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Query: UMLS:C0009450 (infectious diseases)
 83,438 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As long-term survival has become possible in patients with autosomal dominant polycystic kidney disease (ADPKD) with progress in hemodialysis (HD), complications by various extrarenal diseases has presented new problems. Recent experience of two rare cases of ADPKD ending fatally due to complications by polycystic liver is presented. Case 1: A 60-year-old female with a family history of ADPKD without a past history of liver disease, was diagnosed as ADPKD at the age of 45 years. Hemodialysis was started at the age of 58 years. From 6 months prior to her death, abdominal circumference increased (body height: 149 cm, abdominal circumference: 100 cm). Dyspnea, abdominal pain and anorexia appeared and she died of hepatic failure leading to cachexia. Case 2: A 76-year-old female with a family history of ADPKD without a past history of liver disease, was started on HD at the age of 73 years. Abdominal circumference was 84 cm (body height: 138 cm). She was repeatedly admitted to and discharged from the hospital due to febrile episodes. Infection of polycystic liver was complicated by DIC and she died of gastrointestinal hemorrhage. Autopsy revealed abscess in some of the cysts in the liver. Hepatic cysts most frequently complicating ADPKD so far have presented with scarcely any clinical problems. Recently, however, cases of infection of hepatic cysts, portal hypertension and hepatic insufficiency have been reported. The relationship between these hepatic diseases and the prognosis of ADPKD has received attention. Increase in the number of cases of complications similar to the present cases is anticipated.
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PMID:[Two cases of autosomal dominant polycystic kidney disease treated with hemodialysis associated with polycystic liver complications related to the cause of death]. 875 71

Tuberculosis was diagnosed in 26 patients (6 females and 20 males) undergoing maintenance hemodialysis, with an incidence of 23.6%. Infection was characterized clinically by a very insidious onset, the main symptoms being anorexia, loss of weight and low-grade fever, a very high sedimentation rate and lymphocytes predominant in the peripheral circulation, pleural and peritoneal fluids. Pulmonary tuberculosis was seen in 18 patients (70%), 10 of whom presented with pleural effusions. There were extrapulmonary presentations in 8 of the 26 patients (30%). Most of the patients developed the disease about 1 year from the start of their dialysis treatment. With early therapy all patients survived their tuberculosis disease and no recurrence was seen in up to 5 years of follow-up. Despite earlier reports of high mortality, we suggest that awareness of the increased incidence of tuberculosis in dialysis patients, together with its unusual presentation and consequent early diagnosis, results in a very good prognosis.
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PMID:Increased incidence of tuberculosis in patients undergoing hemodialysis. 883 1

In the second part of their article on the emerging field of neuroimmunology, the authors present an overview of the role of neuroimmune mechanisms in defence against infectious diseases and in immune disorders. During acute febrile illness, immune-derived cytokines initiate an acute phase response, which is characterized by fever, inactivity, fatigue, anorexia and catabolism. Profound neuroendocrine and metabolic changes take place: acute phase proteins are produced in the liver, bone marrow function and the metabolic activity of leukocytes are greatly increased, and specific immune reactivity is suppressed. Defects in regulatory processes, which are fundamental to immune disorders and inflammatory diseases, may lie in the immune system, the neuro endocrine system or both. Defects in the hypothalamus-pituitary-adrenal axis have been observed in autoimmune and rheumatic diseases, chronic inflammatory disease, chronic fatigue syndrome and fibromyalgia. Prolactin levels are often elevated in patients with systemic lupus erythematosus and other autoimmune diseases, whereas the bioactivity of prolactin is decreased in patients with rheumatoid arthritis. Levels of sex hormones and thyroid hormone are decreased during severe inflammatory disease. Defective neural regulation of inflammation likely plays a pathogenic role in allergy and asthma, in the symmetrical form of rheumatoid arthritis and in gastrointestinal inflammatory disease. A better understanding of neuroimmunoregulation holds the promise of new approaches to the treatment of immune and inflammatory diseases with the use of hormones, neurotransmitters, neuropeptides and drugs that modulate these newly recognized immune regulators.
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PMID:Neuroimmune mechanisms in health and disease: 2. Disease. 887 36

In the period of 1989-1995 seven patients with amebic liver abscess were observed in Clinic of Infectious Diseases of Pomeranian Medical School in Szczecin. The diagnosis has been made on the base of epidemiological data, presence of intrahepatic defect by a scanning procedure of liver (ultrasonography, CT, scintigraphy) and positive serologic test for amebiasis. All patients were male of Polish nationality, 29-57 years old, who became ill after travel to Africa or India. Intestinal amebiasis was present only in two cases. Five patients had acute onset of disease and two chronic. The most common complaints included fever, abdominal pain, anorexia. A cough, chest pain, diarrhea or weight lose were less common. At physical examination paleness of skin, subjaundice, abdominal tenderness, hepatomegaly and sometimes pleural effusion have been observed. Laboratory tests revealed high RBS, leucocytosis and mild anemia. Slightly higher serum level of bilirubin, alkaline phosphatase were transient. Trophozoits of Entamoeba histolytica have been found in stool specimens of one only patient. Amebic antibodies tested with indirect hemagglutination (IHA) were present in all cases. Visual technics have shown abscess of 3 to 9 cm in diameter located at right liver lobe. Six patients have been treated with both chemotherapy (metronidazole or/and dehydroemetine) and "skin needle" aspiration. In two cases recrudescence of abscess has been observed after one and three years respectively. These two patients have been undergone second course of treatment with using not only needle aspiration and metronidazole/dehydroemetine but luminal agents as well.
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PMID:[Amebic liver abscess--personal observations]. 892 39

A 22-year-old woman was admitted to the hospital with complaints of fever, loss of appetite, coughing, sputum production, and right-sided chest pain. The chest X-ray film and computed tomogram showed infiltrates in both lower lung fields. Meningococcal pneumonia was diagnosed when a sputum culture was found to be positive for Neisseria meningitidis. Infection with this organism is uncommon in Japan. The patient had never gone abroad, and the route of infection was unknown. N. meningitidis is a rare cause of respiratory infections. When this organism does cause respiratory disease, it is usually acute bronchitis rather than meningococcal pneumonia. The patient in this case was not immunodeficient. She was also not deficient in a terminal lytic component sequence (deficiency in that sequence promotes meningococcal infection). The patient was emaciated and malnourished, which was thought to have made her more susceptible to infection. Orally administered DU-6859a, one of a new generation of quinolones, was very effective and had no side effects.
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PMID:[Bilateral meningococcal pneumonia in a young Japanese woman]. 895 7

Trichuris suis is a nematode parasite of swine which can cause serious pathology in infected pigs, such as anorexia, diarrhea, anemia, and death in heavy infections, especially in young animals. Infection with Trichuris suis is difficult to diagnose because much of the pathology occurs when only larval stages are present, and because of sporadic egg production by adult female worms. We have isolated a 20 kDa excretory/secretory (E/S) glycoprotein from culture fluids of adult worms by column chromatography and preparative gel electrophoresis which is diagnostic for Trichuris suis infection in pigs. The antigen did not crossreact in Western blots or enzyme-linked immunosorbent assay with sera from pigs infected with Ascaris suum, Trichinella spiralis, Oesophagostomum dentatum, or Toxoplasma gondii. The antigen was also diagnostic for Trichuris vulpis infection in dogs, and did not crossreact with sera from dogs infected with Toxocara canis, Ancylostoma caninum, or Strongyloides stercoralis. The antigen may be useful in clinical serologic assays for diagnosis of Trichuris infection in pigs and dogs in cases of scouring diarrhea of unknown etiology, and in epidemiological surveys of Trichuris suis infection in swine feeder/finishing operations.
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PMID:A Trichuris specific diagnostic antigen from culture fluids of Trichuris suis adult worms. 906 55

Simian parvovirus is a recently discovered parvovirus that was first isolated from cynomolgus monkeys. It is similar to human B19 parvovirus in terms of virus genome, tropism for erythroid cells, and characteristic pathology in natural infections. Cynomolgus monkeys were infected with simian parvovirus to investigate their potential usefulness as an animal model of human B19 parvovirus. Six adult female cynomolgus monkeys were inoculated with purified simian parvovirus by the intravenous or intranasal route and monitored for evidence of clinical abnormalities; this included the preparation of complete hematological profiles. Viremia and simian parvovirus-specific antibody were determined in infected monkeys by dot blot and Western blot assays, respectively. Bone marrow was examined at necropsy 6, 10, or 15 days postinfection. All of the monkeys developed a smoldering, low-grade viremia that peaked approximately 10 to 12 days after inoculation. Peak viremia coincided with the appearance of specific antibody and was followed by sudden clearance of the virus and complete, but transient, absence of reticulocytes from the peripheral blood. Clinical signs were mild and involved mainly anorexia and slight weight loss. Infection was associated with a mild decrease in hemoglobin, hematocrit, and erythrocyte numbers. Bone marrow showed marked destruction of erythroid cells coincident with peak viremia. Our findings indicate that infection of healthy monkeys by simian parvovirus is self-limited and mild, with transient cessation of erythropoiesis. Our study has reproduced Koch's postulates and further shown that simian parvovirus infection of monkeys is almost identical to human B19 parvovirus infection of humans. Accordingly, this animal model may prove valuable in the study of the pathogenesis of B19 virus infection.
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PMID:Experimental infection of cynomolgus monkeys with simian parvovirus. 915 44

The effects of infection of mice with influenza virus on ingestive behavior were assessed by both 22-h intake of food pellets, and intake of sweetened milk in a 30-minute access period. Infection with a lethal dose of virus resulted in losses in body weight as well as a reduction in food pellet intake. By contrast, infection with a sublethal dose of virus decreased body weight and food pellet intake to a lesser extent, but did not alter milk intake. Acute intraperitoneal injection of endotoxin (LPS, 0.3-5 micrograms), interleukin-1 alpha (IL-1 alpha, 50-100 ng) or IL-1 beta (100 ng) reduced milk intake, suggesting that the reduction of ingestive behavior may be associated with immune activation in general, and IL-1 in particular Pretreatment of the mice with the cyclooxygenase inhibitor, indomethacin (10 mg/kg SC) substantially attenuated, but did not completely reverse, the reduction in milk intake by LPS and IL-1. However, chronic treatment with indomethacin failed to alter the body weight or the intake of sweetened milk in influenza-infected mice, although there was some attenuation of the reduction in food intake. These results suggest that although IL-1 may play a role in the anorexia caused by influenza virus infection, it is not the only factor involved.
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PMID:Influenza virus infection of mice induces anorexia: comparison with endotoxin and interleukin-1 and the effects of indomethacin. 916 99

Interactions between undernutrition, infection, and growth and development are complex, and are reviewed in this article, giving particular emphasis on the importance of diarrheal infection in this process. The effects of diet, nutrition and infection on the nutritional status of a child can vary according to the disease ecology, the age of the child, patterns of feeding and types of food consumed. There are two possible ways in which this relationship can begin; one in which poor nutritional status leads to impaired immunocompetence and reduced resistance to infection, and the other in which exposure to infectious disease can lead to appetite loss and anorexia, malabsorption, and elevated metabolism of energy and other nutrients. Once started, the interactions between these two major environmental stressors becomes increasingly complex, with the nature of the disease ecology influencing the balance of immunoparesis and adaptive immunity and its effect on subsequent disease experience. Furthermore, the disease ecology influences the type and extent of associated physiological phenomena including anorexia, fever, and malabsorption, all of which have an impact on nutritional status. Of disease categories, diarrhea has particularly potent effects in this relationship. The predicted impact of HIV infection among newborn infants is the earlier onset of the undernutrition-infection cycle, as low CD4+ T lymphocyte counts soon after birth are likely to predispose such infants to earlier opportunistic infection.
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PMID:Transdisciplinarity in the study of undernutrition-infection interactions. 922 95

Porcine reproductive and respiratory syndrome (PRRS) is an infectious disease in swine that emerged 10 years ago. Today, PRRS is endemic in many if not all the pig-producing countries. The syndrome is due to a small enveloped RNA virus which belongs to the new Arteriviridae group. This group also includes the equine arterivirus and the simian hemorrhagic fever virus. The disease produces many clinical symptoms in pigs of any age but the two major features of the syndrome are respiratory and reproductive failure. An influenza-like illness is often observed consisting of a transient loss of appetite, slight hyperthermia and respiratory distress. The reproductive problems include late-term abortion, stillbirth and young piglet mortality. The virus is remarkably well adapted to its natural host. It infects almost exclusively pig monocytes or macrophages. For unexplained reasons, the virus may persist in the body for extended periods (several weeks) after an antibody immune response has been mounted. Within herds, the virus may persist for several years. In the acute phase of the infection, the immune functions of the pig may be impaired, however, a chronic immunosuppressive effect does not seem to occur thereafter. Several vaccines are available, which all have protective value against PRRS clinical disorders. None of them, however, has been tested for its ability to prevent or shorten the persistent infection in individual pigs or the long-term effect of virus circulation within herds. In the future, PRRS virus may be only an additional contaminant of farms with limited effects on profitability; however the possibility for this persistent infection to supply swine or eventually other species with new pathogenic variants must be also considered. This review provides a detailed description of the aetiology, pathology, immunology, diagnostic methods and epidemiology of PRRS.
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PMID:[Porcine reproductive and respiratory syndrome: ten years of experience (1986-1996) with this undesirable viral infection]. 931 28


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