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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the winter months 1974/75 we were able to observe a number of unusual respiratory tract infections particularly in children over 6 years of age which appeared as pneumonias. Characteristic clinical findings included a dry, hacky cough, refractive to the usual antitussives, starting 1--2 weeks prior to admission, fever up to 104, malaise, headache, anorexia, shortness of breath and cyanosis. Several Pts were treated prior to admission with a number of antibiotics and failed to respond. Laboratory findings showed a peripheral polymorphonuclear leucocytosis with toxic granulations of neutrophiles. A sedimentation rate above 40 in the first hour occurred in most Pts. X Ray of the lung revealed a characteristic mottled appearance with patchy infiltrations, atelectasis and nodular densities. Frequently a shift of the mediastinum towards the infiltrate was seen. One of the hallmarks on physical examination was the discrepancy between the severity of the clinical illness and the paucity of physical findings. Decreased breath sounds over affected lung areas were often the only findings on auscultation; find rales, rhonchi or dullness on percussion were less often heard. The combination of a typical history, physical examination, laboratory tests and X Ray findings enabled us to make a presumptive clinical diagnosis of Mycoplasma pneumonia before serologic test results were available and to start with the appropriate antibiotic (Erythromycin, Tetracycline) early in the course of the disease. Complement fixation tests with a titer of 1 : 20 and a fourfold rise over the next two weeks or an initial titer of 1 : 80 and above were considered significant for acute disease.
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PMID:[Mycoplasma pneumonias in childhood (author's transl)]. 83 54

The authors reviewed the computed tomographic (CT) scans in 16 patients with pulmonary blastomycosis to describe the abnormalities seen at CT. The CT features were as follows: mass lesions (n = 14), consolidation (n = 9), air bronchograms (n = 14), intermediate-sized nodules (n = 12), satellite lesions (n = 11), pleural thickening (n = 4), small effusions (n = 2), and cavitation (n = 2). One patient had noncalcified hilar lymphadenopathy. Eight patients had acute disease, six had chronic disease, and two had acute exacerbation of a chronic illness. Fifteen patients had cough, fever, and/or dyspnea. Two patients underwent surgical resection for the presumptive diagnosis of bronchogenic carcinoma. In general, there was no correlation between the radiologic abnormalities and the clinical presentation. Consolidation occurred more frequently in acute disease. CT may be useful to help define the radiologic findings and distribution of disease. Familiarity with the characteristic CT findings of pulmonary blastomycosis may encourage an expeditious diagnostic approach to identify the disease and, possibly, prevent unnecessary surgical resection.
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PMID:Blastomycosis of the lung: CT features. 153 3

In August, 1978, in Linnavuori industrial community an epidemic broke reaching nearly one half of the population. The acute disease was manifested by severe respiratory symptoms, fever, cough, and dyspnea. The symptoms were connected with the use of hot water. The symptoms of the disease resembled those of allergic alveolitis or humidifier fever. The tap water of the region was found to be heavily polluted. Besides an ample microbial growth a high endotoxin concentration was found. Specific antibodies to the microbes or radiographic lung changes referring to allergic alveolitis were not found. Leukocytosis and reduced diffusion capacities indicating an inflammatory reaction at the alveolar level were in the acute phase. It may be a toxic lung inflammation caused by endotoxins, at least partly at the bronchiolar-to-alveolar level. According to the follow-up, to date the disease has not caused lung damages.
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PMID:An epidemic of bath water fever--endotoxin alveolitis? 696 75

Breathing air from a humidifier or an air conditioning unit contaminated by various microorganisms can cause an acute lung disease involving fever, cough and dyspnea, termed "humidifier fever". This type of hypersensitivity pneumonitis was first described in 1959 by PESTALOZZI in the Swiss literature and subsequently by BANASZAK et al. in the Anglo-American. Here a chronic form of this disease which led to pulmonary fibrosis is described: A 37-year-old woman who works in a cheese shop presented with dyspnea which had been progressive over two years, weight loss, a diffuse reticular pattern radiographically and a severe restrictive defect in lung function tests. Open lung biopsy revealed chronic interstitial and alveolar inflammation with non-caseating granulomas and fibrotic changes. Circulating immune complexes and precipitins against the contaminated humidifier water and cheese mites were found, but no antibodies suggesting legionnaires' disease. Two out of five otherwise healthy employees of this cheese shop, where a new humidifying system had been installed 7 years earlier, also had precipitins against the contaminated water from the humidifier and the cheese mites. Despite ending of exposure and longterm steroid and immunosuppressive therapy, the signs and symptoms of pulmonary fibrosis persisted. Contrary to the acute disease, this chronic form is termed "humidifier lung". The importance is stressed of investigating the possibility of exposure to contaminated humidifiers or air conditioning units in all cases of newly detected pulmonary fibrosis.
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PMID:[Humidifier lung]. 722 22

Sarcoidosis is an idiopathic multisystem disorder with several clinical and roentgenographic features suggestive of respiratory infection. In the absence of infection, it is characterized by the microscopic presence of noncaseating epithelioid granuloma in affected tissues. When present, constitutional symptoms, fever, coughing, and exertional dyspnea usually develop insidiously, although occasionally Lofgren's syndrome--the triad of bilateral hilar adenopathy, erythema nodosum and polyarticular arthritis--may herald the onset of acute disease. Pulmonary involvement is the roentgenographic hallmark of sarcoidosis; bilateral hilar adenopathy is the most common manifestation. However, parenchymal infiltrates and pleural effusion may occur. Although numerous bacterial and fungal organisms may mimic the clinical and roentgenographic features of sarcoidosis, tuberculosis and fungal infections associated with granulomatous inflammation are the infectious processes most apt to cause diagnostic confusion. Several diagnostic clues are available to the clinician confronted with the consideration of sarcoidosis. Roentgenographic staging of the disorder (stage 0, normal radiograph; stage I, isolated bilateral hilar adenopathy; stage II, hilar adenopathy and parenchymal involvement; stage III, isolated parenchymal involvement; and stage IV, parenchymal fibrosis) provides a framework on which a differential diagnosis of likely infectious agents may be constructed and a history of travel to regions of endemic fungal infection may further narrow the differential diagnosis. An unexplained exudative lymphocytic pleural effusion or CD-4 lymphocyte predominance in bronchoalveolar lavage (BAL) fluid may also suggest a diagnosis of sarcoidosis. However, the definitive diagnosis of sarcoidosis is dependent upon the histological demonstration of noncaseating granuloma and the exclusion of infection in the appropriate clinical and roentgenographic setting.
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PMID:Pulmonary sarcoidosis: a mimic of respiratory infection. 748 Nov 30

Measles is an acute disease characterized by fever, cough, conjunctivitis, erythematous maculopapular rash and pathognomonic enanthem. Vaccination had resulted in decrease of complications and mortality. But vaccination coverage in France is low, about 80%: the virus is always circulating and outbreaks in teenagers are possible. The recommendation of a booster dose at age eleven will contribute to reduce the incidence of the disease. Rubella is asymptomatic in 30 to 50% of infected children. There is a risk of transmission to pregnant women with negative serology. Reduction of virus circulation and immunization of young girls will result in decrease of the congenital rubella syndrome (65 cases/year in France). A vaccine booster dose at eleven in all children, combined with measles immunization, is necessary.
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PMID:[Measles and rubella]. 933 22

Thirty-one patients with acute schistosomiasis were evaluated clinically and immunologically. Cytokine levels were determined in peripheral blood mononuclear cell (PBMC) supernatants. Levels of total and antigen-specific IgE, tumor necrosis factor (TNF)-alpha, and immune complexes were measured in serum samples. Clinical findings included general symptoms, liver damage, pulmonary involvement, and pericarditis. All patients had eosinophilia. Immune complexes were detected in 55% of the patients (mean+/-SD, 7.8+/-7.6 microg Eq/mL) and were associated with cough, dyspnea, and abnormal chest radiographic findings. Levels (mean +/- SD) of TNF-alpha (1349.3+/-767.6 pg/mL), interleukin (IL)-1 (2683+/-1270 pg/mL), and IL-6 (382 +/- 52.3 pg/mL) were elevated in PBMC. Serum TNF-alpha levels were elevated in 87% of the patients and were associated with abdominal pain. Higher interferon-gamma levels were detected in PBMC of patients with acute disease than in those of patients with chronic schistosomiasis; IL-5 levels were higher in those with chronic disease. Low IL-5 levels were associated with weight loss. Proinflammatory cytokines and immune complexes with low Th2 responses might explain the immunopathogenesis of acute schistosomiasis.
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PMID:Clinical and immunologic evaluation of 31 patients with acute schistosomiasis mansoni. 1175 87

Community acquired pneumonia in adults is an acute disease characterized by worsening in general conditions, fever, chills, cough, mucopurulent sputum and dyspnea; associated with tachycardia, tachypnea, fever and focal signs in pulmonary examination. The probability of pneumonia in a patient with acute respiratory symptoms depends on the disease prevalence in the environment where it is acquired and on clinical features. It is estimated that pneumonia prevalence is 3-5% in patients with respiratory disease seen in outpatient facilities. Clinical diagnosis of pneumonia without radiological confirmation lacks specificity because clinical presentation (history and physical examination) does not allow to differentiate pneumonia from other acute respiratory diseases (upper respiratory infections, bronchitis, influenza). Diagnosis must be based in clinical-radiological findings: clinical history and physical examination suggest the presence of pulmonary infection but accurate diagnosis is established when chest X ray confirms the existence of pulmonary infiltrates. Clinical findings and chest X ray do not permit to predict with certainty the etiology of pulmonary infection. Radiology is useful to confirm clinical suspicion, it establishes pneumonia location, its extension and severity; furthermore, it allows differentiation between pneumonia and other diseases, to detect possible complications, and may be useful in follow up of high risk patients. The resolution of radiological infiltrates often ensues several weeks or months after clinical recovery, especially in the elderly and in multilobar pneumonia cared for in intensive care units.
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PMID:[Clinical and radiological diagnosis of community-acquired pneumonia in adults]. 1616 16

Mechanical ventilation is required if ventilatory insufficiency is present. This is typically indicated by hypercapnea. Hypoxemia occurs secondary to hypoventilation. Usually overload of the respiratory muscles (ventilatory pump) will be the underlying mechanism, for the most part caused by acute or chronic disease. In case of sole hypoxemia mechanical ventilation will only be indicated if the oxygen-content (equals oxygen saturation x haemoglobin x 1.39) drops below a critical threshold or if ventilatory pump failure is imminent on account of the underlying disease (eg. pneumonia). The background of our recommendations is to avoid potential damage caused by mechanical ventilation. Especially high inspiratory pressures and oxygen concentrations can be harmful to the lung. Therefore every case has to evaluated for individual target parameters of ventilation. The use of the oxygen-content instead of the arterial oxygen pressure as the target parameter will usually lead to a more careful ventilation. Cardiogenic pulmonary oedema is an exception to this rule since inspiratory positive pressure and PEEP will result in improved diffusion as well as reduction of preload and work of breathing. In recent years progress has been made on the field of ventilation access especially in severe and acute cases. Non-invasive ventilation is superior to invasive ventilation in patients with exacerbated COPD since it improves outcome effectively. This is being caused by a decline in ventilator associated pneumonias, most likely because non-invasive ventilation allows patients to clear their secretions by coughing, resulting in improved lung clearance. Controlled ventilation allows optimal unloading of the respiratory muscles which have been overloaded by the underlying disease. Application of a controlled ventilation mode in acute disease will usually require some kind of sedation. Assisted ventilation will result in improved gas exchange but only incomplete unloading of respiratory muscles and therefore delayed restitution. Permanent controlled ventilation under sedation for a prolonged period (days) requires intermittent periods of assisted- or spontaneous breathing in order to avoid atrophy of the respiratory muscles. This review summarizes background information on the nature of the derangement, the relation between oxygen supply and consumption under special consideration of respiratory muscle insufficiency and impact of different ventilation modes.
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PMID:[Pathophysiological basis of mechanical ventilation]. 1646 51

Bordetellae are respiratory pathogens that infect both humans and animals. Bordetella bronchiseptica establishes asymptomatic and long-term to life-long infections of animal nasopharynges. While the human pathogen Bordetella pertussis is the etiological agent of the acute disease whooping cough in infants and young children, it is now being increasingly isolated from the nasopharynges of vaccinated adolescents and adults who sometimes show milder symptoms, such as prolonged cough illness. Although it has been shown that Bordetella can form biofilms in vitro, nothing is known about its biofilm mode of existence in mammalian hosts. Using indirect immunofluorescence and scanning electron microscopy, we examined nasal tissues from mice infected with B. bronchiseptica. Our results demonstrate that a wild-type strain formed robust biofilms that were adherent to the nasal epithelium and displayed architectural attributes characteristic of a number of bacterial biofilms formed on inert surfaces. We have previously shown that the Bordetella Bps polysaccharide encoded by the bpsABCD locus is critical for the stability and maintenance of three-dimensional structures of biofilms. We show here that Bps is essential for the formation of efficient nasal biofilms and is required for the colonization of the nose. Our results document a biofilm lifestyle for Bordetella in mammalian respiratory tracts and highlight the essential role of the Bps polysaccharide in this process and in persistence of the nares.
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PMID:The Bordetella Bps polysaccharide is critical for biofilm development in the mouse respiratory tract. 1758 29


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