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)

A 28 year-old man was admitted to our hospital because of fever, cough and chest pain. A chest X-ray film taken on admission showed infiltrate in the left upper lung field with ipsilateral pleural effusion. Microscopical examinations of stained specimens of sputa and pleural effusions disclosed no acid-fast bacilli. The level of adenosine deaminase (ADA) in pleural effusion was 46.4 IU/l. A tuberculin skin test was moderately positive. The most probable diagnosis was pulmonary tuberculosis with pleural effusion. Isoniazid (INH) and rifampicin (RFP) were administered on the 5th hospital day and continued to lower the fever and reduce the pleural effusion. The cultured specimens of sputa and pleural effusions yielded Mycobacterium kansasii. After six months of treatment, chest X-ray film showed improvement and the administration of INH, RFP was discontinued without recurrence.
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PMID:[Nontuberculous Mycobacterium pulmonary infection with pleural effusion caused by Mycobacterium kansasii]. 837 27

Between August and December 1991 in Tanzania, a study to determine the prevalence of Pneumocystis carinii and of tuberculosis occurred among 83 18-38 year old HIV seropositive people living in the rural area of Malenga Makali in Iringa district. The adults had difficulty breathing, cough, fever of at least 2 weeks duration, or overt pneumonia. 3.6% of the sputum samples were confirmed positive for P. carinii. 38.5% of preparations and 13.2% of cultures tested positive for Mycobacterium tuberculosis. All these isolates were completely sensitive to standard antibiotics. 2 of the 3 patients testing positive for P. carinii also had pulmonary tuberculosis. These findings showed that sputum contains many mycobacteria. They also confirmed that TB is associated with HIV infection in several African countries and that P. carinii infection occurs less frequently than it does in Europe and the US, but occurs nevertheless. A possible explanation for the low prevalence of P. carinii infection in Africa is that more virulent infections kill AIDS patients before P. carinii pneumonia has a chance to develop. The researchers admit that their inability to use more suitable specimens obtained by bronchoalveolar lavage or transbronchial biopsy could have resulted in considerable underdiagnosis. They recommended further clinical research to determine the real importance of P. carinii in developing countries.
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PMID:Pneumocystis carinii pneumonia and tuberculosis in Tanzanian patients infected with HIV. 846 96

The role of rapidly growing mycobacteria (RGM) as pulmonary pathogens has been unclear. We identified 154 cases of lung disease caused by RGM using the microbiologic and radiographic criteria of the American Thoracic Society (ATS) and availability of the causative organism for study. More than one third of patients had positive lung biopsy cultures. Patients were predominantly white (83%), female (65%) nonsmokers (66%), and they had prolonged periods from onset of symptoms to diagnosis of their disease. Cough was an almost universal presenting symptom, whereas constitutional symptoms became more important with progression of disease. Upper lobe infiltrates were most common (88%), with 77% of patients developing bilateral disease. Cavitation was present in only 16% of the patients. Specific underlying diseases were infrequent, but they included previously treated mycobacterial disease (18%), coexistent Mycobacterium avium complex (8%), cystic fibrosis (6%), and gastroesophageal disorders with chronic vomiting (6%). The majority of isolates (82%) were M. abscessus (formerly M. chelonae subsp. abscessus). Effective treatment for M. fortuitum long disease was accomplished with drug therapy, whereas surgical resection of localized disease was the only effective long-term therapy for M. abscessus. Although the disease was generally slowly progressive, 21 of 154 (14%) patients died as a consequence of progressive RGM lung disease and respiratory failure. RGM should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.
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PMID:Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients. 848 42

In suspected pulmonary tuberculosis (TB), tracheobronchial examination is required for patients with clinical and radiographic features consistent with tuberculosis disease but with negative sputum for Mycobacterium tuberculosis. We report the endoscopic findings of 84 patients who underwent fibreoptic bronchoscopy in recent years, and whose cultures of biological specimens grew M tuberculosis. Cough (86%) and fever (69%) were the most common symptoms, followed by sputum (67%), dyspnoea (30%) and haemoptysis (27%). Chest radiographic abnormalities were mostly localized (60%) with prevalence in the upper lobes; in two cases chest radiography was normal. Sixty two patients (74%) showed endoscopic abnormalities: 1) mucosal inflammation; 2) submucosal granulomas and polyps; and 3) stenoses. They were localized in 58% of patients and diffuse in 42%. Five patients were checked several times during the year following the diagnosis because of a high degree of tracheobronchial involvement. Only one subject recovered, whilst in the other four stenotic sequelae were found. Fibreoptic bronchoscopy confirmed its usefulness in the diagnosis of tuberculosis and in monitoring the course and the outcome of the bronchial tuberculosis involvement.
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PMID:Tracheobronchial involvement in 84 cases of pulmonary tuberculosis. 854 17

Diseases caused by opportunistic ambient mycobacteria (OAM) are common in HIV-positive patients, although they also occur in immunocompetent individuals. The objective of the present study was to describe the risk factors, clinical signs, course and microbiological spectrum of OAM that cause pulmonary diseases in non HIV-infected individuals in our community. We reviewed 29 consecutive patients with OAM-caused pulmonary disease between 1989-1994 (26 men and 3 women, mean age 58 +/- 14 years). Infections were by Mycobacterium kansasii, 19 (66%) cases; M. avium complex, 7 (24%) cases; M. chelonei, 2 (7%) cases, and M. flavescens, one (3%) case. Risk factors most often associated to infection were smoking and a history of pulmonary disease (chronic obstructive pulmonary disease or residual tuberculosis). Clinical signs were non specific, although toxic syndrome and unproductive cough predominated. Chest films were indistinguishable from those for infection by M. tuberculosis, with cavitated alveolar fibrosis being the main pattern. In vitro drug sensitivity tests showed that all strains were resistant to isoniazid, and that M. avium complex and M. chelonei strains were resistant to rifampicin, streptomycin and, to a lesser degree, to ethambutol. With prolonged medical treatment lasting from 12 to 24 months with first line drugs, outcome was good for the 17 patients for whom full follow-up information was available. Therapy failed to eradicate the bacteria in only 2 patients.
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PMID:[Lung diseases due to opportunistic environmental Mycobacteria in patients uninfected with human immunodeficiency virus. Risk factors, clinical and diagnostic aspects and course]. 868 13

A 29-year-old patient with AIDS was hospitalized with weight loss, fever and cough. Mycobacterial cultures from sputum, blood and bronchoalveolar lavage became positive after 3 weeks' incubation. When using a DNA probe for identification of Mycobacterium tuberculosis complex, a weakly positive signal was obtained. Tuberculosis was suspected and treatment was started with isoniazid, ethambutol and ciprofloxacin. Sequencing of the gene of the 16S rRNA, however, identified the isolates as belonging to a new, slow-growing atypical mycobacterial species, Mycobacterium celatum (M. celatum). Treatment was modified to take into account the previously described primary resistance of M. celatum to antituberculous drugs, whereupon the patient improved.
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PMID:[Disseminated infection with Mycobacterium celatum]. 870 Dec 44

A 72-year-old man presented with malaise, weight loss, and cough. Chest radiograph revealed bilateral pleural effusions. On thoracentesis, the left effusion was a clear yellow exudate with more than 90% lymphocytes, and the right effusion was a grossly bloody exudate with more than 90% neutrophils. Cultures of both effusions grew Mycobacterium tuberculosis.
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PMID:Bilateral tuberculous pleural effusions with markedly different characteristics. 879 40

We identified 31 patients with human immunodeficiency virus (HIV) infection and lung abscess. All patients had advanced HIV disease, and the mean CD4 cell count was 17/mm3 (range, 2-50/mm3). Twenty-two patients (71%) had previous opportunistic infections, and 24 (77%) had previous pulmonary infections. Symptoms at the time of presentation included fever (90% of patients), cough (87%), dyspnea (35%), pleuritic chest pain (26%), and hemoptysis (10%). The microbiological etiology was established for 28 patients, and the pathogens recovered were bacteria (65%), Pneumocystis carinii (6%), fungi (3%), and mixed microorganisms (16%). The pathogens included Pseudomonas aeruginosa (11), Streptococcus pneumoniae (6), P. carinii (5), Klebsiella pneumoniae (5), Staphylococcus aureus (4), Aspergillus species (3), viridans streptococcus (2), Haemophilus influenzae (1), Streptococcus milleri (1), Proteus mirabilis (1), and Cryptococcus neoformans (1). Mycobacterium tuberculosis was not isolated; two patients for whom a microbiological etiology was not established responded to antituberculous therapy. Patients were treated for 2-12 weeks; 25% of the patients received > 4 weeks of therapy. The outcome was poor: 36% of the patients had recurrences, and 19% died. In patients with AIDS, lung abscess is associated with advanced HIV infection, is due to a broad spectrum of pathogens, responds poorly to antibiotics, and has a poor prognosis.
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PMID:Lung abscess in patients with AIDS. 882 70

Pulmonary alveolar proteinosis (PAP) is an uncommon disease in which alveoli are progressively filled with surfactant-related material. Although a definitive diagnosis is usually made by an open lung biopsy, bronchoalveolar lavage (BAL) cytology may play a decisive role in the clinical work-up of these patients, and, in some cases, may spare a patient a more invasive diagnostic procedure. The authors present three patients in whom BAL cytology specimens contained the characteristic (although not specific) globules of amorphous proteinaceous PAS-positive material accompanied by only rare background macrophages and inflammatory cells. The patients include a 40-year-old man with an 8-year history of fever of unknown origin, a 30-year-old man with a chronic nonproductive cough, and a 6-year-old boy diagnosed at 5 months of age with osteopetrosis and hypogammaglobulinemia who subsequently developed a disseminated Mycobacterium avium-intracellulare infection. All specimens stained with Gomori methenamine silver (3) and Ziehl-Neelsen (2) were negative for microbial organisms, Ultrastructural examination of two specimens revealed the characteristic lamellar structures of surfactant, increasing diagnostic specificity. Lung biopsies and/or autopsy subsequently confirmed the diagnosis in all three cases. The characteristic cytologic and ultrastructural features of PAP in BAL specimens are presented along with the morphologic differential features of other entities which potentially could be confused with PAP.
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PMID:Bronchoalveolar lavage cytology in pulmonary alveolar proteinosis. 885 40

Two cases of tubercle bacilli infected bulla are reported. Case 1; A 78-year-old man visited our hospital complaining of fever and chest pain. The chest radiograph revealed the bulla with air fluid level in the left upper lung field. Mycobacterium tuberculosis was detected in the fluid obtained by percutaneous lung aspiration. He was treated with anti-mycobacterial drugs and showed improvement. Case 2; A 66-year-old man visited our hospital complaining of fever, chest pain and dry cough. The chest radiograph revealed the bulla with air fluid level in the left upper lung field. A diagnosis of tubercle bacilli infected bulla was considered because of high level of ADA in the fluid obtained by percutaneous lung aspiration, and anti-mycobacterial drugs were administered. His symptoms were improved and the frequent chest radiograph showed gradual absorption of the fluid. It is suggested that ADA and bacteriological examinations of the fluid obtained by percutaneous lung aspiration are useful for early diagnosis of tubercle bacilli infected bulla.
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PMID:[Two cases of tubercle bacilli infected pulmonary bulla]. 890 Dec 30


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