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

A renal transplant recipient was receiving prednisone and azathioprine therapy when he developed fever, cough, and erythema-nodosum-like lesions on the extremities. Disseminated histoplasmosis was diagnosed by skin biopsy. Disseminated histoplasmosis should be considered when a patient under immunosuppressive therapy develops a lesion similar to erythema nodosum or erysipelas with panniculitis.
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PMID:Disseminated histoplasmosis in an immunosuppressed patient. 32 2

A retrospective study was carried out by a computerized questionnaire in a sample of 109 sarcoidosis patients (43 men, 66 women) diagnosed between 1977 and 1990 in Pisa. 94% of the patients were resident in Tuscany. The onset of disease was earlier in the men than in the women; in 73% of the patients the symptoms were first noticed between February and July with two incidence peaks; 71% of them had never smoked; 10% of patients were symptom-free and the disease was discovered by chance; the other patients (90%) underwent chest X-ray because of joint symptoms (35%), erythema nodosum (34%), cough (28%), dyspnoea (27%), and fever (24%) which was often associated with other symptoms. Symptoms from the respiratory tract was present in 66 patients (61%); 58% of patients were resident in rural areas; the level of education was limited to primary school in 50% of the patients; as to the prevailing working positions, 27% were clerical workers, 24% manual workers, and 26% housewives.
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PMID:Sarcoidosis in Tuscany. A preliminary report. 134 53

Sarcoidosis is a granulomatous multisystemic disorder, of unknown origin, that commonly affects young adults between 20-40 years of age. The disease usually manifests itself with changes in the chest which are radiologically visible in 90% of the patients in the form of bilateral hilar lymphadenopathy to interstitial infiltrates in the lungs and bronchi. Once the diagnosis of sarcoidosis has been established, the next step is to evaluate the activity and stadium of the disease. These activity markers include clinical, biochemical and immunological parameters. The clinical criteria include symptoms which indicate the clinical manifestation of sarcoidosis, as well as symptoms which are of prognostic importance for the further course of the disease: dry cough, dyspnea, erythema nodosum, posterior uveitis, polyarthralgia, myopathy, cardiac, renal or nervous system involvement, lymphadenopathy, skin lesions, splenomegaly, enlarged parotid and lacrimal glands, changes in chest x-ray and changes in pulmonary function tests. Biological criteria: biochemical markers in serum which are related to: macrophage and epithelioid cell activity, to lymphocyte activity, to granuloma activity and to collagen metabolism alterations; isotopic markers--67 gallium scan and cellular and soluble components in bronchoalveolar lavage fluid (BAL).
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PMID:[Sarcoidosis activity markers]. 180 91

Although most patients with coccidioidomycosis are asymptomatic, up to 40 percent develop fatigue, cough, chest pain and fever. Erythema nodosum is often present. Chest radiographs may be normal or may show hilar adenopathy, infiltrates, pulmonary nodules or thin-walled cavities. The spherulin skin test is usually positive within three weeks of infection. Specific IgM [corrected] antibodies may be detected early in the course; IgG [corrected] antibodies develop after two to three months. In most patients, the disease has a self-limited course and requires no specific therapy. A few patients develop progressive pulmonary or disseminated disease. Extrapulmonary sites of disease include the skin, the skeleton and, rarely, the nervous system. Amphotericin B and ketoconazole are used to treat disseminated disease. Because coccidioidomycosis is caused by a fungus that is endemic in the Southwest, a travel history should be elicited from patients with persistent pulmonary symptoms.
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PMID:Coccidioidomycosis: office diagnosis and treatment. 233 27

One hundred and twenty-five cases of biopsy proven sarcoidosis have been found during a prospective study since 1972 in Calcutta, Eastern India. The presentation, clinical course and radiological features are considerably different from those seen in the West. Elderly males over 40 years are more prone. Low grade fever, cough, dyspnoea, arthralgia are common symptoms while hepatosplenomegaly, hypercalcaemia, hypercalciuria and hyperglobulinaemia are frequent signs. Nearly 60% are MT negative (up to 100 TU). Serum angiotensin converting enzyme and high lymphocyte count in bronchoalveolar lavage fluid are usual findings in active disease. Chest X-ray usually shows mottled opacities or fibrosis in 60% cases. Clinico-radiological dissociation (i.e. remarkable dissociation between the alarming-looking chest X-ray and scanty physical signs and symptoms in chest) was a very remarkable feature in this series. Treatment with oral steroid or steroid aerosol with oxyphenbutazone and chloroquine give equally good results initially. However, most cases tend to relapse inspite of adequate initial treatment. The pattern of the disease is similar almost all over India with minor regional differences like more erythema nodosum and eye involvement in Chandigarh in the extreme north (which could also have been due to case selection). The pattern from Northern India (Delhi) and Western India is nearly similar to our figures.
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PMID:Sarcoidosis in India: a review of 125 biopsy-proven cases from eastern India. 234 18

Coccidioides immitis is the cause of coccidioidomycosis, the fungus has been found extensively in the Southwestern United States, and Mexico, and certain areas of Central and South America. Some climatic conditions, such as hot summers with little winter frost, combined with arid, alkaline soils produce ideal circumstances for preservation of the arthroconidia. Children and other human groups are infected by dustbone arthroconidia or by contact with infected soils. There has been limited epidemics of infantile coccidioidomycosis, however, only very few have been verified as to the source of the outbreak by the soil-culture of the fungus. The primary pulmonary infection is usually asymptomatic, but it may resemble influenza with cough, fever, and chest pain. Chronic pulmonary lesions are rare in children. Erythema multiforme an erythema nodosum have been described, namely in females. Arthralgias occurs in some patients. The disseminated form is similar to tuberculosis with lungs, lymph nodes, bones, joints, abdominal organs and skin being the frequently affected sites. Meningitis and limited dissemination to one of few sites is more common in mexican children than adults. Serologic tests are very useful in moderate to severe illnesses. Precipitins can be easily detected by immunodifusion. Higher and persistent complement fixation titers are observed in severe and disseminated infection. Conversion of a skin test with coccidioidin or spherulin from negative to positive strongly suggest coccidioidomycosis. Most cases do not require treatment, but amphotericin B or ketoconazol, are the standard therapy in severe pulmonary disease or disseminated forms, and surgery has been advocated for localized, persistent or drug-resistant, progressive lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Coccidioidomycosis in children]. 266 35

Mother, father (26 y.o.) and their only child (5 y.o.) developed nonproductive cough, fever (39.5 to 40.4 degrees C) and bilateral pulmonary infiltrates within three weeks. In addition the mother developed a small left pleural effusion and a pericardial effusion, a relative bradycardia, a pruritic vesicular exanthem of the extremities and the trunk, an erythema nodosum and arthritis of the tarsal joints. The father's coulter counter red blood count was distorted by microagglutination at room temperature (hemoglobin 13.2 gr/dl; erythrocytes 1,91 X 10(6) mm-3 and MCH 69.1 pg; MCV 120 fl and hematocrit 23.8%) but not at 37 degrees C (13.2; 4.15 and 31.8; 92 and 39.3, respectively). In the daughter myringitis, pharyngitis, cervical lymphadenopathy and splenomegaly were observed. Cold agglutinins and serologic evidence for mycoplasma pneumoniae infection were demonstrable in all three. Treatment with Tetracycline (parents) and Erythromycin (child) was effective.
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PMID:[Familial Mycoplasma pneumonia. The varied picture of pulmonary and extrapulmonary manifestations]. 311 25

Sarcoidosis is an idiopathic multisystem disorder with several clinical and roentgenographic features suggestive of respiratory infection. In the absence of infection, it is characterized by the microscopic presence of noncaseating epithelioid granuloma in affected tissues. When present, constitutional symptoms, fever, coughing, and exertional dyspnea usually develop insidiously, although occasionally Lofgren's syndrome--the triad of bilateral hilar adenopathy, erythema nodosum and polyarticular arthritis--may herald the onset of acute disease. Pulmonary involvement is the roentgenographic hallmark of sarcoidosis; bilateral hilar adenopathy is the most common manifestation. However, parenchymal infiltrates and pleural effusion may occur. Although numerous bacterial and fungal organisms may mimic the clinical and roentgenographic features of sarcoidosis, tuberculosis and fungal infections associated with granulomatous inflammation are the infectious processes most apt to cause diagnostic confusion. Several diagnostic clues are available to the clinician confronted with the consideration of sarcoidosis. Roentgenographic staging of the disorder (stage 0, normal radiograph; stage I, isolated bilateral hilar adenopathy; stage II, hilar adenopathy and parenchymal involvement; stage III, isolated parenchymal involvement; and stage IV, parenchymal fibrosis) provides a framework on which a differential diagnosis of likely infectious agents may be constructed and a history of travel to regions of endemic fungal infection may further narrow the differential diagnosis. An unexplained exudative lymphocytic pleural effusion or CD-4 lymphocyte predominance in bronchoalveolar lavage (BAL) fluid may also suggest a diagnosis of sarcoidosis. However, the definitive diagnosis of sarcoidosis is dependent upon the histological demonstration of noncaseating granuloma and the exclusion of infection in the appropriate clinical and roentgenographic setting.
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PMID:Pulmonary sarcoidosis: a mimic of respiratory infection. 748 Nov 30

Sarcoidosis is a systemic disease of unknown etiology with variable presentation, prognosis, and progression. At diagnosis, about 50% of patients are asymptomatic, 25% complain of cough or dyspnea, and 25% have skin lesions (erythema nodosum, lupus pernio, or plaques or scars) or eye symptoms (or develop them during the course of the disease). Bilateral hilar adenopathy is the most common radiographic finding. Other characteristic findings include interstitial lung disease, occasional calcification of affected lymph nodes, and pleural effusions and thickening. Computed tomography is more sensitive than radiography in the detection of adenopathy and subtle parenchymal disease; gallium-67 scintigraphy is useful in identifying extrathoracic sites of involvement, detecting active disease, and assessing response to treatment. The diagnosis is established most securely when clinicoradiologic findings are supported by histologic evidence of widespread noncaseating granulomas. The disease ranges from a self-limited subclinical process to chronic debilitation and death, with the major complications being fibrosis, mycetoma formation, and cor pulmonale. Because the disease so often involves thoracic structures, chest radiography plays a crucial role in the diagnosis, staging, and follow-up of sarcoidosis.
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PMID:Thoracic sarcoidosis: radiologic-pathologic correlation. 776 46

Glucocorticosteroids represent the "drugs of choice" for treatment of sarcoidosis. Steroids can be given by all routes of administration. Daily therapy with oral steroids is most widely applied. Initial therapy should consist of prednisolone 30-60 mg/day or its equivalent. Alternate day therapy can be used during the maintenance phase. Inhaled steroids can also be tried during the maintenance phase for treatment of pulmonary sarcoidosis. Other drugs, which may be effective in sarcoidosis, and have a steroid-sparing capacity, are methotrexate, azathioprine, chlorambucil and cyclophosphamide. Chloroquine can be used for chronic skin lesions and potassium para-aminobenzoate may soften fibrotic lesions and keloids. Duration of treatment varies with the clinical situation; from between 6 and 18 months to lifetime. In principle, continuing signs of disease activity and functional impairment require continuing treatment. Determination of on-going activity may be a difficult task. Symptomatic patients with stage II-III pulmonary sarcoidosis, and many extrapulmonary manifestations of the disease, must be adequately treated. Symptom-free patients with deteriorating lung function and/or biochemical signs of disease activity also require treatment. Steroids are not indicated for pulmonary stage I disease (hilar lymphadenopathy) with or without erythema nodosum unless there are troublesome persistent chest symptoms (cough, pain, pressure symptoms) or arthralgia, oedema and pain of the legs.
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PMID:Treatment of sarcoidosis. 803 53


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