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Query: UMLS:C0004623 (bacterial infection)
 15,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

28 cases of allergic bronchopulmonary mycosis (ABPM) were diagnosed by criteria formulated in 1977 by Rosenberg and by referring to the results of serum IgE-Af and IgG-Af detection. The common clinical features were wheezing, fever, bloody sputum, sputum plugs, chest pain and loss of energy. On chest X-ray, infiltrates were found in 28 cases, fibrosis in 12, atelectasis in 4, lobar shrinkage in 1, and aspergilloma in 1, Chest films in 14 cases showed shadows suggesting in the presence of CB. Tomography (linear and/or axial) showed CB in 9 cases. All the cases had positive immediate reactions in skin test to moulds. Serum precipitating antibody against moulds were demonstrated in 27 cases. A cross reactivity exists among moulds either in skin test or in gel double diffusion technique. The sensitizing mould was chiefly Aspergillus species, especially Af. Serum IgE-Af and IgG-Af were measured in 14 cases caused by Af. The mean OD value was over 2 times greater than that in the patients with asthma who had positive skin test to Af. Corticosteroids were used for treatment, and the results of followup of 23 cases suggested that such long term complications as CB, fibrosis and refractory bacterial infection were the chief causes of poor prognosis.
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PMID:[Clinical and immunological features of allergic bronchopulmonary aspergillosis]. 166 Jul 74

Serological evidence of bacterial infection was prospectively studied in less than 6 years old patients during 188 acute episodes of expiratory difficulty requiring hospital treatment. Such evidence indicated by antibody or antigen assays was found in 40 patients (21%). Streptococcus pneumoniae was identified in 25 cases; antigenemia was found in 10, antigenuria in 2 and seroconversion in 14 cases. Seroconversion to nontypable Haemophilus influenzae was found in 9 and to Branhamella catarrhalis in 2 cases. Seroconversion to Chlamydia spp. was demonstrated in 8 patients, but specific tests for C. trachomatis were negative. C-reactive protein was over 40 mg/L in 35 patients (19%); serological evidence of bacterial infection was present in 14 and absent in 21 of them. Thus, either serological evidence of bacterial infection or an elevated C-reactive protein was found in 61 of the 188 cases (32%). We conclude that bacterial infection is commonly associated with acute wheezing in children under school age. We suggest that bacterial, as well as viral, infections may trigger an acute obstructive attack in children with reactive airways.
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PMID:Bacterial infection in under school age children with expiratory difficulty. 189 33

The incidence, etiology, epidemiology, clinical presentation, treatment, prognosis, and prevention of bronchiolitis are discussed with a critical evaluation of the available studies on various therapeutic approaches. Bronchiolitis is a lower respiratory-tract viral infection that affects 6-10% of all children below two years of age. Respiratory syncytial virus (RSV) is the usual pathogen. The symptoms range from mild wheezing to severe respiratory distress. An infected child usually has a fever, a rapid pulse, an increased breathing rate, and difficulty in breathing. Because most of the infants hospitalized with bronchiolitis have hypoxemia, the administration of oxygen is the mainstay of therapy. Correct fluid therapy is essential to avoid dehydration and overhydration. Limited data are available on the use of drugs in the management of bronchiolitis. Although a variety of adrenergic drugs, theophylline, and corticosteroids are used, sound efficacy data are lacking, and most studies have documented a lack of therapeutic benefits. One study reported that the combined use of corticosteroids and albuterol may be beneficial in severely ill patients. Recent studies have shown that the continuous administration of ribavirin may decrease viral shedding. Antibiotics are not indicated unless a secondary bacterial infection is present. Oxygen and fluid therapy have a clear role in the management of patients with bronchiolitis; however, no specific guidelines are available for the use of drugs in the treatment of these patients.
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PMID:Management of bronchiolitis. 389 Dec 1

Respiratory infection, most prominently bronchiolitis, contracted in infancy is frequently associated with recurrent wheezing episodes and asthma in later life. Atopic individuals and those with a family history of allergy or asthma in first-degree relatives are especially susceptible to the development of chronic airway dysfunction and should be identified early. It is also noteworthy that parenteral cigarette smoking may serve as an additional marker of the high-risk patient. Respiratory infection affecting older children and adults is more commonly due to rhinovirus and influenza A and may cause a transient hyperreactivity to bronchoconstrictor agonists, but does not cause persistent dysfunction. The mechanism(s) by which antecedent respiratory infection is related to recurrent wheezing and asthma remain speculative, and at present a direct causal relationship cannot be established with certainty. Infectious respiratory disorders are also a cause of exacerbations of asthma in adults but more commonly in children, and these also are primarily viral in origin. Consequently, in the absence of clear evidence of bacterial infection, routine antibiotic use in this setting is unwarranted.
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PMID:The role of infection in asthma: implications for antibiotic therapy. 671 12

Signs, symptoms, and radiographic abnormalities of sinusitis are frequent in children with asthma; it is not known whether sinus inflammation is associated with bacterial infection or other mechanisms. Eight asthmatic patients with exacerbation of asthma despite bronchodilator therapy were studied after maxillary sinusitis was confirmed by radiographs. All had cough, wheezing, nasal stuffiness, rhinorrhea and were afebrile. Four patients had headaches, and two had facial pain. Maxillary sinus aspirates were obtained, and bacterial cultures were positive in five: Branhamella catarrhalis (2), nontypeable Hemophilus influenzae (2), Streptococcus pneumoniae (1). Nose and throat cultures did not correlate with sinus cultures. All patients received bronchodilators, and four of eight patients received steroids. All were treated for 14 to 28 days with antibiotics during which seven of the eight patients improved clinically including all with positive sinus cultures. Asthma-symptoms diary scores were kept by five; all demonstrated improvement. Pulmonary-function tests improved in five of seven patients after the antibiotic and asthma therapy including the four patients with positive cultures. Sinus radiographs cleared in three, improved in three, and were unchanged in two patients after antibiotic therapy.
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PMID:Asthma and bacterial sinusitis in children. 674 40

In Colombia, health workers obtained a nasopharyngeal wash from 103 infants aged less than 12 months hospitalized for acute lower respiratory infection (ALRI) at the General Hospital of Medellin during April 1994 to April 1995 so researchers could determine the frequency of ALRI caused by respiratory syncytial virus (RSV) in hospitalized children. Immunofluorescence detected RSV infection in 43 (41.7%) patients. The presence of the following signs and symptoms allowed a clinical diagnosis of a viral infection: rhinorrhea, prolonged expiration, expiratory wheezing, interstitial infiltrates, and hyperinflation on chest radiographs as well as negative tests for 3 or 4 acute phase reactants. The physicians initiated antibiotic therapy (for 1-3 days) in 12 cases (27.9%) based on acute phase reactant findings who actually had an RSV infection. When the physicians learned that the laboratory confirmed RSV infection, they stopped antibiotic therapy. Antibiotics were continued in 16 (37.2%) other RSV infected infants, all of whom were less than 2 months old, due to mixed pneumonia (viral and bacterial). 39.4% of RSV-infected children whose clinical findings strongly suggested RSV received no antibiotics. None of these children or other ALRI patients with a viral disease suffered complications. They required less hospitalization time--since no further diagnostic tests were needed--than ALRI patients with a bacterial infection. Admissions for both ALRI and RSV infection peaked during November to January. RSV incidence peaked in January (23.3%). The leading reasons for hospitalization were pneumonia and bronchiolitis. These findings show that RSV diagnosis is useful and it lessens the indiscriminate use of antibiotics.
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PMID:Frequency of respiratory syncytial virus in hospitalized infants with lower acute respiratory tract infection in Colombia. 897 Feb 24

In the D ward of Nagoyashi-Koseiin geriatric hospital (36-beds), upper respiratory illnesses were recognized in all the inpatients between July and August in 1995, and we studied 7 elderly subjects with parainfluenza 3 infection diagnosed by serology and viral culture. The outbreak of upper respiratory illnesses occurred in the ward during the 17 days from July 21 through August 6, 1996. Fifteen of the 18 elderly persons with upper respiratory illnesses were tested by serology; parainfluenza 3 infection was identified in 7. One of the 7 patients, parainfluenza 3 virus was isolated. Seven elderly subjects with parainfluenza 3 infection were 2 males and 5 females and five of them (71.4%) were bedridden. The most common complaint was fever and coughing in 7/7 (100%), followed by sputum in 5/7 (71.4%), wheezing in 4/7 (42.9%). The pyrexial period in the parainfluenza-infected group ranged from 1 to 4 days (average 3.1 days), and was significantly shorter than that of the influenza group. The maximum recorded temperature in the parainfluenza-infected group ranged from 37.0 to 39.2 degrees C (average 38.1 degrees C), and was significantly lower than that of the influenza group. Two of the 7 patients with parainfluenza 3 virus infection had pneumonia, but nobody died, and all 7 patients recovered without sequele. It is possible that parainfluenza 3 virus infection among elderly subjects cause secondary bacterial infection, so we think that prevention of nosocomial parainfluenza infection should be a high priority in the case of outbreak of such an infection in a ward.
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PMID:[An outbreak of parainfluenza 3 virus infection in the elderly in a ward]. 1035 86

There is renewed interest in the possible role of events occurring during early life in determining predisposition to asthma and allergies. Among these events, respiratory illnesses associated with viral infections have been the matter of considerable research interest. There is now evidence suggesting that an immune response to viral infection in early life that is skewed toward an IgE- or an eosinophil-mediated slant is predictive of persistent wheezing symptoms up to the age of 6 years. Genetic and environmental factors (specifically bacterial infection burden) may be important determinants of the maturation of immune responses from a default 'Th-2-like' at birth to mature, non-Th-2-like responses. Homing of Th-2-like responses to the lung may be determined in part by inheritance of bronchial hyperresponsiveness, and in part by the progressive nature of chronic, uncontrolled airway inflammation. The main risk factor for the development of wheezing episodes in children who are not predisposed to allergic asthma is diminished airway function, which can also be detected shortly after birth. These children may stop wheezing later during childhood, but their levels of lung function track with age. It is tempting to speculate that chronic obstructive pulmonary disease may occur more frequently in these children.
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PMID:Role of respiratory infection in onset of asthma and chronic obstructive pulmonary disease. 1042 23

The aims of this retrospective study were to (i) determine the risk of contamination of lower respiratory tract samples obtained during fiberoscopy in children; (ii) determine the incidence and profile of the bacterial flora of the lower respiratory tract in a selected group of asthmatic children at high risk for bacterial infection; and (iii) identify risk markers for such findings. In 29 asthmatic children, comparison of bacterial cultures of specimens obtained from the upper and, lower respiratory tracts showed that contamination was a possibility in only 3.4% (1/29) of cases. The results from bacterial samples obtained via flexible bronchoscopy in a further 273 consecutively investigated physician-diagnosed asthmatic children were analysed. Patients were selected for bronchoscopy if they had severe chronic asthma or in order to exclude other diseases able to provoke wheezing. Their mean (SD) and median ages were 32.2 (38.3) and 17.5 mo, respectively. The incidence of positive bacterial cultures was 12.1% (33/273 patients). Bacterial flora included H. influenzae (39.5%, 15/38), B. catarrhalis (23.7%, 9/38), Neisseria species (7.9%, 3/38), M. pneumoniae (7.9%, 3/38), P. non-aeruginosa (5.3%, 2/38) and P. aeruginosa (2.6%, 1/38). No clinical or radiological markers were significantly associated with lower respiratory tract bacterial infection. Large quantities of bacteria were present in the lower respiratory tracts of a substantial number of children (1/8) in this selected group of asthmatics. For the moment, however, the clinical implications of this finding remain unclear.
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PMID:Bacterial flora of the lower respiratory tract in children with bronchial asthma. 1059 22

Exacerbations of COPD, which include combinations of dyspnea, cough, wheezing, increased sputum production (and a change in its color to green or yellow), are common. The role of bacterial infection in causing these episodes and the value of antibiotic therapy for them are debated. An assessment of the microbiological studies indicates that conventional bacterial respiratory pathogens, such as Streptococcus pneumoniae and Haemophilus influenzae, are absent in about 50% of attacks. The frequency of isolating these organisms, which often colonize the bronchi of patients in stable condition, does not seem to increase during exacerbations, and their density typically remains unchanged. Serologic studies generally fail to show rises in antibody titers to H influenzae; the only report available demonstrates none to Haemophilus parainfluenzae; and the sole investigation of S pneumoniae is inconclusive. Trials with vaccines against S pneumoniae and H influenzae show no clear benefit in reducing exacerbations. The histologic findings of bronchial biopsies and cytologic studies of sputum show predominantly increased eosinophils, rather than neutrophils, contrary to what is expected with bacterial infections. The randomized, placebo-controlled trials generally show no benefit for antibiotics, but most have studied few patients. A meta-analysis of these demonstrated no clinically significant advantage to antimicrobial therapy. The largest trials suggest that antibiotics confer no advantage for mild episodes; with more severe attacks, in which patients should receive systemic corticosteroids, the addition of antimicrobial therapy is probably not helpful.
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PMID:Do bacteria cause exacerbations of COPD? 1117 60


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