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)

Five hundred and twenty-six cases of bacterial pneumonia in adults admitted to Chulalongkorn Hospital during the period January 1987 to December 1991 were studied, comparing the elderly aged > or = 60 years (241 cases) with the nonelderly < 60 years of age (285 cases). The study indicates that there was a significantly increased number of community and hospital-acquired pneumonia in the elderly than previously reported. Pneumonia in the elderly might present with no fever, no cough no signs of parenchymal infiltration, but significant mental changes. There was a higher incidence of pleural involvement, but lower incidence of septic shock in the non-elderly than the elderly, which suggests that the nonelderly had better systemic resistance against bacterial infection than the elderly. There was no significant difference in complete blood count between the two groups. However, sputum specimens to be collected through endotracheal tube and Gram-negative bacilli on Gram stain were found more in the elderly than the non-elderly. The elderly had more respiratory failure requiring mechanical ventilation, septic shock, and had higher mortality than the non-elderly. They also required longer duration of treatment and hospitalization. There were parameters which indicated the high-risk factors for mortality among the elderly. These included hospital-acquired pneumonia, bronchopneumonia, Gram-negative pneumonia, abnormal status of host, sputum specimens requiring collection by suction, respiratory failure and septic shock.
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PMID:Bacterial pneumonia in the elderly. 784 90

To characterize the morbidity of pertussis in Canada, we did a retrospective review of all children with laboratory-confirmed pertussis seen at the Hospital for Sick Children, Toronto, between 1980 and 1990. A total of 975 patients were identified, of which 223 (23%) were admitted to hospital. The peak incidence of disease was observed in the fall. The incidence of disease did not vary with gender. Only 41% of children admitted had the classical symptoms of pertussis (paroxysmal cough and whoop). Compared with children older than 6 months of age, children younger than 6 months of age were more likely to be hospitalized, tended to be hospitalized longer, were less likely to be age-appropriately vaccinated and were more likely to require intensive care unit monitoring. Seventeen (8%) of 223 children required intensive care unit monitoring, and 12 of these children required mechanical ventilation therapy, for a duration of 3.5 +/- 0.6 days (mean +/- SD). One (0.1%) patient with secondary bacterial pneumonia died. This hospital-based study indicates that pertussis continues to be a cause of serious illness in children, particularly those younger than 6 months of age.
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PMID:Clinical and microbiologic features of children presenting with pertussis to a Canadian pediatric hospital during an eleven-year period. 797 Sep 50

We present the pulmonary findings in 36 autopsies of children affected by the acquired immunodeficiency syndrome (AIDS). Twenty-three patients were male and 13 were female, ranging in age between 3 days and 13 years. Twenty children had human immunodeficiency virus (HIV)-positive parents or parents who were at high risk of exposure (intravenous drug abusers and prostitutes), five had a history of transfusion, and one had a history of renal transplantation and blood transfusion. Clinically, the patients presented with recurrent infections, failure to thrive, hepatosplenomegaly, fever, cough, and/or hemoptysis. Histologically, specific infectious processes were the most common finding (75% of cases), with Pneumocystis carinii pneumonia being the most prevalent type of infection, followed by bacterial pneumonia. Neoplastic conditions and lymphoid interstitial pneumonia were less frequent (approximately 10% of cases). In addition, in approximately 10% of the cases the pulmonary findings were non-specific (ie, pulmonary edema and atelectasis) and probably unrelated to HIV infection. Our findings suggest that specific infectious conditions constitute the most common type of pulmonary pathology in children with AIDS. However, because there is a small percentage of children with nonspecific findings, a transbronchial biopsy is important for proper evaluation before institution of therapy.
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PMID:The spectrum of pathological changes in the lung in children with the acquired immunodeficiency syndrome: an autopsy study of 36 cases. 808 62

We report a 63-year-old male case of Wegener's granulomatosis. His complaints were cough and fever, and chest X-ray showed subpleural infiltrative opacities in the bilateral lungs and small nodular lesions in the middle portion of the right lung. He had been treated as bacterial pneumonia at another hospital without any improvement and was referred to this hospital. Chest CT scan disclosed several small nodular lesions in the subpleural region of the right lung, consolidation in the posterior mediastinum, and the left pleural effusion. Transbronchial lung biopsy revealed inflammatory granulation with predominantly lymphocytes and micro-necrosis in the peribronchiolar region. Although these findings suggested Wegener's granulomatosis, open lung biopsy was performed because both antineutrophil cytoplasmic antibodies (ANCA) and antibodies to proteinase-3 were negative and ear, nose, and throat abnormalities were not found. Pathologic findings consisted mainly of granulomatous inflammation with lymphocytes, histiocytes, and multinucleated giant cells, and granulomatous vasculitis with micro-necrosis. Furthermore, the patient was diagnosed as having bilateral episcleritis by an ophthalmologist. No renal involvement was found. Standard treatment with cyclophosphamide and glucocorticoid resulted in marked improvement within a couple of weeks, and the patient was in complete remission eight months after initiation of therapy. This case is of interest in that the distribution of lesions was not typical and ANCA was negative.
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PMID:[A case of Wegener's granulomatosis with episcleritis, mediastinal lesions, and pleural effusion and without serum anti-neutrophil cytoplasmic antibodies]. 811 75

A 76-year-old male patient suffered from recurrent bacterial pneumonia of the right upper lobe and both lower lobes since 2 years after total gastrectomy for gastric cancer. He was treated with antibiotics repeatedly without complete remission. Meanwhile, chronic cough, purulent sputum, and persistent bilateral pulmonary infiltration developed gradually. Upper digestive tract endoscopy showed moderate reflux esophagitis. For diagnosis, we performed upper digestive tract scintigraphy, a "modified-salivagram", to detect aspiration and GER. Although aspiration was not detected, GER reaching to the upper portion of the esophagus was observed 46 min after taking radio-labeled albumin, and chronic aspiration pneumonia with GER was thus diagnosed. Bed blocks and gragling with ponvidone-iodine after meals and before sleep greatly improved the symptoms of cough and sputum. The bilateral infiltrative shadows disappeared with resolution of symptoms. Chronic aspiration resulting from GER is an important cause of chronic airway infection. Even if a patient with reflux esophagitis is asymptomatic, chronic aspiration pneumonia should be suspected in cases of recurrent or persistent pneumonia in both lower lobes. The "modified-salivagram" is a sensitive test to detect aspiration and GER in hypoacidic states, such as in total gastrectomy and elderly patients.
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PMID:[A case of chronic aspiration pneumonia after total gastrectomy caused by gastroesophageal reflux revealed by a "modified-salivagram"]. 827 18

Pulmonary tuberculosis (TB) and bacterial pneumonia are both characterized by fever, cough, and purulent sputum production. Although TB alone can cause these symptoms, the possibility of a concomitant bacterial pneumonia has led some clinicians to treat these patients empirically with antibacterial agents. Neither the benefit of such empiric antibiotic therapy nor transtracheal aspirate cultures from patients with pulmonary TB have yielded consistent results. Consequently, we performed a prospective study to obtain lower airway secretions via a bronchoscopic protected specimen brush (PSB) technique for quantitative aerobic and anaerobic cultures from untreated patients with extensive pulmonary TB (defined as cavitary disease or involvement of > or = 3 segments). We obtained bronchoscopic samples from 3 untreated men aged 21, 61, and 60 years with extensive pulmonary TB. There was no significant bacterial growth (aerobic or anaerobic) from the specimens obtained. These results, therefore, do not support the hypothesis that bacterial pneumonia is a common concomitant of extensive pulmonary TB.
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PMID:The role of bacterial super infection in extensive pulmonary tuberculosis. Data from protected brush cultures in untreated patients from the University of South Alabama Medical Center, Mobile, Alabama, USA. 836 13

Persistent coughing and bloody sputum developed in a 75-year-old man with mycosis fungoides. Chest X-ray films on admission showed combined patterns of alveolar and interstitial shadows in both lung fields. Histological examination of the transbronchial lung biopsy specimen revealed patchy infiltration of mycosis fungoides cells in alveolar septa. VEPA chemotherapy was ineffective against skin lesions and caused bacterial pneumonia, but combined treatment with etoposide (200 mg, once a week) and prednisolone (30 mg, 3 days per week) resulted in remission. The patient has been taking oral etoposide and prednisolone regularly, and has been free of skin and pulmonary lesions for two years. Combined therapy with low-dose etoposide and prednisolone may be worth trying in cases of advanced mycosis fungoides with pulmonary involvement.
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PMID:[A case of mycosis fungoides with pulmonary involvement: effect of etoposide and prednisolone]. 853 82

A 60-year-old male with type C chronic hepatitis was admitted to Kibikogen Rehabilitation Center with high fever, cough and general fatigue. Chest X-ray film on admission showed consolidation in the left middle and lower lung lung field. Initial treatment with intravenous ceftazidime, imipenem/cilastatin and clindamycin were ineffective due to continuous high fever and cough and spread of the pneumonia shadow. Administration of minocycline was started for suspected non-bacterial pneumonia whereupon his symptoms improved and the pneumonia shadow began to decrease in size. However, his symptoms and pneumonia shadow worsened after taking him off of minocycline due to progressive pancytopenia and liver dysfunction. He was transferred to our hospital and intravenous erythromycin treatment was initiated for suspected Legionell pneumonia because of the elevation of Legionella micdadei serum antibody titer. Immediately after starting treatment, his symptoms improved and the pneumonia shadow decreased in size. Erythromycin was stopped after the 14th day of administration. In this case, diagnosis of L. micdadei pneumonia was made because of the positive results of the polymerase chain reaction test and elevation of the L. micdadei serum antibody titer (from 0 to 1,024). This is the second report of a L. micdadei pneumonia case here in Japan.
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PMID:[A case of Legionella micdadei pneumonia]. 862 71

This study is based on a retrospective logistic regression analysis of all human immunodeficiency virus (HIV)-infected patients with Staphylococcus aureus pneumonia (SAP) admitted to the Department of Infectious Diseases, Catholic University, Rome, Italy between January 1986 and December 1994. Nineteen patients with 24 episodes of SAP were enrolled in the study. A control group of 38 HIV-infected patients without pneumonia was included. The attack rate of SAP was 8.31/1000 HIV-related hospital admissions and the frequency, out of the total number of bacterial pneumonia observed in the study period, was 16% (24 of 154 patients). The large majority of SAP was community acquired. On the univariate analysis, intravenous drug abuse (IVDA) (P = 0.02), history of previous Pneumocystis carinii pneumonia (PCP) (P = 0.03) and cirrhosis (P = 0.03) were significant risk factors for SAP. In addition, IVDA and previous PCP were independent risk factors on multivariate analysis. All patients presented with fever associated with cough (74%), chest pain (26%) or shortness of breath (37%). Chest X-ray documented lobar pneumonia (78%), predominantly in the lower lobes, consolidation with cavitation (11%), and interstitial-nodular infiltrates (11%). Pleural effusion was present in 31% of patients. The response to therapy was favourable in 79% of patients. Recurrence occurred in 26% and death occurred in 21% of patients. Death was significantly associated with the low level (< 50 mm-3) of circulating T CD4+ cells (P = 0.03) and the recurrence of pneumonia (P = 0.03). In conclusion, the present study indicates that S. aureus is an important aetiologic agent of bacterial pneumonia in HIV-infected patients, especially if they are drug abusers with previous PCP.
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PMID:Predictors of Staphylococcus aureus pneumonia associated with human immunodeficiency virus infection. 898 27

We describe the first case, to our knowledge, of apparently isolated pulmonary vasculitis mimicking bacterial pneumonia in a patient infected with human immunodeficiency virus (HIV). Patients presenting with fever, cough, and pulmonary infiltrates present a diagnostic challenge. As a result of severe T cell mediated immunosuppression and humoral dysregulation, the differential diagnosis is diverse. One must consider both noninfectious and infectious etiologies. Noninfectious etiologies such as pulmonary lymphoma, endobronchial Kaposi's sarcoma, and adverse drug reactions are common. Recent recognition of the paradoxical association between HIV and systemic vasculitis requires additional acknowledgment of this problem in diagnosis.
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PMID:Isolated pulmonary microangiitis mimicking pneumonia in a patient infected with human immunodeficiency virus. 910 14


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