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

Early recognition and treatment of immunologically mediated diseases of the lung are vital to prevent irreparable damage. Extrinsic allergic alveolitis and allergic bronchopulmonary aspergillosis are often confused but should not be difficult to distinguish. The former is nonatopic and is marked by chills, fever, chest pains, cough, dyspnea, and restrictive pulmonary function. The immunologic hallmark is the presence of precipitating antibody to the suspected antigen. Allergic bronchopulmonary aspergillosis is atopic and is marked by low-grade fever, obstructive pulmonary function, markedly elevated serum IgE levels, and positive immediate and late response on skin tests. Both diseases respond well to early corticosteroid therapy. Prophylactic measures are also important in controlling extrinsic allergic alveolitis.
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PMID:Immunologically mediated lung diseases. Extrinsic allergic alveolitis and allergic bronchopulmonary aspergillosis. 94 40

Pulmonary aspergillosis is a rare disease, most commonly presenting as secondary invasion of pre-existing cavitary disease. In Toronto General Hospital 24 patients have been recognized as having this disorder in the 10 years from 1965 to 1975. The most common presenting symptoms were cough, sputum production, and hemoptysis, with the hemoptysis occasionally being massive. Tuberculosis and bronchiectasis were the commonest pre-existing diseases. Thirteen of these patients were treated by surgical resection because of major complications or progression of the aspergillosis. Five of these patients died following surgery, all of these having had major complications prior to surgical intervention. Of the eight surviving patients seven are progressing well, but one had developed further extension of his disease.
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PMID:Surgery in pulmonary aspergillosis. 118 85

A 59-year-old male was admitted to our hospital in Jan. 1991 with complaints of general malaise and palpitation. Laboratory findings on admission showed anemia, thrombocytopenia and leukopenia consisted of 2.0% myeloblasts with Auerbodies. The bone marrow study showed granuloid hyperplasia with 45.5% myeloblasts. The diagnosis of acute myeloblastic leukemia (M1) was made. After BHAC-AMP therapy, he obtained complete remission. However, he complained of fever and cough, and his chest X ray film showed a focal infiltrative shadow in the right upper lung field. Antibiotics for bacteria and fungus were administered and the abnormal shadow improved in a week. However, as he had hemosputum, the bronchoscopic examination was performed, and multiple ulcers covered by yellow-white tissue were revealed on the wall of the trachea and bilateral main bronchi. Biopsy specimens obtained by transbronchial biopsy showed bronchial aspergillosis. Though intravenous infusion and inhalation of amphotericin B were effective for aspergillosis, he had a relapse of the leukemia and died in autumn, 1991.
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PMID:[A case of tracho-bronchial aspergillosis complicated with acute myeloblastic leukemia]. 140 19

A 49-year-old man with high alcohol consumption was admitted with fever, cough and progressive dyspnea after a one week history of influenza-like symptoms. Chest X-ray film on admission showed diffuse peribronchial shadows and patchy infiltration in the right lower lung field. Chest X-ray film the following day and chest CT film on the 4th day of admission showed multiple nodular shadows and cavity formation. At bronchoscopy the bronchial surface was covered by white plaque, and Asp. fumigatus was subsequently cultured from BAL fluid. On the basis of suspected invasive pulmonary aspergillosis, anti-fungal agents were commenced. However, the shadows on chest X-ray increased, and the patient died on the 10th day of admission of respiratory failure and septic shock. Histological examination revealed bronchial wall invasion by hyphae of aspergillus and abscess formation in the pulmonary parenchyma. The precipitin antibody against aspergillus antigen was positive in reserved serum. Anti-Influenza A virus antibody (CF) was positive (X 256), and hemagglutination inhibition test of Influenza A (H3N2) was positive (X 2048) in serum on admission. The suppression of cellular immunity and destruction of the mucociliary system of airways induced by Influenza A infection was suspected to have predisposed to aspergillus superinfection.
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PMID:[A case of invasive broncho-pulmonary aspergillosis associated with influenza A (H3N2) infection]. 140 13

We discuss the cases of two patients affected with chronic eosinophilic pneumonia (CEP) pleurisy and eosinophilia in pleural effusion, not previously mentioned in the literature, to point out their peculiarity, to consider differential diagnosis and the effect of steroid therapy. Both patients, a 57-year-old man and a 55-year-old woman, were atopic: they had been suffering from allergic rhinitis and asthma for several years when they suffered sudden onset of cough, dyspnea and thoracic pain. This symptomatology persisted for more than 6 weeks. Chest radiography highlighted pulmonary infiltrates, not fixed in the first case, fixed in the second. The laboratory features revealed eosinophilia in peripheral blood and in pleural effusion. These data conformed to the criteria suggested by Jederlinic et al. for the diagnosis of chronic eosinophilic pneumonia. Tuberculosis had been present in the remote history of the second case; the repeated research for mycobacteria was negative, and no improvement was seen after antitubercular chemotherapy for one month. We excluded the diagnosis of allergic bronchopulmonary aspergillosis because of the absence of both precipitating antibodies against Aspergillus fumigatus and bronchiectasis. Neither vasculitis nor autoantibodies were found; possible drug-related correlations were excluded; culture data and serological researches for infections were negative in both cases; no involvement of other districts correlated to hypereosinophilia was evidenced. Clinical and radiological remission was obtained in both cases after steroid therapy for a month at the dosage of 1-2 mg/kg daily. No clinical recurrence was seen during a follow-up period of 6 months. Pleural effusion has already been reported in patients with CEP, while we have not found any references to pleural fluid eosinophilia in this disease; this finding has instead been already reported in patients affected with acute eosinophilic pneumonia or hypereosinophilic syndrome.
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PMID:[Chronic eosinophilic pulmonitis with eosinophilic pleurisy. A report on 2 clinical cases seen by the authors]. 145 57

Invasive pulmonary aspergillosis usually occurs in severely immunocompromised or neutropenic patients. Six patients with invasive aspergillosis are described whose only defence impairment was underlying lung disease and corticosteroid treatment. Cough, fever, and sputum production were the usual reasons for presentation and four patients developed the sepsis syndrome. Radiographic findings included de novo cavitation in three patients and rapid radiographic progression in four. Aspergillus species were isolated from respiratory secretions of all patients early in the course of the disease. Treatment was effective in only two patients and the subsequent progress of the others was consistent with a chronic necrotising process. Invasive pulmonary aspergillosis is uncommon in patients with respiratory diseases receiving corticosteroids, but should be considered when pneumonia and cavitary infiltrates occur.
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PMID:Corticosteroid treatment as a risk factor for invasive aspergillosis in patients with lung disease. 158 5

A previously healthy boy presented with cough and diffuse pulmonary interstitial infiltrates. Acute eosinophilic pneumonia was diagnosed by bronchoalveolar lavage in the absence of a demonstrable infectious etiologic agent. Corticosteroid therapy resulted in immediate improvement but was followed by respiratory distress and death from invasive aspergillosis and Pseudomonas cepacia sepsis.
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PMID:Fatal pulmonary aspergillosis presenting as acute eosinophilic pneumonia in a previously healthy child. 188 95

A 41-year-old female was admitted because of cough and hemosputum. She had no underlying disease and the presence of respiratory disease had not been pointed out. Chest X-ray and CT scan showed a solid, homogeneous tumor with a distinct margin near the right hilum. The tumor measured approximately 5 x 4 cm. Because other laboratory data concerning the serum levels of tumor marker and anti-aspergillus antibody were normal, benign lung tumor or malignant lymphoma was suspected at first. Transbronchial cytology and biopsy were performed, but there were no significant findings. However transbronchial aspiration cytology of the specimen obtained from the bifurcation between the right upper lobe bronchus and the truncus intermedius demonstrated Aspergillus. After the administration of antifungal drugs, the tumor decreased in size, and an air crescent sign appeared. This was thought to be a very rare case of locally invasive form of pulmonary aspergillosis, as described by Sider et al demonstrating a necrotic fungal ball during its clinical course.
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PMID:[A case of pulmonary aspergillosis with a tumor shadow, diagnosed by transbronchial aspiration cytology]. 192 Sep 92

The role of Aspergillus species as a pathogen in acquired immunodeficiency syndrome (AIDS) has not been clearly defined. From 1984 to 1989, more than 2,000 AIDS patients were seen at Beth Israel Medical Center, New York. Aspergillus was isolated in ten patients; seven had invasive disease and three had noninvasive disease. Invasive pulmonary aspergillosis (IPA) was diagnosed in six patients and invasive renal aspergillosis was found in one patient. Five were homosexual men and two were intravenous drug users. At presentation, all ten had fever, seven had cough, eight had dyspnea, and five had pleuritic chest pain. Chest roentgenograms revealed focal infiltrates in six patients, bilateral interstitial infiltrates in two patients, and bilateral pneumothoraces in one patient. Predisposing conditions included corticosteroid therapy in four, granulocytopenia (less than 1,000/cu m) in two, and broad-spectrum antibiotic therapy in five. Three of the four patients receiving corticosteroids received them as adjuvant therapy for Pneumocystis carinii pneumonia (PCP). Aspergillus was identified antemortem in eight patients, in bronchoalveolar lavage (BAL) fluid in six, in transbronchial biopsy specimen in three, in open lung biopsy specimen in one, and postmortem in one patient. Six of seven patients had at least one concomitant pulmonary process. Six underwent necropsy and findings showed IPA in three, disseminated aspergillosis in two, and PCP in one. Invasive aspergillosis, although significant, is uncommon in AIDS. When Aspergillus is isolated in the setting of corticosteroid therapy, antibiotics, or granulocytopenia, one must suspect invasive disease.
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PMID:Aspergillosis in the acquired immunodeficiency syndrome. 195 5

Expectoration of bronchial casts (plastic bronchitis) is an uncommon but ancient problem. Herein we describe a 40-year-old man, with no prior lung disease, who had dyspnea, cough, and expectoration of long branching bronchial casts. No specific cause was delineated, although special stains for eosinophilic granule major basic protein demonstrated occasional foci of eosinophils and small amounts of extracellular major basic protein in the bronchial casts. Various diseases, such as allergic bronchopulmonary aspergillosis, bronchiectasis, and cystic fibrosis, have been associated with the formation of bronchial casts and should be considered in the differential diagnosis. Although most previously reported cases have been associated with some type of pulmonary disease, our patient had no evidence of an underlying pulmonary disorder.
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PMID:Plastic bronchitis: an old disease revisited. 200 88


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