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)

One hundred and eighty eight outpatients with community acquired pneumonia have been treated by spiramycin in general practice. Community acquired pneumonia was defined by the association of fever > or = 38 degrees C, respiratory symptoms as cough, sputum production, dyspnea or thoracic pain, and pulmonary opacity on the chest X-Ray. The mean age of patients was 44.7 +/- 16.6 and few of them had concomitant chronic illness, as cardiovascular (9%) or bronchopulmonary disease (9%). Twenty one percent of patients have been included after a previous antibiotherapy failure. In 92% on these cases, prior antibiotherapy was a beta lactam. At inclusion, the fever was greater than 39 degrees C in 56% of patients, 58% had localized crepitations at the chest auscultation. The chest X-Ray was performed 1.4 +/- 2.1 days after inclusion and showed a lobar consolidation in 77%. One third of patients presented a clinical picture evoking acute bacterial pneumonia. One hundred and seventy one patients have been reviewed for a second evaluation 4 +/- 1.5 days after inclusion. One hundred and eighty seven patients have visited for the long term follow up 19 +/- 6.5 days after the onset of treatment. Ninety six per cent of them have consulted with a control chest X-ray. At this visit, the antibiotherapy was changed in 2 other patients with of failure. Overall, 83% of patients were clinically and radiologically cured by Spiramycin 3 MU twice a day for 13 +/- 3.5 days. Fourteen percent of patients were improved without necessity of changing the antibiotic regimen. This study confirms the efficacy of spiramycin in the management of community acquired pneumoniae in general practice, either in first line therapy of after the failure of beta lactam.
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PMID:[Community-acquired pneumonia in healthy adults: 188 patients treated with spiramycin in private practice]. 130 46

Purulent bronchitis was identified in 19 of 422 patients undergoing fiberoptic bronchoscopy during a 32-month period because of suspicion of an opportunistic lung infection complicating acquired immunodeficiency syndrome or human immunodeficiency virus infection. Five patients had Pneumocystis carinii pneumonia, but other opportunistic lung infections were excluded in the remaining 14 patients. Characteristics of these 14 patients included fever (greater than 38.3 degrees C), cough, and dyspnea in 14 of 14 patients; purulence of expectorated sputum (11/14); and widened alveolar-arterial oxygen gradient (13/14). Rapid (2 +/- 1.4 days) clinical response (defervescence and resolution of pulmonary symptoms) occurred with antibiotic therapy in 10 of 14 patients. In three patients, there was no improvement, and adult respiratory distress syndrome developed. Bacterial isolates from bronchoalveolar lavage included Streptococcus viridans (n = 12), Haemophilus influenzae (n = 7), Staphylococcus aureus (n = 3). Roentgenographic features of bronchiectasis were present in seven patients. Differential cell counts revealed greater than 50% neutrophils in the bronchial washings of all patients with purulent bronchitis. Neutrophil percentages in bronchoalveolar lavage were as follows: patient with purulent bronchitis without P carinii pneumonia (n = 14), 54.53% +/- 29.18%; patients with purulent bronchitis and concomitant P carinii pneumonia (n = 5), 62% +/- 31.9%. In a control group of 17 patients with P carinii pneumonia who did not have purulent bronchitis, the neutrophil percentage was 6.8% +/- 6.17% (p = less than 0.00001, t-test). Purulent bronchitis appears to be a distinct, treatable entity in patients with HIV infection and may accompany bacterial pneumonia, bronchiectasis, and P carinii pneumonia.
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PMID:Bronchitis mimicking opportunistic lung infection in patients with human immunodeficiency virus infection/AIDS. 151 86

Two cases of hypersensitivity pneumonitis due to contamination of ultrasonic-humidifier were reported. The first case, a 64-year-old man, developed fever and dyspnea on exertion in January 1986. He was hospitalized for 18 days and received antibiotics for presumptive bacterial pneumonia. Half a day after discharge, those symptoms recurred. On readmission, fine crackles were heard at the left lung base, and chest X-ray film showed ground glass shadows all over the lung fields. Bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) were performed on the next day after readmission. TBLB specimen revealed lymphocyte alveolitis, granulomatous tissue and infiltration of polymorphonuclear neutrophils (PMN) in alveoli. Differential cell count of the BAL fluid showed not only lymphocytosis (38.2%) but also increased PMNs (44.2%). In the second BAL performed 18 days later, the value of PMNs demonstrated a dramatic decrease. Environmental challenge tests revealed that his hypersensitivity pneumonitis was caused by an ultrasonic humidifier in his bed room. Immunological examinations showed positive Arthus type skin reaction and serum precipitin against Aspergillus fumigatus. Inhalation challenge with A. fumigatus produced cough and dyspnea with a decrease of 10 Torr in PaO2. These data suggest that A. fumigatus may be the causative antigen in this case. The second case, a 64-year-old man who had used ultrasonic humidifier in his living room, was admitted for 8 weeks with an illness characterized by cough, low fever and general malaise on 22 January 1987. Examination revealed fine crackles on both lung bases. Chest X-ray film demonstrated diffuse nodular shadows. The TBLB specimen showed lymphocytic alveolitis and bronchiolitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Two cases of hypersensitivity pneumonitis due to contamination of an ultrasonic humidifier]. 189 86

Approximately 4% of recipients of solid organ transplants in the United States develop bacterial pneumonia in the posttransplant period, often in the first 3 months following transplantation. The incidence of bacterial pneumonia is highest in recipients of heartlung (22%) and liver transplants (17%), intermediate in recipients of heart transplants (5%), and lowest in renal transplant patients (1 to 2%). The crude mortality of bacterial pneumonia in solid organ transplantation has exceeded 40% in most series. Beyond those risk factors identified for nosocomial pneumonia, the occurrence of primary cytomegalovirus (CMV) infection, graft rejection, maintenance antirejection therapy with prednisone, azathioprine, and antilymphocyte globulin, antirejection therapy with high-dose corticosteroids or OKT3 and splenectomy have been associated with a significantly increased risk of bacterial pneumonia in these patients. In the first 3 months posttransplant, gram-negative bacilli, Staphylococcus aureus and Legionella predominate and mortality is very high, in excess of 60%. Thereafter, bacterial pneumonias are caused primarily by Streptococcus pneumoniae and Hemophilus influenzae, with considerably lower mortality. Bacterial pneumonia must be suspected in any transplant patient presenting with fever and cough, especially associated with dyspnea or infiltrates on chest radiograph. If large numbers of bacteria and polymorphonuclear leukocytes are not visualized in respiratory secretions the work-up should proceed directly to fiberoptic bronchoscopy with bronchoalveolar lavage and/or protected brush specimen to establish the microbiologic diagnosis as accurately as possible. For presumptive gram-negative bacillary pneumonia, the initial regimen must be effective against Pseudomonas aeruginosa. Prevention of bacterial pneumonia in transplant patients must begin with immunization against S pneumoniae and Influenza A, and include precautions taken to prevent nosocomial pneumonia. It further may include measures to prevent CMV infection and the use of trimethoprim/sulfamethoxazole prophylaxis during the first year posttransplantation. Ultimately, novel technologies such as selective antimicrobial decontamination and/or protective isolation during the early postoperative period may prove effective.
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PMID:Bacterial pneumonia in solid organ transplantation. 218 17

Although commonly found at autopsy, leukemic infiltration of the lung is rarely recognized as a cause of respiratory symptoms or roentgenographic densities. Previously reported cases of patients who had symptomatic or roentgenographic acute leukemic lung diseases invariably presented with diffuse pulmonary infiltrates. We describe three patients with leukemic involvement of the lung who presented with cough, fever, and localized roentgenographic infiltrates suggestive of bacterial pneumonia. In each case, the diagnosis was made by transbronchial biopsy specimen and confirmed by complete response to chemotherapy. In common with the other reported cases, all of our patients had peripheral blast counts above 40 percent (greater than 6,000 blasts per ml3) at the time the pulmonary diagnosis was made. Leukemic invasion of the lung should be considered in patients with acute leukemia who develop lung infiltrates--whether diffuse or focal--in association with a high peripheral blast count.
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PMID:Localized leukemic pulmonary infiltrates. Diagnosis by bronchoscopy and resolution with therapy. 240 52

A retrospective review was conducted of all children admitted to our intensive care unit over eight years with a diagnosis of pertussis that had been proved on culture. Altogether 789 children were seen as outpatients and inpatients. Twenty four of these children were admitted to the intensive care unit, 13 of whom required ventilatory support; two of the ventilated patients died. Intubation and ventilation were usually started for appreciable apnoea. Most patients requiring support were less than 3 months of age and required intervention within the first 16 days of cough. For these patients ventilation was neither difficult nor prolonged. Coughing spasms were not a problem and intubation and ventilation appeared to attenuate the progress of the disease. The presence of severe bacterial pneumonia associated with difficult ventilation requiring neuromuscular paralysis indicated a poor prognosis. It is suggested that intubation and ventilation can be safely used in very severe pertussis infection and, because of their greater risk of hypoxic damage and death, it should not be reserved as a last resort in critically ill infants.
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PMID:Artificial ventilation in severe pertussis. 336 4

The spread of influenza virus through a community typically causes large increases in medical visits for febrile respiratory disease. Increased school absenteeism occurs early in the epidemic, and school children appear to be important for disseminating the virus. Industrial absenteeism, hospitalizations of adults and infants for pneumonia, and deaths due to pneumonia-influenza all tend to peak later in the epidemic. Although influenza infection rates are highest in persons of school age, hospitalizations and deaths occur primarily in infants and in the elderly, particularly among those with pulmonary, cardiovascular, or other debilitating disorders. Influenza viruses can be spread by aerosol or contact. The primary target cells are those of the respiratory epithelium. In healthy adults, the typical influenza syndrome includes fever, cough, and general aches for three to seven days, but lassitude, cough, and evidence of small-airways disease may persist for weeks. Laryngotracheobronchitis, pneumonia, and unexplained fever are prominent manifestations of influenza that lead to hospitalization of young children. Adults are more likely to have complications of bacterial pneumonia and worsening of chronic pulmonary disease or congestive heart failure. Less frequent complications include myositis, various neurologic disorders, and Reye's syndrome. These consequences of influenza clearly justify strenuous efforts at prevention and control.
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PMID:Clinical manifestations and consequences of influenza. 359 13

Four adults had varicella pneumonitis. All developed respiratory symptoms within a week of the exanthem. Cough and/or dyspnea, cyanosis and chest pain were common. Radiological signs of disease were more marked than physical signs. A slight polymorphonuclear leukocytosis and normal sputum culture were usual. One man with mild symptoms recovered. Two women, one pregnant, had severe symptoms and died. A second man succumbed to secondary bacterial pneumonia. The lungs in fatal cases showed interstitial pneumonitis with mononuclear cell infiltrate, focal areas of necrosis, and acidophilic inclusion bodies in two cases. Patients received oxygen, antibiotics and, in one instance, corticosteroid therapy. The value of antibiotics and corticosteroid treatment is questionable. Use of gamma globulin in preventing varicella pneumonitis is mentioned and residual pulmonary changes are discussed.
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PMID:Varicella pneumonitis. 601 59

Using the double-blind comparative trial method, we conducted a multicenter cooperative study at 52 institutions throughout Japan on the efficacy and the safety of cefotetan (CTT) at a dose of 2 g/day and cefmetazole (CMZ) at a dose of 4 g/day in treating bacterial pneumonia and other lower respiratory tract infections and achieved the following results. 1. The patients were classified according to severity of symptoms and based on the judgment of the committee, it was concluded that in regard to clinical efficacy CTT proved to be significantly superior to CMZ in bacterial pneumonia cases of moderate severity. Even in all cases, CTT tend to show a superior clinical effectiveness on cases moderate severity. No other significant differences in regard to clinical efficacy were observed between these 2 drugs either by the committee or the attending physicians. 2. An analysis of all cases accepted by the committee showed that CTT was significantly superior in effectively relieving fever, and CMZ was significantly superior in relieving cough symptom. 3. No significant difference was observed between 2 drugs in regard to bacteriological effectiveness. 4. No significant difference was observed between 2 drugs in regard to the nature or frequency of side effects or abnormal clinical laboratory findings. 5. No significant difference was observed between 2 drugs in regard to clinical usefulness. From the above findings we concluded that 2 g/day of CTT was equal or superior in some cases to 4 g/day of CMZ in the treatment of respiratory tract infections.
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PMID:[Double-blind clinical study on cefotetan and cefmetazole in treating respiratory tract infections]. 634 63

A retrospective study of 35 patients with Rocky Mountain spotted fever was undertaken to determine the frequency of respiratory symptoms, as well as to analyze the types of pulmonary problems encountered to hospital patients. Cough, present in only 33% of patients, led to an incorrect initial diagnosis and delay in therapy in eight individuals. Lower respiratory tract involvement (rales, abnormal chest roentgenograms, and abnormal gas exchange) was present in 42% of patients at some point during the illness. The conditions of nine patients deteriorated during the first week of hospitalization. Pulmonary edema (probably noncardiogenic) was the usual explanation for worsening gas exchange. Bacterial pneumonia and hemorrhage were detected in only two patients.
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PMID:Lower respiratory tract involvement in Rocky Mountain spotted fever. 735 17


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