Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We experienced 17 cases of pulmonary aspergillosis with air-fluid level in a cavity. The incidence of this phenomenon was 39% in 44 patients who were diagnosed as having pulmonary aspergillosis during the period from 1983 to 1991 at Yaizu Municipal Hospital. There were two clinical patterns: primary air-fluid type and secondary air-fluid type. Primary air-fluid type disease began with cavitation with an air-fluid level. Our 14 cases of this type had severe symptoms and inflammatory reaction. In secondary air-fluid type, the fungus ball disappeared and an air-fluid level appeared in a cavity during treatment. Our 3 cases of this type had only mild cough and sputum. The fluid disappeared later in two of these three cases. Some cases of primary air-fluid type changed to fungus ball type or productive aspergilloma on the inner wall of a cavity. Primary air-fluid type thus seems to represent incipient pulmonary aspergilloma, and to be important for early diagnosis and treatment. Of the immunological tests, precipitins to Aspergillus fumigatus proved most useful for early diagnosis.
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PMID:[Pulmonary aspergillosis with air-fluid level in a cavity]. 836 18

The isolation of Aspergillus fumigatus from airway secretions from patients with cystic fibrosis (CF) is common and usually denotes asymptomatic colonization or allergic broncho-pulmonary aspergillosis (ABPA). A 12-year-old boy with CF acutely developed moderately severe symptoms of unremitting cough, fever, dyspnea, weight loss, and cyanosis. Chest radiographs demonstrated widespread unilateral infiltrates and volume loss. By bronchoscopy tenacious mucous plugs were seen occluding the left lower lobe bronchus. Cultures from sputum and sequential bronchoalveolar lavage grew Aspergillus fumigatus, but other significant criteria for diagnosing ABPA were lacking. No improvement was seen with a 3 week course of systemic corticosteroid and antibiotic therapy. Treatment with amphotericin B and short-term mechanical ventilation resulted in rapid resolution of all symptoms. This form of endobronchial aspergillosis has not been described previously.
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PMID:Unusual form of endobronchial Aspergillosis in a patient with cystic fibrosis. 841 45

A National Show Horse with a mediastinal granuloma was presented with clinical signs which included fever, nasal discharge and cough. The mediastinal mass was identified radiographically and ultrasonographically. A presumptive diagnosis of aspergillosis was made following isolation of Aspergillus spp. from both transtracheal aspirate and bronchoalveolar lavage fluid samples and agar gel immunodiffusion (AGID) identification of serum antibody to Aspergillus spp. The diagnosis was confirmed by histopathologic examination of the mediastinal mass obtained at necropsy examination.
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PMID:Aspergillosis granuloma in the mediastinum of a non-immunocompromised horse. 846 5

To determine the value of aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis (IPA), we initiated a prospective randomized multicenter trial. The scheduled intent-to-treat interim analysis included 115 patients (30%) with prolonged neutropenia after chemotherapy for acute myeloid leukemia, acute lymphoblastic leukemia/high-grade non-Hodgkin's lymphoma, or solid tumors undergoing autologous stem cell transplantation. Sixty-five patients had been randomized to receive prophylactic aerosol amphotericin B inhalations at a dose of 10 mg twice daily (group A); for the remaining 50 patients no aerosol amphotericin B prophylaxis was used (group B). No serious side effects from amphotericin B inhalations occurred, but coughing (54%), bad taste (51%), and nausea (37%) caused early cessation of aerosol amphotericin B prophylaxis in 23% (15/65) of courses. In group A, the incidence of proven, probably, or possible IPA was 5% (3/65) as compared with 12% (6/50) in group B (p > 0.05). Microbiologically documented bacterial pneumonias were observed in 5/65 (8%) patients in group A and in 1/50 (2%) patients in group B (p > 0.05). Thus, no reduction in incidence of IPA from use of prophylactic aerosol amphotericin B inhalations was found in this interim analysis. As there were no serious side effects from aerosol amphotericin B prophylaxis, accrual in the study will continue for a total of 380 patients.
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PMID:Aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis in neutropenic cancer patients. 853 60

A 36-year-old woman who raised plants in a large greenhouse came to our hospital because of a cough and purulent sputum. A chest X-ray film showed infiltrative shadows in the left middle lung field. Aspergillus fumigatus was isolated from samples of sputum and bronchoalveolar lavage fluid obtained from the left B5. Biopsy specimens revealed hyphae elements of aspergillus species and eosinophils in a plug of viscous material. Also, eosinophils and lymphocytes had infiltrated through bronchial epithelium without aspergillus species. She was given a diagnosis of allergic aspergillosis caused by Aspergillus fumigatus. Fluconazole was given and her symptoms and infiltrative shadows improved. Seventy days after treatment with fluconazole began, her symptoms recurred along with an abnormal shadow in the left upper lung field on a chest x-ray film. Aspergillus flavus, but not Aspergillus fumigatus, was isolated from samples of sputum and bronchoalveolar lavage fluid obtained from the left lung (S1+2). Biopsy specimens of the lung showed eosinophilic pneumonia. She was treated with itraconazole and her symptoms and abnormal radiographic shadows disappeared. She had no asthmatic attack or central bronchiectasis du ring the illness. This was a case of allergic pulmonary aspergillosis without asthmatic symptoms. It is interesting that one species of aspergillus was replaced by another during treatment.
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PMID:[Development of infection with Aspergillus flavus in woman being treated for allergic pulmonary Aspergillosis caused by Aspergillus fumigatus]. 854 82

A 67-year-old man was admitted to our hospital because of coughing, a low-grade fever, and abnormal shadows on a chest X-ray film. He had had asthma as a child, but had no asthmatic symptoms on admission. A CT scan showed collapse of the right middle lobe and mucoid impactions in the lingula. Bronchoscopy revealed thick mucus obstructing the right middle-lobe bronchus and the left upper-lobe bronchus. The eosinophil count and the IgE level were abnormally high. Aspergillus fumigatus was detected in his sputum. Tests for immediate skin reaction and precipitating antibody to aspergillus antigen were positive. After treatment with itraconazole he became asymptomatic. Radiographic abnormalities had resolved by 1 month after the start of treatment; a high resolution CT scan obtained after clinical improvement revealed central bronchiectasis. In this patient with allergic bronchopulmonary aspergillosis, a course of itraconazole alone was followed by satisfactory improvement.
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PMID:[Allergic bronchopulmonary aspergillosis successfully treated with itraconazole]. 916 55

The tolerance of aerosolised amphotericin B as prophylaxis against invasive pulmonary aspergillosis was investigated in 61 granulocytopenic periods in 42 patients treated for a haematologic malignancy. Each patient was to receive amphotericin B in doses escalating to 10 mg three times daily (t.i.d.), but only 20 (48%) patients managed to complete the scheduled regimen. One patient tolerated the full dose initially, but had to discontinue treatment when dyspnea developed as a result of pneumonia and acute respiratory distress. Another 22 patients (52%) experienced side effects, including eight (19%) who reported mild coughing and dyspnea but who tolerated the full dose and three (7%) patients whose dose was reduced to 5 mg t.i.d. Another six (14%) patients could tolerate only 5 mg t.i.d., and five (12%) others stopped treatment because of intolerance. Elderly patients (p < 0.05) and those with a history of chronic pulmonary obstructive disease (p = 0.09) were more likely to develop side effects during inhalation. Twelve (28%) patients developed proven of possible invasive fungal infections, but no correlation was established between infection and the total amount of amphotericin B inhaled. Inhalation of aerosolised amphotericin B is poorly tolerated and does not appear useful in preventing invasive pulmonary aspergillosis in granulocytopenic patients.
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PMID:Tolerance and efficacy of Amphotericin B inhalations for prevention of invasive pulmonary aspergillosis in haematological patients. 922 76

A 25-year-old man was admitted to the hospital because of uncontrollable coughing and sputum production. He had been suffering from coughing and sputum production since he was 7 years old. He was given a diagnosis of bronchiectasis and persistent airway infection with Pseudomonas aeruginosa when he was 16 years old. One year of treatment with erythromycin and another year of treatment with roxithromycin were not effective. After he was referred to our hospital in 1993, he was given clarithromycin together with tosufloxacin for two years as an outpatient. The treatment was not very effective, but some prophylactic effect was seen with regard to prevention of acute exacerbations of Pseudomonas aeruginosa airway infection. Examination after admission revealed a high level of serum IgE (3703 U/ml), a strong skin reaction to aspergillus allergen, and marked central bronchiectasis in both upper lobes. He had no history of eosinophilia or of attacks of dyspnea. Our diagnosis was acute exacerbation of long-standing allergic bronchopulmonary aspergillosis and chronic airway infection. Treatment with oral prednisolone (30 mg per day) together with intravenous cefsulodin for three weeks resulted in marked relief symptoms and improvement in pulmonary function. The delay in correct diagnosis seems to have been caused by the lack of an obvious episode of asthma, and by the fact that the chronic productive coughing was thought to have been due to bronchiectasis, and to chronic bacterial infection. The characteristic bronchiectasis of this patient prompted us to examine the allergic reaction to aspergillus and let us to the correct diagnosis.
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PMID:[Allergic bronchopulmonary aspergillosis in a patient without bronchial asthma who had chronic airway infection with Pseudomonas aeruginosa]. 929 8

We report on the case of a 25-year-old female with severe systemic lupus erythematosus (SLE) who presented with pancytopenia, fever, arthralgia and abdominal pain. After antibiotic treatment, the patient was afebrile for 3 days before her temperature rose again. Dyspnoea and cough pointed towards pneumonia which was confirmed by X-ray. Different antibiotics and the antimycotic agent fluconazol were given. The lupus flare was treated with high-dose prednisolone. After a couple of days, the dyspnoea increased and mechanical ventilation became necessary. Bronchoscopy and transbronchial biopsy revealed the diagnosis of invasive aspergilloses. Despite of an immediate treatment with amphotericin B, the patient died because of respiratory insufficiency. The literature on aspergillosis in SLE is reviewed and prophylactic, diagnostic and therapeutic options are discussed for this infectious complication which has an 80% mortality in patients with SLE.
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PMID:A fatal case of severe SLE complicated by invasive aspergillosis. 935 8

A 53-year-old man was admitted to the hospital because of productive coughing general malaise, and right-sided chest pain. At 41 years of age he was given a diagnosis of gastric cancer, underwent a and gastrectomy, was treated with anti-cancer drugs. At 49 years of age he suffered from atypical mycobacteriosis and received anti-tuberculosis drugs for 1 year. A chest X-ray film showed infiltrative shadows with a cavity in the right upper lung field. Semi-invasive aspergillosis was diagnosed on the basis of the clinical and radiographic findings, positive sputum cultures, and positive serologic tests. After 8 months of therapy with intravenous and oral fluconazole, no pulmonary aspergillosis was evident. Treatment with fluconazole was effective in this case of semi-invasive aspergillosis.
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PMID:[Successful use of fluconazole against semi-invasive--pulmonary aspergillosis]. 937 61


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