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

Eight patients in whom new respiratory symptoms developed following pulmonary resection have been evaluated. The bronchial stumps in all of these patients had been closed with Tevdec suture material. The total number of pulmonary resections using Tevdec suture from January, 1971, to January, 1980, was 180, yielding an incidence of the complication of 4.4%. No patient had empyema or bronchopleural fistula. Symptoms included nonproductive cough (eight patients), hemoptysis (five patients), wheezing (two patients), and coughing up suture material (two patients). The underlying disease necessitating pulmonary resection was carcinoma in five patients, carcinoid adenoma in one patient, tuberculosis in one patient, and bronchiectasis in one patient. The median time interval between resection and development of respiratory symptoms was 18 months, with a range of 8 to 57 months. The chest roentgenograms showed no change from earlier postoperative films. Bronchoscopy under general anesthesia was performed in all eight patients. Granulation tissue around loosened Tevdec sutures was present in all patients so examined. No residual tumor or specific infection was identified. Immediate and sustained relief of symptoms was obtained in seven of eight patients by removal of the loosened sutures. One patient has had recurrence of minor hemoptysis 18 months following suture removal but has refused further endoscopy. Stainless steel staples have been used for bronchial stump closure in over 100 pulmonary resections since 1977 and no such complications have been seen.
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PMID:Bronchoscopic diagnosis and treatment of bronchial stump suture granulomas. 720 61

A 75-year-old male, who had undergone left extrapleural plombage for left pulmonary tuberculosis 46 years before, was admitted because of cough and sputum. The Chest X-ray and CT-scan films on admission show fluid collection in plombs. Left postero-lateral thoractomy was performed on January 14, 1994. There were thickness of the parietal pleura and no findings of empyema or fistulas. Extrapleural plombs and partial part of the vegetation were removed safely. There were two damaged plombs and fluid collection in another two plombs. No findings of residual tuberculosis were found on postoperative pathological and bacteriological examinations. He has been well for 8 months postoperatively.
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PMID:[A case of extirpation of the extrapleural plombs]. 760 4

In this study, 31 cases of childhood empyema thoracis admitted over 4 1/2 years to the Hospital Universiti Sains Malaysia, in Kelantan, Malaysia, were retrospectively reviewed. Twenty-two males and nine females were included, with a mean age of 1.9 years (range: 26 days to 7 years). Frequent symptoms were fever, cough, and dyspnoea, while common signs were temperature above 38 degrees C, decreased breath sounds, dullness to chest percussion, and intercostal recession. Radiography demonstrated unilateral moderate to large effusions in 68 per cent of cases, while consolidated lung was seen in 45 per cent of patients. Pleural fluid cultures were positive for Staphylococcus aureus (48 per cent), Streptococcus pneumoniae (7 per cent), while no growth was seen in 42 per cent of cases. Ninety-four per cent of children had a blood leukocytosis above 10 000 cell/mm3, but blood cultures were negative in 21 out of 26 patients (81 per cent). Most cases were treated with a combination of intravenous antibiotics and chest tube drainage. Antibiotics and pleural tap(s) were used in the remainder. Patients stayed in hospital for an average of 20.7 days (range: 4-52 days). Surgical intervention was necessary in only four children. The mortality rate at the time of discharge was zero, with 100 per cent radiographic resolution among the 23 patients who were followed-up.
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PMID:Empyema thoracis in hospitalized children in Kelantan, Malaysia. 763 41

A 63-year-old man, who had undergone induction of artificial pneumothorax at 20 years of age as a treatment for right tuberculosis, developed fever and cough. A chest X-ray film showed marked pleural effusion in the right chest. Examination of sputum and the pleural effusion revealed tubercle bacillus, and right tuberculous empyema was diagnosed. At surgery, the right thoracic cavity was occupied by empyema, and multiple bronchopleural fistulae were observed. Because of the presence of tubercle bacilli in the empyema cavity, extraperiosteal air plombage thoracoplasty was insufficient for control of the empyema. Therefore, omentoplasty was added. Two months after the operation, the patient was discharged in good condition. He has been doing well without any sign of recurrence of empyema for the last two years. Although extraperiosteal air plombage thoracoplasty is a considerably effective therapy for empyema, its curability rate is lower in cases like the present one in which bronchopleural fistulae and bacteria are present in empyema cavity, such as our case. We consider that our method, extrapriosteal air plombage thoracoplasty with omentoplasty, is a reliable one for control of empyema, in patient with high risk factors for recurrence, such as bronchopleural fistulae and bacteria in the cavity.
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PMID:[A case of chronic empyema due to tuberculosis with bronchopleural fistulae treated successfully by extraperiosteal air plombage thoracoplasty and omentoplasty]. 771 84

Acute sinusitis is one of the most commonly observed entities in clinical practice. Despite the frequency of the disease, diagnosis and therapy often remain empiric. Most cases are secondary to sinus ostia obstruction associated with the common cold or allergies. Maxillary sinusitis is most common. Because of the proximity of vital anatomic structures and venous drainage systems, serious complications frequently arise from sphenoid, frontal, and ethmoid sinusitis. Clinical signs and symptoms most helpful in the diagnosis of maxillary sinusitis are the presence of a maxillary toothache, lack of improvement with decongestants, a purulent nasal discharge, cough, purulent secretions observed on nasal examination, abnormal transillumination, and sinus tenderness. Plain film radiographs are helpful, but do not adequately visualize the anterior ethmoid sinuses. Computed tomography provides superior visualization, but cost remains prohibitive for routine cases. Most maxillary sinusitis in adults is secondary to Streptococcus pneumoniae or Hemophilus influenzae. Moroxella catarrhalis is common in children. Staphylococcus aureus is observed more frequently in frontal or sphenoid disease. Most patients with acute sinusitis are treated without microbiological diagnosis and respond well to commonly used oral antimicrobials with activity against the usual pathogens. Complications of sinusitis include meningitis, periorbital infections, subdural empyema, epidural abscess, brains abscess, cavernous sinus thrombosis, and osteomyelitis.
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PMID:Acute sinusitis. 776 9

Pleuropulmonary blastoma is a rare childhood malignancy that may simulate an empyema both clinically and radiographically. A 3-year-old boy with fever, cough, and abdominal pain developed complete opacification of the left hemithorax with contralateral mediastinal shift over the course of several weeks. At thoracotomy, a pleuropulmonary blastoma was discovered. The radiology, pathology, and clinical course of this rare neoplasm are discussed.
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PMID:Pleuropulmonary blastoma simulating an empyema in a young child. 776 24

A 36-year-old man with hemophilia A was admitted to hospital because of otalgia, hearing loss, nasal obstruction, nonproductive cough, and high fever. His laboratory data showed high-grade acute inflammatory reactions. His chest X-ray and CT films showed multiple cavitary masses in the right lower lung field. Bronchoscopy performed at our institution revealed bronchial nodules in the intermediate truncus, and BAL revealed increases in the neutrophils and an IgG index (BAL IgG/albumin divided by serum IgG/albumin). Biopsy specimens obtained from nasal mucosa showed epithelioid granulomas with Langerhans' giant cells and necrotizing vasculitis. Antineutrophil cytoplasmic antibodies were also positive, but no evidence of glomerulonephritis was observed. The diagnosis of limited Wegener's granulomatosis was thus made. He was treated with standard therapy (daily cyclophosphamide and glucocorticoids), but within 1 month he had complications of empyema with herpes zoster, and bronchopleural fistula. The complications resolved with appropriate treatment.
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PMID:[A case of limited Wegener's granulomatosis with hemophilia A, complicated by empyema, bronchopleural fistula and herpes zoster during therapy]. 781 60

A 71-year-old female was seen with a complaint of chest pain and cough, and a history of tuberculous pleurisy and artificial pneumothorax 40 years ago. The diagnosis of empyema with carcinoma was made by chest X-ray and CT scans. The examination of lung function showed a restrictive disorder. The value of the predicted postoperative FEV1 0.75 l encouraged to perform operation. A left pleuropneumonectomy and combined resections of the invasive portion of the pericardium and left atrium was performed. Histological examination revealed large cell carcinoma of lung (pT 4 N 1 M 0). The literatures are reviewed concerning the thoracic malignant tumor arising in chronic empyema cavity on Japanese cases.
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PMID:[Chronic empyema associated with large cell carcinoma of lung: case report with review of the literature]. 815 87

Fifty seven children with thoracic empyema (37 boys and 20 girls) aged less than 12 years were seen at the University of Port Harcourt Teaching Hospital between January 1989 and December 1991. Staphylococcus aureus was the most common organism isolated from the pus of these patients (36 (63%) patients). Pseudomonas aeruginosa, the next most common organism, was isolated in 10 (18%) patients. The most common symptoms at presentation were acute illness with fever and cough (51 (89%) patients). All the patients were treated with closed intercostal tube drainage and appropriate antibiotics. Decortication was resorted to in only one patient. There were two deaths and the overall survival rate was 97%.
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PMID:Thoracic empyema: a study of 56 patients. 825 81

Chronic granulomatous disease of childhood is an inheritable disorder of phagocytic cell respiratory burst resulting in recurrent, life-threatening, catalase-positive infections. The lung is the most common site of infection, and pulmonary disease is the primary cause of death in greater than 50% of children with chronic granulomatous disease. Still, the role of surgery in management of this disease remains undefined. Between 1974 and 1990, 19 patients with chronic granulomatous disease required 31 thoracic interventions at our institution. Patients ranged in age from 2.5 to 27 years (mean age, 15 years). Seventeen of 19 patients (89%) had had previous pulmonary infections. Patients presented as toxic (temperature > 38.5 degrees C, chest pain, and cough) in 22 instances before the 31 procedures. Aggressive surgical intervention for diagnosis and extirpation of localized infections was undertaken with lobectomy/pneumonectomy with or without other procedures (5), bisegmentectomy (2), segmentectomy with or without other procedures (5), or wedge with or without other procedures (13). In five instances, an empyema was drained; a chest tube for a sterile collection was placed in one instance. There was one intraoperative death, and 3 patients died 22 to 600 days postoperatively with overwhelming sepsis. The mean hospitalization was 101 days (range, 24 to 600 days). Wound complications occurred in 5 patients, requiring 17 separate anesthetic debridements. A change in therapy was dictated by the results of the procedure in 23 of 31 instances (74%). Thoracic surgeons must be aware of this rare cause of immunosuppression in these children and, due to the unusual nature of the pulmonary infections, should follow an aggressive approach in their diagnosis and management.
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PMID:Surgical management of pulmonary infections in chronic granulomatous disease of childhood. 846 36


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