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

The clinical data of 52 patients with tuberculous pleural effusion were analyzed. Their average age was 48 years old. Thirty two (62%) of them were sick for less than one week. Fever, chest pain and cough were the predominant pictures. Six of the 52 patients had coexisting disease. Intermediate strength protein purified derivative (PPD) test was found to be positive in 14 out of 31 (45%) patients. Their pleural effusions were usually unilateral, right-sided, and nearly half of them occupied more than half of the hemithorax. One third of these patients and concomitant pulmonary tuberculosis and pleural effusion. None of the patients had grossly bloody effusion. All of the effusions were exudative, and the glucose levels in the pleural fluid were invariably above 60 mg/dl. Presence of mesothelial cells in the pleural fluid was found in 28% of them, but none of the patients presented with significant eosinophils in the pleural fluid. Pleural fluid and sputum cultures for Mycobacterium tuberculosis usually reveal a negative study unless a concomitant pulmonary lesion was present. Combined antituberculosis and prednisolone treatment decreased the duration of constitutional symptoms and hastened the resolution of pleural effusion. In conclusion, tuberculous pleural effusion should be considered in elderly patients presenting with massive exudative pleural effusion even with a negative PPD study. Cultures of sputum and pleural fluid are less helpful in patients without parenchymal disease. Prednisolone is recommended in extremely ill patients.
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PMID:The clinical manifestations of the tuberculous pleural effusion in adult patients. 280 70

Pulmonary tuberculosis (TB) continues to pose a health threat to the elderly population. In order to delineate age-related differences in disease presentation a comparison between young and old male veterans hospitalized over a five-year period with culture proven Mycobacterium tuberculosis is reported. The study sample included 27 patients 60 years of age and older (range, 60 to 85; mean, 70) and 52 patients under 60 years of age (range, 22 to 59; mean, 51). The elderly were significantly less likely to demonstrate cavitary lesions on admission radiographs or present with hemoptysis but were more likely to present with right lower lobe infiltrates and complaints of dyspnea. Symptoms prior to admission occurring with equal frequency in both young and old subjects included fever, anorexia, weight loss, and cough. Although treatment was delayed in the elderly, there were no age-related differences in mortality. Skin testing was underutilized in all patients regardless of age. The results support the notion that the clinical presentation of pulmonary TB is remarkably similar in young and old males.
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PMID:Clinical features of pulmonary tuberculosis in young and old veterans. 357 3

Clinical and autopsy findings obtained from 15 male patients treated for acquired immunodeficiency syndrome (AIDS) at 3 hospitals in Sao Paulo provided a clearer profile of AIDS cases in Brazil. Of the 12 patients whose sexual orientation was recorded, 9 were homosexual and 3 were bisexual. 75% were between the ages of 22-36 years; 14 were white. The duration of diseases ranged from 14 days-7 months in this series, confirming the rapid evolution of AIDS from 1st symptom to death. The most common clinical manifestations of disease were fever, cough, weight loss, diarrhea, and lymphadenopathy. Organs most frequently involved were the lungs (13 cases) and encephalum (9 cases). Microscopic findings revealed 9 types of microorganisms, fungi, and protozoa, the most common of which was Cytomegalovirus (7 cases). The cause of death was meningoencephalitis in 7 cases and panlobar pneumonia in 3 cases. The incidence of Kaposi's sarcoma (2 cases) was surprisingly low in this series. In addition to lesions produced by microorganisms, there were important associated lesions represented by lymphocytic depletion, acute myocarditis, brown atrophy of neuronia, acute pancreatitis, and liver cirrhosis. Several microorganisms and tumors in these AIDS patients were discovered only at autopsy, confirming the importance of necropsy to the study of the natural history of this disease. An unexpected pathological finding in this series was the absence of cellular reactions to microorganisms, particularly Pneumocystis carinii, Cryptococcus neoformans, and Mycobacterium tuberculosis.
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PMID:Acquired immune deficiency syndrome (AIDS) in Brazil. Necropsy findings. 362 18

This study reports the results of field research on a leprosy epidemic among the Kapingamarangi people, Polynesians living in two communities on Ponape Island and Kapingamarangi Atoll in the Federated States of Micronesia. The patterns of infection in the two communities are seen to replicate in detail patterns of personal mobility by age and gender and patterns of kinship and friendship relations that order people's social interactions in the communities. These patterns of demographic and social relationship form the context of infectious contact, enabling us to differentiate between more- and less-probable means by which Hansen's disease is spread. We compare coughing and sneezing with inoculation through the frayed fibers of pandanus leaf floor mats and sleeping mats as alternative ways of spreading leprosy infection. We find that frayed mats, because they are ubiquitous in the contexts in which people interact, are more likely to spread infection than coughing and sneezing. Finally, we find that demographic patterns of the communities are not identical with genealogical relationships such that people with close genealogical relationships often do not interact on a regular basis. Thus, genealogical distance and social distance are independent of each other in this community. This makes genetic assessment of inheritance of resistance and susceptibility to Mycobacterium leprae an enterprise unencumbered by a necessarily linked demographic variable.
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PMID:Social and demographic aspects of a leprosy epidemic on a Polynesian atoll: implications of pattern. 365 62

During a 10 year period 49 patients were recorded as having pulmonary infection caused by opportunist mycobacteria. Six different species were identified of which M. kansasii (65%) and M. avium-intracellulare (20%) were the most common. Cough and sputum (82%) or haemoptysis (26%) were frequent symptoms on presentation and over two thirds of patients had pre-existing respiratory disease. Chest radiographs showed predominantly apical disease with the right apex (44%) being twice as commonly affected as the left (22%). In 30% the radiograph showed bilateral disease. Clinicians had an individual approach to treatment with no uniform pattern of drug prescribing. A majority of patients (59%) received rifampicin for at least 9 months and those patients with M. kansasii infection responded well with no bacteriological relapses in 20 patients followed for a mean period of 3.9 years. M. avium-intracellulare, M. malmoense and M. xenopi were less responsive to treatment and in four patients receiving chemotherapy death was attributed to mycobacterial infection.
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PMID:Pulmonary infection with opportunist mycobacteria on Merseyside 1974-1983. 376 44

The experience with nontuberculous mycobacterial disease at an "acute-care" hospital in southern California between 1971 and 1981 is reported. Forty-five patients with nontuberculous mycobacterial or Mycobacterium bovis-caused disease were identified by retrospective review. Of these, 31 patients (69%) had pulmonary infection alone, nine (20%) had cervical lymphadenitis, two (4%) had disseminated disease, two (4%) had cutaneous infection, and one had soft tissue infection. Nonmycobacterial pulmonary disease was noted in 15 (33%) of the patients and underlying malignant neoplasms were noted in eight (18%). Symptoms most frequently reported at initial examinations of patients with pulmonary disease were cough, weight loss, sputum production, and fatigue. Response to therapy was more successful in patients with Mycobacterium kansasii-caused disease than in those with Mycobacterium avium-intracellulare-caused pulmonary disease. We conclude that nontuberculous mycobacterial disease is not rare in the general hospital setting in southern California.
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PMID:Nontuberculous mycobacterial disease. Experience in a southern California hospital. 633 73

Fifteen patients with AIDS were hospitalized on the pulmonary service during the period from 1981 to 1983. We were impressed with the frequency and severity of lung involvement in these patients and evaluated them with respect to their pulmonary manifestations of AIDS. The 13 men and two women had a mean age of 32 years. Ten were active intravenous drug abusers with a mean drug use of 8.1 years. All presented with profound weight loss, ten with nonproductive cough, and eight with significant dyspnea. Fourteen of 15 patients had Pneumocystis carinii pneumonia (PCP) at the time of our evaluation. Chest radiographs in these 14 patients showed no uniform pattern which was predictive of PCP. However, all 13 patients tested had a widened alveolar arterial oxygen gradient (mean: 59 mm Hg) which correlated well with the presence of PCP. The most common pulmonary finding in our AIDS patients was infection: 14 had PCP which was readily diagnosed by transbronchial lung biopsy in eight patients, and five patients were found to have disseminated Mycobacterium avium-intracellulare which often developed after "recovery" from PCP. Therapy for PCP with trimethoprim/sulfamethoxazole (TMP/SMZ) was unsuccessful in eight of ten patients; four of these eight TMP/SMZ failures responded to pentamidine. Mortality was 100 percent in patients who had AIDS for more than one year, and 70 percent in those less than one year. Despite some symptomatic responses to therapy for pulmonary infections, the mortality in AIDS seems to be unaffected by appropriate therapy for the pulmonary manifestations of this disease.
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PMID:Pulmonary manifestations of the acquired immunodeficiency syndrome (AIDS). 660 53

Corynebacterium equi, an aerobic, variably acid-fast, gram-positive "diphtheroid," is an unusual cause of pulmonary infection in immunosuppressed patients. Initially, infection with C. equi may be mistaken for a mycobacterial infection. Two cases in a two-year period were observed and compared with the 10 cases previously reported in the literature. All but one patient had pulmonary involvement, and the presentation of all other patients was typically insidious, with fatigue, fever, and nonproductive cough. Chest roentgenograms showed cavitary lesions in seven of 11 patients. Four of 12 patients had associated bacteremias, and three of 12 had subcutaneous abscesses or lymphadenitis. One of our patients developed multiple brain abscesses. Overall mortality was 25%. The organism is susceptible to vancomycin, erythromycin, aminoglycosides, and chloramphenicol. Optimal duration of antibiotic therapy and the proper role of surgery in treatment is uncertain, but relapses have been common and many weeks of antibiotic therapy have generally been required for cure.
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PMID:Corynebacterium equi: a review of 12 cases of human infection. 665 80

Because of declining prevalence of tuberculosis in the United States, standard laboratory tests detect fewer actively infected patients. Of 6,884 cultures for Mycobacterium tuberculosis (MTB) in three years at our hospital, only 2% were positive. To select other effective screening variables, we retrospectively reviewed patients in whom cultures were ordered. Charts of 79 patients with active tuberculosis and 226 patients whose cultures were negative were reviewed for 45 signs, symptoms, and laboratory tests determined at the time of initial contact. Those variables which distinguished the MTB-active from the nonactive were: history of weight loss, prior exposure, night sweats, fever, abnormal chest roentgenogram, positive skin test (PPD) (at P less than .001), and cough and abnormal pulmonary examination (at P less than .05). An algorithmic analysis suggests that weight loss and/or cough, followed by abnormal chest x-ray film and/or positive PPD, would detect 77% of the MTB-infected persons in whom these tests were done. The classic signs and symptoms of pulmonary tuberculosis continue to be excellent screening variables. When combined with the chest x-ray film and PPD, they may allow use of the culture as a confirmatory test, rather than its current inappropriate use as a screening test, for a disease of low prevalence.
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PMID:Clinical determinants of tuberculosis screening. 678 Oct 72

A case of pulmonary alveolar proteinosis associated with tuberculosis of the lung is reported. The patient had fever, cough, and pulmonary cavities. Sputum cultures for Mycobacterium tuberculosis were positive on three occasions. Thirty-three months later, diffuse bilateral lower lobe infiltrates developed. An open lung biopsy revealed filling of the alveoli by a periodic-acid-Schiff-positive amorphous granular material. There is a significant association between this disease and various infectious and fungal agents, but its association with tuberculosis is rare. It has been reported only three times before in the English literature. This appears to be the fourth documented case with this association. A review of the literature with special emphasis on tuberculosis associated with alveolar lipoproteinosis is presented. The electron-microscopic findings are also described.
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PMID:Association of pulmonary alveolar lipoproteinosis with mycobacterial infection. 742 32


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