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 34-month-old black boy who had contracted acquired immunodeficiency syndrome from his mother presented with fever, vomiting, and cough. He was cachectic, hypertonic, and developmentally delayed. A brain computed tomography scan revealed masses in the left frontal horn, subependymal, and periventricular regions; secondary edema; and hydrocephalus. The differential diagnosis was cerebral lymphoma versus toxoplasmosis. The patient had disseminated Mycobacterium avium-intracellulare infection, lymphoid interstitial pneumonitis, as well as Pseudomonas and Klebsiella pneumonia. He died of respiratory insufficiency 53 days after admission. The autopsy confirmed a primary cerebral B-cell lymphoma, large cell type, which was positive for Epstein-Barr virus, latent phase, by in situ hybridization. Primary central nervous system lymphomas are rare in children, in contrast to adults. To our knowledge, only five well-documented cases of primary cerebral lymphomas in infants and children with acquired immunodeficiency syndrome have been reported previously. The current study shows that these childhood lymphomas are associated with and presumably caused by Epstein-Barr virus and thus have a pathogenesis similar to that of primary central nervous system lymphomas in adults.
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PMID:Epstein-Barr virus-associated primary central nervous system lymphoma in a child with the acquired immunodeficiency syndrome. A case report and review of the literature. 943 21

The impact of HIV infection on Taiwan's tuberculosis epidemic was investigated in a prospective study of all 378 pulmonary tuberculosis patients (mean age, 53.5 years) admitted to the Taiwan Provincial Chronic Disease Control Bureau in 1996. Bacteriologic or pathologic evidence of pulmonary tuberculosis was obtained in 306 cases (81%); the remaining 72 patients had chest radiographs and clinical courses consistent with a tuberculosis diagnosis. In the former group, the sputum smear yielded acid-fast bacilli in 279 patients (73.8%) and sputum cultures grew Mycobacterium tuberculosis in 263 (69.6%). Only 1 patient, an overseas Chinese man with a history of encounters with prostitutes, was HIV-positive. His symptoms included cough, weight loss, and malaise of 4 months' duration. His sputum culture was positive for M. tuberculosis and the chest radiograph revealed diffuse non-cavity infiltration lesions over the bilateral lung parenchyma and mediastinum lymphadenopathy. These findings suggest that the impact of HIV infection on Taiwan's tuberculosis epidemic is not significant at present, in part because HIV remains uncommon. However, continued monitoring of dual infection is essential to guide tuberculosis control efforts.
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PMID:Screening of human immunodeficiency virus infection in pulmonary tuberculosis patients in Taiwan. 948 Oct 69

This study examined the clinical characteristics and outcome of pulmonary tuberculosis in African Americans hospitalized in a teaching hospital in south-central Los Angeles from May 1992 through April 1994. The charts of 41 African Americans with culture-positive Mycobacterium tuberculosis were reviewed. Predisposing factors for pulmonary tuberculosis were identified in nearly half of cases. Cough and fever were the most common symptoms. Seventy-six percent had positive acid-fast bacilli (AFB) smears. Nine patients were human immunodeficiency virus (HIV)-positive, and 6 of 9 HIV-positive patients had positive AFB smears whereas 17 of 19 HIV-negative patients had positive AFB smears. Radiographic changes were not significantly different between HIV-positive and HIV-negative patients. Drug resistance was identified in nine of 31 patients (29%). Eight of 41 patients (19.5%) died, with 2 being drug resistant. Human immunodeficiency virus infection was a major predisposing factor for tuberculosis, and no statistical differences were found in radiographic features or AFB smear positivity between HIV-positive and HIV-negative patients. Drug resistance and mortality were disproportionately high. These results indicate that HIV infection and drug resistance are major problems that predispose for tuberculosis infection and make its treatment difficult.
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PMID:Tuberculosis in African Americans: clinical characteristics and outcome. 951 Jun 20

The prevalence of mycobacterial infection in AIDS patients has increased in Japan. This report describes details of the clinical and radiological features of eight AIDS patients with mycobacterial disease (6 with M. tuberculosis infection and 2 with M. kansasii infection) in our hospital during the period from October 1995 through February 1997. Six of the 8 were men, and two were women. The mean age was 36.5 years. Six were Japanese, one was from Myanmar, and one was Malaysian. The median CD4 positive T lymphocyte counts (CD4 count) at the time of diagnosis of the M. tuberculosis was 75.5 (range 14-569/microliter, and the M. kansasii was 21.5 (range 19-24)/microliter. Clinical findings and symptoms of all patients were non-specific, but almost all patients had a cough and fever. In the radiographic findings, the patients of the M. tuberculosis group presented multiple hilar and mediastinal lymphadenopathy, miliary shadow, and obstructive pneumonia. Both M. kansasii patients showed a multiple infiltration shadow. There were no drug resistant strains in M. tuberculosis except on isolate with moderate resistant. to Streptomycin. These observations suggest that AIDS-associated mycobacterial disease shows atypical clinical and radiological features in some cases, especially in advanced stages of AIDS. Therefore, we need to recognize the characteristics of the clinical and radiological features of the patients with mycobacterial diseases and AIDS.
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PMID:[Mycobacterial lung infection in 8 patients with AIDS: clinical and radiological features]. 958 97

A 30-year-old-man was admitted to our hospital because of headache and fever. His consciousness on admission was clouding. Sputum examination was positive for acid fast bacilli which later identified as Mycobacterium tuberculosis. Chest-X-ray and computed tomogram on admission showed multiple cavitary lesions on bilateral upper lung fields and bilateral diffuse nodular shadow. He was diagnosed as miliary tuberculosis with tuberculous meningitis. His mother admitted because of pulmonary tuberculosis four months ago, and her sputum examination was smear positive for acid fast bacilli, Gaffky 4, and she complained of cough for 6 months before admission. Because of this situation, he rapidly underwent the contact examination with chest X-ray, but not examined by tuberculin skin test because he was 30-year-old. As then chest X-ray was normal, he was not indicated of chemoprophylaxis, and he died of miliary tuberculosis and tuberculous meningitis 4 months after the contact examination.
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PMID:[A preventable case who died of miliary tuberculosis after receiving contact examination]. 963 20

Because of the difficulty in confirming childhood tuberculosis (TB), the World Health Organization (WHO) proposes a hierarchical approach to diagnosis using history and certain clinical features to help to improve the control of TB in communities. The objective of this study was to evaluate prospectively in children the diagnostic value of recent weight loss or failure to gain weight adequately, cough or wheezing for >2 weeks and recent household contact with an adult case of pulmonary TB. These evaluations were performed in 627 children presenting to the paediatric outpatient department of a tertiary hospital situated in the Western Cape Province of South Africa and serving a community with a very high incidence of TB (>1,000 per 100,000). If at least one of the criteria was present, the diagnosis of TB was investigated further by clinical investigation, Mantoux test, chest radiography and TB culture from gastric aspirate. One or more of the proposed criteria for diagnosing TB in childhood were present in 206 children (33%). TB confirmed by culture of Mycobacterium tuberculosis from gastric aspirate was found in 10 children (5%). After diagnostic work-up, 23 children (11%) were considered to have probable TB, whereas 173 (84%) were, after follow-up of 8 weeks, thought not to have TB. In this study the simultaneous presence of the three WHO criteria for suspecting TB had a positive predictive value of 63%. These results should assist in the more precise delineation of the predictive value of the proposed World Health Organization approach to the diagnosis of tuberculosis in childhood.
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PMID:Prospective evaluation of World Health Organization criteria to assist diagnosis of tuberculosis in children. 964 65

During the study's first stage, 284 homeless people from crisis and long-term accommodation sites were surveyed using stratified, systematic sampling. The second stage involved a survey of a convenience sample of 100 homeless people from squats and the streets. Participants completed a questionnaire, Mantoux testing was performed and blood taken for gamma-interferon assay, liver and renal function tests. The group's health status was poor, with 72% experiencing medical conditions in the preceding two years and 77% symptoms in the month prior to interview. Bronchitis, asthma and gastroenteritis were the most commonly reported conditions; productive and persistent coughing, shortness of breath and wheezing the commonest symptoms. Twenty-one per cent had Mantoux reactions 15 mm or greater, 28% a raised GGT and 19% a raised ALT. Seventy-seven per cent smoked, 74% were current drinkers, 28% had injected drugs at some time in their lives and 14% were regularly injecting drugs. Forty-four per cent had experienced mental illness, 49% of whom reported depression and 15% schizophrenia. Homeless people in Melbourne have poor health status and engage in behaviours that place their health at risk. The high number of respiratory and gastro-intestinal complaints, the high level of cigarette smoking and injecting drug use (IDU) and the proportion likely to be infected with Mycobacterium tuberculosis (MTb) are all issues with important health consequences. Participants recruited from the street had significantly poorer health and engaged in more risk behaviours than those from accommodation sites; those from the accommodated sample were more likely to be infected with Mtb.
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PMID:Health indicators and risks among people experiencing homelessness in Melbourne, 1995-1996. 965 74

Little is known about the profile of infection with Mycobacterium tuberculosis in bone marrow transplant (BMT) recipients. Of five BMT series with a total of more than 5,000 patients, only 10 cases of M. tuberculosis infection were described, with an overall incidence of 0.19%. We have conducted a prospective evaluation of 183 consecutive BMT recipients, and 10 patients were found to develop pulmonary tuberculosis post-BMT, yielding an incidence of 5.5%. We described the clinical features of these 10 patients, and analyzed the risk factors for development of tuberculosis using age- and sex-matched case control subjects who did not develop the disease. The median age of the 10 patients who developed tuberculosis was 29 yr (range, 17 to 40 yr). The median time for onset of symptoms was 150 d (range, 23 to 550 d), mainly presenting with fever and cough, with infiltrates on chest radiograph. Respiratory tract specimens, mostly sputum, yielded positive smears for acid-fast bacilli in three and positive M. tuberculosis culture in eight, whereas lung tissue histology was the first diagnostic test in two patients. Treatment with standard antituberculosis drugs for a longer duration was highly effective, with no excessive side effects. Risk factors identified for development of tuberculosis included allogeneic BMT (p < 0.05, relative risk [RR] = 23.7), total body irradiation (p < 0. 05, RR = 4.9), and chronic graft-versus-host disease (GVHD) (p < 0. 05, RR = 3.6). It is postulated that chronic GVHD predisposed to development of tuberculosis mainly via disruption of host reconstitution of immune defenses against M. tuberculosis.
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PMID:Risk factors for pulmonary tuberculosis in bone marrow transplant recipients. 976 78

A fifty-year-old Portuguese man presented with a six-month history of low back pain, which initially was mechanical and slowly became inflammatory. Secondarily, he complained of right atypical sciatalgia. He did not report any fever, loss of weight, cough nor personal or familial history of tuberculosis. General examination was normal. Neurologic examination showed weakness of the extensors of the right leg, with a symmetric increased reflexes of the lower extremities suggesting a pyramidal syndrome without Babinski's sign. Laboratory data were normal as well as chest radiographs. Dorsolumbar gadolinium enhanced MRI revealed an intramedullary ringlike enhancing mass at T12 level. Lumbar puncture showed 11 WBC/mm3 (95 p. 100 lymphocytes), a normal protein and glucose content. PCR and culture for Mycobacterium tuberculosis were negative. Within a few days, he developed meningoencephalitis with fever, CSF examination revealed then 360 WBC/mm3 (65 p. 100 lymphocytes and 17 p. 100 neutrophils), a protein content of 7 g/l and a glucose level of 1.7 mmol/l. The clinical picture was then suggestive of tuberculosis and a specific therapy with rifampin, izoniazid, pyrazinamid, ethambutol and steroids was started. Clinical improvement and a second CSF culture that revealed one month later Mycobacterium tuberculosis complex confirmed this diagnosis. Ten months later, the patient was asymptomatic with a normal MRI. To our knowledge, this is the first total recovery of an intramedullary tuberculoma on medical therapy alone, confirmed by MRI normalization. We reviewed also 19 recent cases of tuberculomas in the literature, intending a therapeutic attitude when discovering an intramedullary ringlike enhancing mass on MRI.
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PMID:[Intramedullary tuberculoma: a case report]. 977 87

A 33-year-old male was admitted with complaints of cough, dysphagia, and swelling of face and upper extremities. Chest X-ray and CT scan revealed a large mediastinal mass and infiltrates in the right upper lobe. Percutaneous biopsy proved the mediastinal tumor as thymoma with cellular atypia. After irradiation, the tumor was surgically removed. Caseous epitheloid granulomas were found in the dissected mediastinal lymph nodes. AFB (Acid fast bacillus) stain of the patient's gastric fluid was positive for Mycobacterium. The coexistence of these two diseases was incidental, however, this case suggested that clinicians should perform careful evaluation of lung parenchyma as well as mediastinum on chest X-ray to identify occult diseases including pulmonary tuberculosis in patients with mediastinal mass lesion.
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PMID:[The coexistence of pulmonary tuberculosis and thymoma a case report]. 978 Jun 9


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