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

Disseminated histoplasmosis (DH) is recognized as an opportunistic infection in patients with the human immunodeficiency virus (HIV), especially in regions where histoplasmosis is endemic. At the Kansas University Medical Center 148 patients were hospitalized with the diagnosis of AIDS from December 1983 to March 1991; 23 of these patients (16%) had disseminated histoplasmosis. The charts of these 23 patients were reviewed. Clinical signs and symptoms included fever (91%), cough (65%), and weight loss (48%). Splenomegaly, hepatomegaly, or lymphadenopathy was present in 52% of all patients. Anemia (39%), leukopenia (65%), and thrombocytopenia (52%) were common, and 22% had pancytopenia. Diagnosis was made by peripheral smear examinations (organisms visualized on 7 of 22 smears [32%]), blood cultures (positive for H capsulatum in 16 of 20 patients, [80%]), bone marrow cultures (positive in 14 of 15 patients, [93%]), and bone marrow aspirate and biopsy examinations (organisms seen on 18 of 21 stains, [86%]). The combination of these four tests revealed the diagnosis of DH in 23 of 23 patients (100%). Induction and maintenance amphotericin B therapy was given to all but 2 patients, and currently 8 of the 23 are alive. DH is a common opportunistic infection in AIDS patients from regions endemic for histoplasmosis. When DH is suspected, a peripheral smear examination, blood cultures, bone marrow cultures and bone marrow aspirate and biopsy should be done to make the diagnosis, since suppression of the disease is possible with appropriate therapy.
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PMID:Disseminated histoplasmosis in patients with AIDS. 147 Sep 57

We report herein a 61-year-old man with chronic cold agglutinin disease which occurred after a diagnosis of aplastic anemia. The patient's pancytopenia was recognized upon visiting a local doctor because of high fever and cough on December 21, 1985. He was subsequently admitted to our hospital because of anasarca on January 31, 1986, and was diagnosed as having aplastic anemia. He was treated with prednisolone, and was discharged after his anemia improved. He was readmitted on October 23, 1988, because of icterus. Laboratory data on the patients second admission revealed increased reticulocyte count, hyperplastic bone marrow with a predominance of erythroblasts, increased serum indirect bilirubin, increased serum LDH1 value and decreased serum haptoglobin. Moreover, cold agglutinin titer was increased, anti-IF antibody was positive, and anti-IgM antibody was recognized with direct anti-globulin test. There was no precedent infection such as mycoplasma pneumonia or infectious mononucleosis. Hence, this patient was diagnosed as having chronic cold agglutinin disease.
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PMID:[Chronic cold agglutinin disease occurring after a diagnosis of aplastic anemia]. 154 14

We report a 47-year-old man diagnosed as angio-immunoblastic lymphadenopathy with dysproteinemia (AILD) with fibrosis of the bone marrow, lymph node, liver and spleen, and proliferation of epithelioid cells in lymph node. He was admitted to a hospital in May, 1980 because of general fatigue, cough, fever and systemic lymphadenopathy. The diagnosis of AILD was based on a biopsy of right cervical lymph node. His symptoms were improved but recurred with the addition of icterus and progressive pancytopenia with decrement of prednisolone. He was referred to our hospital in July, 1980 and his physical examination revealed generalized lymphadenopathy, icterus and hepatosplenomegaly. Hemogram showed pancytopenia, and needle biopsy of the bone marrow disclosed fibrosis. Sections from the lymph node showed AILD with proliferation of epithelioid cells. Administration of 60 mg/day of prednisolone improved the fever, lymphadenopathy and hepatosplenomegaly. However he died suddenly of acute respiratory failure on July 30. Autopsy showed fibrosis of bone marrow, lymph node, liver and spleen with infiltration of abnormal lymphocytes, and pulmonary aspergillosis.
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PMID:[Angio-immunoblastic lymphadenopathy with fibrosis of bone marrow, lymph node, liver and spleen, and proliferation of epithelioid cells in lymph nodes]. 221 92

A 67 year-old man was admitted to our hospital because of cough and sputum. He smoke one pack of cigarettes a day for more than twenty years and the chest X-ray film revealed a mass in the left hilum and left sided pleural effusion. The diagnosis of small carcinoma of the lung (limited disease, T4N1MO, stage 3B) was made by trans-bronchial lung biopsy and radiographic studies. Both chemotherapy (nimustine (ACNU), cyclophosphamide, vincristine, and methotrexate) and radiation therapy was started, however, the chemotherapy was discontinued in July 1987 because of severe anemia. The diagnosis of refractory anemia with excess of blasts in transformation (RAEB in T) was made by bone marrow aspiration and the patient was treated by transfusion (400-800 ml/week). In December 1987 transition to acute myeloblastic leukemia was confirmed by another bone marrow aspiration biopsy and the patient was given low dose cytosine arabinoside (Ara-C). The response was favorable in the beginning but in about two months pancytopenia became refractory and the patient died in June 1988. Clinically there was no sign of local or distal recurrences of lung cancer, and the complete remission of small cell lung cancer (SCLC) was confirmed by autopsy. Survival in SCLC remains poor, so that the choice of treatment is still the primary concern, however, development of other malignancies which include acute leukemia is another problem which should be taken into account when the treatment is extensive.
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PMID:[Acute myeloblastic leukemia development in a patient with small cell lung cancer in complete remission]. 256 Sep 98

A patient with immunoblastic lymphadenopaty which evolved into immunoblastic sarcoma is reported. A 48-year-old female was admitted to our department because of cough and fever. A diagnosis of immunoblastic lymphadenopathy had been made two years before the present admission. Physical examination revealed generalized lymphadenopathy. Chest radiograms showed a left hilar mass. The pulmonary tumor and enlarged lymphnodes were treated by irradiation. Although there was marked improvement at first, she experienced several relapses. One year after the admission, chest radiograms showed multiple pulmonary lesions. She developed pancytopenia and bone metastases. At autopsy, the lymphnodes showed histological evidence of immunoblastic sarcoma; a pulmonary lesion showed immunoblastic lymphadenopathy.
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PMID:[Case of immunoblastic sarcoma (IBS)]. 664 66

A 25-year-old quadriplegic man with mitral leaflet prolapse syndrome was seen for complaints of intermittent fever, chills, and cough of three months' duration. Subacute bacterial endocarditis was diagnosed. Unusual complications of this disorder included hyperplenism with pancytopenia, pericardial effusion, and multiple infections in the blood and the spleen. Antibiotic therapy was begun, and splenectomy was performed. After seven weeks of treatment, the patient was free of symptoms and was discharged with advice on appropriate antibiotic prophylaxis. We believe that although bacterial endocarditis is a major complication of mitral leaflet prolapse syndrome, it can be prevented with antibiotic prophylaxis whenever dental, surgical, or other invasive procedures are performed.
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PMID:Bacterial endocarditis in mitral leaflet prolapse syndrome. 707 Oct 31

A 28-year-old woman with high fever and cough was admitted because of an abnormal shadow on the chest X-ray film. Mycobacterium kansasii was detected by sputum culture. The complete blood cell count disclosed pancytopenia and the myelogram showed slight hypoplasia and abnormality of the cell morphology. We diagnosed her disease as atypical mycobacteriosis and myelodysplastic syndrome. We began medical therapy with antituberculous drugs against Mycobacterium kansassi, and the sputum culture became negative. She was discharged after 4 months, but cardiothoracic ratio (CTR) increased gradually and pericardial effusion was detected by echocardiogram during follow-up. She was admitted again. We did not perform exploratory puncture, because the pericardial effusion did not increase for 6 months after admission and she had no complaints. We continued the antituberculous drugs, and CTR and the pericardial effusion decreased during follow-up. We considered the diagnosis in this case to be pericarditis due to Mycobacterium kansasii.
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PMID:[A case of myelodysplastic syndrome with pericarditis due to atypical Mycobacterium]. 811 65

A 60-year-old male with type C chronic hepatitis was admitted to Kibikogen Rehabilitation Center with high fever, cough and general fatigue. Chest X-ray film on admission showed consolidation in the left middle and lower lung lung field. Initial treatment with intravenous ceftazidime, imipenem/cilastatin and clindamycin were ineffective due to continuous high fever and cough and spread of the pneumonia shadow. Administration of minocycline was started for suspected non-bacterial pneumonia whereupon his symptoms improved and the pneumonia shadow began to decrease in size. However, his symptoms and pneumonia shadow worsened after taking him off of minocycline due to progressive pancytopenia and liver dysfunction. He was transferred to our hospital and intravenous erythromycin treatment was initiated for suspected Legionell pneumonia because of the elevation of Legionella micdadei serum antibody titer. Immediately after starting treatment, his symptoms improved and the pneumonia shadow decreased in size. Erythromycin was stopped after the 14th day of administration. In this case, diagnosis of L. micdadei pneumonia was made because of the positive results of the polymerase chain reaction test and elevation of the L. micdadei serum antibody titer (from 0 to 1,024). This is the second report of a L. micdadei pneumonia case here in Japan.
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PMID:[A case of Legionella micdadei pneumonia]. 862 71

A 24-year-old woman consulted a physician because of fever, dry cough, and arthralgia of one month duration. She was transferred to our hospital for more detailed examination of pancytopenia and diffuse infiltrative shadows on a chest X-ray film. On admission she was depressed, and had oral ulcers. Pleural and pericardial effusions were observed. Laboratory studies were positive for anti-nuclear antibody, anti-DNA antibody, and lupus erethymatosus. Casts were found in the urine, and systemic lypus erythematosus was diagnosed. Chest radiography and CT scan showed nodular shadows in the right S8 (2nodules with 1 cm diameter)(1 cm x 2), right S10 (0.5 cm diameter), and left S8 (0.5 cm diameter) regions, as well as diffuse infiltrative shadows in both lower lung fields. A specimen obtained by transbronchial lung biopsy revealed acute interstitial pneumonia with arteritis. After treatment with prednisolone (60 mg/day), the nodular and infiltrative shadows rapidly disappeared. Cases of lupus pneumonitis presenting as nodular shadows are very rare and are valuable in diagnostic imaging.
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PMID:[Acute lupus pneumonitis presenting as multiple nodular shadows]. 871 6

We report on the case of a 25-year-old female with severe systemic lupus erythematosus (SLE) who presented with pancytopenia, fever, arthralgia and abdominal pain. After antibiotic treatment, the patient was afebrile for 3 days before her temperature rose again. Dyspnoea and cough pointed towards pneumonia which was confirmed by X-ray. Different antibiotics and the antimycotic agent fluconazol were given. The lupus flare was treated with high-dose prednisolone. After a couple of days, the dyspnoea increased and mechanical ventilation became necessary. Bronchoscopy and transbronchial biopsy revealed the diagnosis of invasive aspergilloses. Despite of an immediate treatment with amphotericin B, the patient died because of respiratory insufficiency. The literature on aspergillosis in SLE is reviewed and prophylactic, diagnostic and therapeutic options are discussed for this infectious complication which has an 80% mortality in patients with SLE.
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PMID:A fatal case of severe SLE complicated by invasive aspergillosis. 935 8


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