids and tetracyclines (after 8 years of age) is indicated. Respiratory functional sequelae are possible.
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PMID:[Bronchopulmonary infections caused by Mycoplasma pneumoniae in children]. 897 63


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