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)

Mycoplasma pneumonia usually follows a benign course and the patient does not require hospitalization. The present report summarizes the feature of eight children admitted for a moderately severe pneumonia during an epidemic of Mycoplasma pneumoniae in Victoria. All children were previously healthy. The usual presenting symptoms included cough, fever, lethargy, and weight loss. All children had moderately severe respiratory distress and physical signs in the chest consistent with extensive parenchymal involvement. Half of this group had radiological evidence of a small pleural effusion. Complement fixation titres for Mycoplasma pneumoniae in paired samples confirmed the diagnosis. Clinical and radiological resolution was complete after one to three months. It is suggested that severe mycoplasma pneumonia may be more common than previously appreciated.
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PMID:Severe mycoplasma pneumonia in previously healthy children. 721 82

Clinical effect of acetylspiramycin, one of macrolide antibiotics, primary atypical pneumonia and serologically proven Mycoplasma pneumonia in children was studied. Twenty-four cases of these pneumonia (PAP 11, MP 13) in children were selected and acetylspiramycin was given in dose of approximately 30 mg/kg/day orally. Clinical response was evaluated in terms of improvement in fever, cough and chest X-ray. Clinical response was excellent in 4, good in 5, fair in 14 cases and none in 1 case. No definite adverse effect was observed, however 3 cases showed skin rashes. Two cases showed evanescent small erythematopapulous rash and 1 case developed urticaria on the 2nd to 4th day after this drug was given. These skin rash seemed one of the manifestation of Mycoplasma infections, rather than adverse side effect. One case showed elevated transaminase activity before acetylspiramycin was given and improved on the 2nd week, although this drug was continued. No other side effect was observed. We were able to use acetylspiramycin only in the form of 200 mg tablet and difficulty of the administration was encountered in children under 5 years of age. Other form (dry syrup, etc.) of this drug should be considered for the clinical use in children. In conclusion, acetylspiramycin was effective and safe for the treatment of primary atypical pneumonia and Mycoplasma pneumonia.
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PMID:[Clinical effect of acetylspiramycin on primary atypical pneumonia in children (author's transl)]. 732 Nov 87

We studied methacholine bronchial inhalation challenge in 12 patients at 4th week and 12th week after recovered from Mycoplasma pneumoniae pneumonia, compared with 12 healthy subjects as controls. The aerosolized methacholine was produced by an atomized nebulizer of the Provocationtest I, Pari-Starnberg, Germany and the aerosol was kept into a reservoir bag. Then, it was inhaled slowly by a subject. Increasing concentration of methacholine solutions (0, 0.5, 1, 5, 10, and 25 mg/ml) were used. The results revealed that 67% of the patients had bronchial reactivity to methacholine at the first time of challenge with a mean concentration of methacholine producing a fall in FEV1 of 20% from baseline (PC20) of 12.3 +/- 6.44 mg/ml. Fifty percent of the patients were still positive to the test on the second time of challenge with a mean PC20 of 20.1 +/- 6.89 mg/ml. None of the healthy subjects had bronchial hyperreactivity (PC20 > 25 mg/ml). Two patients experienced wheezing and asthmatic attacks requiring bronchodilator therapy during acute phase pneumonia. They were also diagnosed as having bronchial asthma for the first time. Many patients had prolonged coughing during the recovery phase lasting more than 4 weeks. This prolonged coughing seemed to have a correlation with the development of bronchial hyperresponsiveness (BHR). We concluded that M. pneumoniae could induce BHR which may be transient or persistent. The effect of mycoplasma respiratory tract infection may result in airway inflammations and asthmatic attacks.
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PMID:Methacholine inhalation challenge in patients with post-Mycoplasma pneumoniae pneumonia. 748 45

Forty-eight hysterectomy produced piglets reared in a pathogen-free environment were housed in 4 separate units. Three groups were intratracheally challenged with M hyopneumoniae at 2 wk, or at 16 wk, or at 2 and 16 wk of age. The fourth group was uninfected and received broth medium. Coughing started 2 weeks after the first infection but the booster infection did not induce any coughing. Macroscopic lesions, typical of mycoplasmal pneumonia, were noted 1 wk post-infection. After 7-9 wk, piglets showed recovering lesions. In the group that was twice infected, only 1 pig had extensive pneumonia after the second infection. The remaining pigs only had recovering lesions (RL) (resulting from the first challenge). Histopathology and scanning electron microscopy confirmed the macroscopic observations. Antibodies were detected by ELISA and immunoblotting at 3-4 wk post-infection, peaking after 11-12 wk and then gradually decreasing. However, the antibody response increased after the second infection. These findings showed a noticeable recovery following infection with M hyopneumoniae and a clear resistance to pneumonia following the booster infection.
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PMID:Mycoplasma hyopneumoniae infection in pigs: duration of the disease and resistance to reinfection. 831 10

From 1982 to 1991, we experienced 76 patients with Mycoplasma pneumoniae pneumonia which were confirmed by serologic tests. There were 32 (42%) male and 44 (58%) female patients. One patient had underlying disease of diabetes mellitus while the other patients were in good health. The age ranged from 9 months old to 72 years old. All the patients complained of fever and coughing; 63% had dry cough and 37% had sputum production. Upper respiratory tract complaints such as rhinorrhea, sore throat, or earache were noted in 57% of the patients. Fifty-five percent of the patients had GI symptoms of anorexia, nausea, vomiting, or diarrhea. Other complaints included myalgia/arthralgia (29%), headache (30%), and general malaise (32%). Dyspnea (17%) and chest pain (20%) were occasional complaints. Seventy-one percent of the patients had WBC counts < 10000/cu mm and 29% > 10000/cu mm. The mean value of C-reactive protein (CRP) was 53.1 micrograms/ml, while 16% of the patients had a CRP value above 100 micrograms/ml. Thirty-one percent of the patients were noted to have a transient elevation of serum transaminase. Four different patterns of infiltration were seen in chest radiographic manifestation: 1) peribronchial and perivascular interstitial infiltrates (18.4%), 2) nonhomogeneous patchy consolidations (22.4%), 3) homogeneous acinar consolidations (27.6%), and 4) mixed interstitial and alveolar infiltrates (27.6%). Interstitial infiltration was more commonly seen in pediatric than adult patients (46% vs 20%). Other features of the radiologic manifestation were as follows: unilateral lesions in 80% of patients, single lobe lesions in 77%, lower lobe predominant in 69%, pleural effusion in 7%, and radiographic deterioration in 10%. Mycoplasmal pneumonia should be considered in the differential diagnosis of community-acquired pneumonias.
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PMID:Clinical study of Mycoplasma pneumoniae pneumonia. 832 Jul 55

Pneumonias caused by atypical organisms usually have extra-pulmonary features. Chlamydial pneumonia often starts with hoarseness and fever, and respiratory tract symptoms may not appear for days. Mycoplasmal pneumonia may manifest with ear pain and a nonproductive cough. Legionnaires' disease presents with high fevers and central nervous system and gastrointestinal abnormalities. Diagnosis of chlamydial infection is accomplished with serologic testing. Patients are unresponsive to erythromycin treatment and should be started on empirical doxycycline (Doryx, Vibramycin) therapy. The presence of cold agglutinins in the appropriate clinical setting permits a presumptive diagnosis of mycoplasmal infection. Clinical diagnosis of Legionella pneumonia may be made in patients with pneumonia who also have relative bradycardia with elevated serum transaminases or hypophosphatemia with gastrointestinal or central nervous system symptoms. Erythromycin is the mainstay of treatment of legionnaires' disease, but treatment failures have been reported. Doxycycline is less expensive, has a better safety profile, and is better tolerated than erythromycin.
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PMID:Atypical pneumonias. Clinical and extrapulmonary features of Chlamydia, Mycoplasma, and Legionella infections. 849 98

There has been no detailed study of cough sensitivity during acute lower respiratory infection. The aim of this study was to clarify cough sensitivity in Mycoplasma pneumonia, which is a well known acute lower respiratory infection with persistent nonproductive cough. We examined cough sensitivity to inhaled capsaicin and tartaric acid in both the acute and the convalescent phases of Mycoplasma pneumonia, cell differentials in bronchoalveolar lavage fluid, and pathologic findings of transbronchoscopic bronchial biopsy specimens. Although dry cough was observed in all patients during Mycoplasma pneumonia, cough sensitivity in the acute phase [capsaicin: 19.8 (GSEM, 0.214) microM, tartaric acid: 0.26 (GSEM, 0.356) M] were not enhanced compared with those in both control subjects [capsaicin: 27.9 (GSEM, 1.24) microM, tartaric acid: 0.316 (GSEM, 0.079) M] and patients in the convalescent phase [capsaicin: 15.7 (GSEM, 0.219) microM, tartaric acid: 0.50 (GSEM, 0.326) M] when all symptoms including cough had disappeared. The percentage of lymphocytes and neutrophils in bronchoalveolar lavage fluid BALF was significantly greater than in the control subjects, and lymphocyte-dominant bronchitis was observed in biopsied specimens. We conclude that cough threshold to inhaled capsaicin or tartaric acid was not enhanced during acute Mycoplasma pneumonia with lymphocyte-predominant bronchitis. This is the first report examining cough sensitivity in patients with acute lower respiratory infection with pneumonia.
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PMID:Cough receptor sensitivity to capsaicin and tartaric acid in patients with Mycoplasma pneumonia. 961 44

A previously healthy 26-year-old woman presented with a fever and coughing on October 1, 1995. Despite treatment with beta-lactam antibiotics at another hospital, she had a high fever, coughing, and dyspnea. A chest roentgenogram showed diffuse infiltrates in both lung fields. On October 9, she was transferred to our hospital. On admission, a chest X-ray film showed marked diffusely infiltrates in both lung fields and a effusion in the left lung. Arterial blood gas analysis after inhalation of 4 liters per minute of oxygen via a nasal cannula revealed a PaO2 of 39.0 torr. Despite treatment with various antibiotics, including minocyclin and gamma-globulin, her respiratory condition rapidly deteriorated. She was mechanically ventilated by with intermittent mandatory ventilation and positive end-experiatory pressure, and received antibiotics and methylprednisolone pulse therapy. He chest X-ray and arterial blood gase findings, gradually improved. The passive hemagglutination titer for Mycoplasma rose from 1:4 on October 9, to 1:2,560 on the 14th hospital day. Acute respiratory failure due to Mycoplasma pneumoniae pneumonia was diagnosed. A chest X-ray film obtained 2 months after admission showed linear-reticular shadows in both lung fields and pulmonary-function tests revealed abnormally low vital capacity and diffusing capacity. Examination of a specimen obtained by transbronchial lung biopsy revealed focal intraalveolar exudate with fibrin and macrophages. Very mild interstitial thickening was also noted. The lymphocyte stimulation responses to PPD, PHA, and Con A were low early in the illness and became normal after recovery. Several reports have said that an enhanced pulmonary cellular immune response may be responsible for the development of severe Mycoplasma pneumoniae, resulting in a temporary decrease in the cell-mediated immune response. This case supports that hypothesis. We believe that in severe cases, steroid therapy including pulse therapy should be started as soon as possible.
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PMID:[Fulminant Mycoplasma pneumoniae pneumonia resulting in respiratory failure and a prolonged pulmonary lesion]. 969 53

The clinical syndrome "Bronchiolitis Obliterans Organising Pneumonia" (BOOP) has to be considered in patients with a flu-like illness since some weeks, fine crackles, and on chest X-ray bilateral patchy infiltrates. There is no response to antibiotics. BOOP is essentially idiopathic, but associations to other conditions exist. Lung function is often restrictive; biochemistry is not pathognomonic. BAL shows a mixed cellular pattern. The gold standard for pathologic diagnosis is open or thoracoscopic lung biopsy. However, a BOOP pattern or reaction is often seen on histologic specimens without the clinical-radiologic features of the BOOP-entity. Therapy consists of corticosteroids, which have to be prescribed for a long time at a rather high dose. Recurrence is frequent, but prognosis is good. Evolution to respiratory insufficiency and death is rare and may occur in rapidly progressive BOOP. This study reports on 11 cases (6 males/5 females) of clinical-pathological BOOP-syndrome (mean age 58 yrs, range 17-73 yrs), with an unexpectedly high mortality rate of 36% (4 cases). The disease was idiopathic in 7, and was associated with intake of amiodarone (in 1), with past Mycoplasma pneumonia (in 1) and with connective tissue disease (in 2). There was a history of a flu-like syndrome, cough and dyspnea of a mean duration of 4 months (range 1 week to 8 months). Lung function was mostly restrictive or/and obstructive with a diffusing capacity ranging between 47 and 95% predicted; there was hypoxia in about half of the patients. Chest X-ray and computed tomography (CT) scan showed a patchy consolidation with linear opacities (unilateral in 4 patients, bilateral in 5) and/or a ground glass pattern (in 4 patients), and a focal pseudo-tumoral lesion (in 1). Bronchoalveolar lavage showed a variable pattern of mixed, or eosinophilic or neutrophilic alveolitis. Histologic diagnosis was based on open lung biopsy (in 3), on thoracoscopic biopsy (in 2), on transbronchial biopsy (in 2), on wedge resection of the nodular lesion (in 1) and on postmortem lung biopsy (in 3). One patient recovered spontaneously, 1 remained cured after resection of the focal lesion, 7 were treated with 16-125 mg methylprednisolone (of whom 3 had a temporary flare-up during tapering the corticosteroids and 2 died after 1 and 3 months due to infectious complications), 2 died due to rapidly progressive BOOP.
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PMID:Bronchiolitis obliterans organising pneumonia. A report of 11 cases and a review of the literature. 986 59

The porcine respiratory disease complex (PRDC) is an increasingly important cause of decreased swine productivity and is characterized by slow growth, decreased feed efficiency, anorexia, cough, and dyspnea. Mycoplasma hyopneumoniae is among the most prevalent and important infectious agents associated with PRDC. Understanding of mycoplasmal pneumonia has been hindered by inadequate diagnostic methods. Many of the currently available tests are relatively insensitive or nonspecific when used in a diagnostic laboratory setting or are too costly or difficult for routine diagnostic use. Several polymerase chain reaction (PCR) assays have been described, but they are not sensitive enough to detect the microorganisms in live pigs, from either nasal or tracheal swabs. A nested PCR using 2 species-specific sets of primers from the 16S ribosomal DNA gave positive results with as little as 80 microorganisms and did not cross-react with other mycoplasma species or with other microorganisms commonly found in the respiratory tract of pigs. This assay was better suited for detection of M. hyopneumoniae from nasal swabs than was conventional PCR. Nasal swab samples were taken at different time periods following experimental challenge of 10 susceptible pigs. Only 2 of the 55 swabs examined gave a positive result with conventional PCR, whereas 30 of the 55 swabs gave a positive result using the nested PCR. Twenty of 40 (50%) nasal swabs from pigs experiencing a respiratory disease outbreak where M. hyopneumoniae had been diagnosed also gave a positive result with the nested PCR. To confirm that the amplified product was specific, 4 nested PCR products were purified, sequences were determined and aligned, and they were confirmed to be from M. hyopneumoniae.
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PMID:Application of a nested polymerase chain reaction assay to detect Mycoplasma hyopneumoniae from nasal swabs. 1035 56


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