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

Fifty cases of septicaemic melioidosis were reviewed. There was a preponderance of disease among males (male:female ratio 3.2:1) and those aged over 30 years. The presenting clinical features were very varied and not pathognomonic, ranging from fever, cough and septicaemia to fulminant septicaemia and shock. Pulmonary involvement was recorded in 58% of the patients. Skin and soft tissue sepsis was seen in 24%, but many had signs and symptoms of multiorgan involvement. Associated underlying illness was identified in 76% of patients, diabetes mellitus being the commonest (38%), while 34% had more than one predisposing factor. The mortality of 65% in our series is a reflection of the less than satisfactory status of the diagnosis and therapy of septicaemic melioidosis. Only 24% of our patients received appropriate empirical antibiotic therapy. A high index of suspicion of melioidosis in endemic areas and the use of appropriate empirical antimicrobial therapy would be a step towards reducing the high mortality rate.
 ...
PMID:Septicaemic melioidosis: a review of 50 cases from Malaysia. 128 45

A retrospective analysis was done in 81 patients with visceral abscess due to melioidosis treated at Khon Kaen Hospital, northeastern Thailand from 1985 to 1993. The clinical presentations were fever 100 per cent, abdominal pain 39 per cent, cough 34.8 per cent, abdominal tenderness 27.5 per cent and palpable mass 24.6 per cent. The laboratory findings were not diagnostic of the etiology. The abscesses were detected by ultrasonography in 97.25 per cent and computed tomography 2.25 per cent. The lesions were found in the spleen 72.8 per cent, liver 45.7 per cent, kidney 12.3 per cent and prostate gland 2.5 per cent. Seventy-six per cent of the patients had diseases in multiple organs (viscera, lungs and others). The preliminary diagnoses were fever of unknown origin, septicemia and urinary tract diseases in one-half of the cases. Patients presenting with fever of unknown origin from an endemic area, like northeastern Thailand, should arouse suspicion of melioidosis and search for the organism is advised. Diagnostic imaging methods, ultrasonography and computed tomography are valuable tools for detection of a solid internal organ abscess.
 ...
PMID:Visceral abscess in melioidosis. 756 44

A rare case of pulmonary melioidosis is reported. The patient was a 62-year-old man presenting with subacute fever, dry cough, and significant weight loss. A chest x-ray revealed a right paratracheal mass. The findings from fiberoptic bronchoscopy were a blunt carina and normal tracheobronchial tree. The patient had an underlying disease of poorly controlled diabetes mellitus, heavy smoking, and heavy alcoholic drinking. One of the two cultured blood specimens grew B. pseudomallei. The pathological finding of transbronchial biopsy at the apical segment of the right upper lung showed lymphocytic infiltrates. He was treated with two weeks of intravenous ceftazidime plus cotrimoxazole followed by 5 months of oral doxycycline plus cotrimoxazole. Clinical symptoms significantly improved and the right paratracheal mass disappeared.
 ...
PMID:Pulmonary melioidosis presenting with right paratracheal mass. 1569 Nov 41

Between 1997 and 2002, 107 patients with symptoms of superior vena cava (SVC) obstruction presented at a university hospital in Northeast Thailand. Age averaged 50.7 years (range, 1 to 84). The male to female ratio was 5.7:1. Duration of symptoms before diagnosis was 29.4 days (range, 2 to 240), including facial swelling, cough, and chest discomfort. About 20% of cases developed respiratory failure and 11.2% died shortly after admission. The mean hospital stay was 23.7 days. Anteroposterior and lateral chest radiographs and computed chest tomography helped locate the lesion. Transbronchial biopsy through bronchoscopy, transthoracic needle biopsy under computed tomography, lymph node biopsy, pleural fluid cytology and/or biopsy were used for histopathologic sampling. High levels of alpha-fetoprotein and beta-HCG indicated an anterior mediastinal mass. The most common etiology of SVC obstruction was bronchogenic carcinoma (51.8%), followed by an anterior mediastinal mass (14.5%), lymphoma (13.6%--with an LDH of 262 to 1459 U/l), metastatic cancer (9.1%), and acute lymphoblastic leukemia (1.8%). Benign SVC thrombosis was found in four patients with Behcet's disease or some other idiopathy. Mediastinal fibrosis from melioidosis occurred in three patients, which is rare, has not been previouly reported. Most patients (63.6%) received a combination of radiotherapy and corticosteroid and this helped 55.2% improve.
 ...
PMID:Etiology and outcome of superior vena cava (SVC) obstruction in adults. 1569 Nov 55

Melioidosis is an infection of the Gram-negative bacterium Burkholderia pseudomallei. While it is known as an important cause of sepsis or chronic abscess-forming disease in Southeast Asia and northern Australia, no case has yet been reported in Korea. A 50-yr-old man visited our hospital for intermittent fever associated with dry cough and sputum. Roentgenographic examination showed migrating pulmonary infiltration. Symptoms and chest radiograph and computed tomography (CT) image findings did not improve despite use of fluoroquinolone antibiotics. Gram-negative bacteria were isolated on bronchoscopic washing culture and were identified as B. pseudomallei on DNA sequencing of 16S ribosomal RNA with 100% homology. Treatment for melioidosis was commenced with high dose ceftazidime, and the patient's fever, cough, and sputum were improved and the lesion on chest radiograph and CT almost disappeared.
 ...
PMID:A case of melioidosis presenting as migrating pulmonary infiltration: the first case in Korea. 1571 19

Herein, we report a case of fatal melioidosis in a newborn. The newborn died of serious melioidosis with respiratory and multiorgan failure at 16 days of age despite extensive treatment with antibiotics and methylprednisolone. Burkholderia pseudomallei was isolated from the infant's blood and cerebrospinal fluid and identified as a novel sequence type (ST-1341). His father had cough and fever when the newborn was born, and a localized patchy infiltration on the right upper lung was seen in chest radiography, but B. pseudomallei was not isolated. Two years later, the father developed cough and fever again, and the same novel sequence type of B. pseudomallei was isolated from the blood of the father. It is postulated that transmission of B. pseudomallei from the father to the newborn might have occurred during close contact in the first couple of days after birth. Given the high mortality of neonatal melioidosis, particular attention must be paid when the caretakers of the newborn develop fever of unknown origin in a melioidosis-endemic region.
...
PMID:Fatal Melioidosis in a Newborn from Hainan, China. 2716 67

Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is an important cause of sepsis in tropical areas of Eastern Asia, mainly affecting immunocompromised adults. Diabetes mellitus is the most important host risk factor. Here, the authors report a case of a 54-year-old Saudi male with uncontrolled diabetes mellitus for 10 years who presented to our hospital with a 6-week history of fever, cough, night sweats and weight loss. The patient was a frequent traveler to the Philippines, with his last visit being during the rainy season 2 weeks before the onset of symptoms. Definite diagnosis of melioidosis was not made because of insufficient facility to culture the organism in our laboratory; nevertheless, a diagnosis of melioidosis was made based on the cumulative clinical scenario. The patient was discharged on trimethoprim-sulfamethoxazole and doxycycline for 3 months and showed significant improvement at follow-up. For prompt diagnosis and treatment, clinicians must maintain a high index of suspicion for melioidosis in febrile patients with a history of traveling to endemic areas, especially diabetic patients.
 ...
PMID:Melioidosis: Can Tropical Infections Present in Nonendemic Areas? A Case Report and Review of the Literature. 3078 31

We report a case of a patient with pulmonary melioidosis which radiologically mirrored a bronchogenic carcinoma with mediastinal lymphadenopathy. Such findings were observed in a Computed Tomography (CT) scan (Thorax) and Positron Emission Tomography (PET) scan (Body) in a previously healthy 57-year-old man with no significant medical risk factors for melioidosis other than his previous exposures to soil during outfield military training in Thailand, 37 and 28 years ago. He presented with acute symptoms of dry cough, pleuritic pain and fever. A CT Scan thorax revealed a left lower lobe mass with left pleural and pericardial effusion and mediastinal lymph nodes. Similarly, the PET scan showed various fluorodeoxyglucose (FDG)-positron uptake in these areas. However the lung mass biopsy cultured Burkholderia pseudomallei concurrently with a Melioidosis serology titre of >1:1024. He responded to intravenous Meropenem followed by Co-Trimoxazole and Doxycycline over the course of 21 weeks, ultimately leading to the resolution of any significant radiological findings.
 ...
PMID:A mimic of bronchogenic carcinoma - pulmonary melioidosis. 3202 84

In 2012, the United States Marine Corps began annual deployments around Australia, including highly endemic areas for Burkholderia pseudomallei. B. pseudomallei infection, or melioidosis, is difficult to diagnose, and culture remains the gold standard. Accurate and timely diagnosis is essential, however, to ensuring appropriate therapy. Ten days after returning from Australia, a Marine presented to a community hospital with massive cervical lymphadenopathy, fever, and cough. Computed tomography demonstrated scattered pulmonary infiltrates with small cavitations; lymphadenopathy involving the cervical, supraclavicular, and mediastinal nodes; and splenomegaly. Sputum and blood cultures were negative. Empiric antimicrobial therapy with ceftazidime was initiated for suspected melioidosis. Retrospectively, a prototype iSTAT cartridge modified to detect B. pseudomallei capsular polysaccharide antigen was used to test a specimen of the patient's blood and was determined to be positive. Over the course of therapy, B. pseudomallei capsular antigen levels in blood declined as the patient improved. The leveraging of an existing point-of-care (POC) analyzer to create a rapid diagnostic assay for melioidosis provides a template for rapid POC diagnostics that could significantly improve the ability of clinicians to deliver timely and appropriate therapy for serious infections.
 ...
PMID:Indirect Detection of Burkholderia pseudomallei Infection in a US Marine After Training in Australia. 3239 1