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

A case of spontaneous rupture of the spleen with hematoma is presented. The spleen presumably with ruptured while the patient was in the hospital, during a severe coughing episode secondary to viral pneumonia. The time interval between splenic rupture and operation was 31 days. Along with pertinent diagnostic acids, difficulty in making the diagnosis is stressed. Knowledge that this condition exists is a major factor in making the diagnosis.
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PMID:Spontaneous rupture of the spleen with EMATOMA. 115 74

We performed a 5-year review of 40 patients less than or equal to 30 days of age with viral pneumonia. Isolates included respiratory syncytial virus (55%), enteroviruses (15%), rhinoviruses (15%), adenoviruses (10%), parainfluenza virus (7.5%) and herpes simplex virus (5%). Most infants were previously healthy but had ill family members. Nine were born at less than 37 weeks of gestation. Symptoms and signs included tachypnea, decreased feeding, cough, cyanosis, lethargy, retractions, apnea, bradycardia, seizures and depressed consciousness. Seasonality and clinical features, but not radiographic patterns, suggested specific pathogens. Patients were moderately to severely ill. The median duration of hospitalization was 7 days; therapies administered included oxygen (90%), mechanical ventilation (45%), blood transfusions (25%) and supplemental oxygen after discharge (27%). The case fatality rate was 7.5%. Prematurity, ill appearance at presentation, lobar consolidation and adenovirus infection were risk factors for severe disease.
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PMID:Viral pneumonia in the first month of life. 217 40

A case of miliary tuberculosis associated with acute respiratory failure during pregnancy was reported. A 39-year-old, 29-week pregnant woman was admitted to our hospital with complaints of nonproductive cough and fever on June 12. On admission, her temperature was 38.2 degrees C; pulse rate was 90/min., and blood pressure was 120/76 mmHg. Physical examination revealed moist rales at right lung basis. Chest X-ray showed small nodular infiltrates in right lower lung field. Laboratory data revealed positive CRP, accelerated ESR and increased level of alpha 2-globulin. The number of T-cells was markedly decreased (14/mm3). The PPD skin test was negative, and the sputum smears for acid-fast bacilli were negative. Suspected of bacterial or viral pneumonia, the patient was treated with antibiotics (CPM, EM and CAZ), which had no effects for her. On June 16, the Chest X-ray showed infiltrates throughout bilateral lung fields, and the patient became increasingly dyspneic. On June 18, the results of arterial blood gas, analysis under room air were: PaO2 26.7 Torr, PaCO2 29.0 Torr, pH 7.505. Because of severe hypoxemia, she was intubated and placed on a volume-cycled respirator. Hydrocortisone (1000 mg, daily) was added to treatment because ARDS was suspected. Since the smears of tracheobronchial secretions showed acid-fast bacilli on June 24, she was diagnosed to have miliary tuberculosis. Then the intensive therapy with antituberculosis drugs (isoniazid 400 mg, rifampicin 450 mg, and streptomycin 1g, daily) was started. The non specific antibiotics were discontinued; hydrocortisone was tapered and stopped. The next week, she became afebrile and hypoxemia steadily improved.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of miliary tuberculosis associated with acute respiratory failure during pregnancy]. 225 55

During the 2-year period 1977 through 1979, 26 patients with Legionnaires' disease were seen at the Mayo Clinic and affiliated hospitals. The patients ranged in age from 17 to 81 years with a median of 51 years. Twelve (46%) were immunologically compromised. Most of the other patients had underlying chronic tobacco bronchitis. Hectic fever, cough, and diarrhea were common symptoms. Chest radiographs showed patchy perihilar infiltrates that often progressed to consolidation. Diagnosis was made by indirect fluorescent antibody testing in 15 patients (58%), but in no case was the test diagnostic during the first week of illness. In seven patients the diagnosis was established by positive direct flourescent antibody testing of lung tissue, in two cases by culture of lung tissue, and in one case each by direct fluorescent antibody positivity of sputum or bronchial washing. Of the 26 patients, 3 (12%) required hemodialysis for acute renal failure and 5 (19%) died. A favorable clinical response to therapy with erythromycin was noted. The differential diagnosis of Legionnaires' disease must include other bacterial pneumonias, as well as mycoplasma, psittacosis, Q fever, and viral pneumonia. For critically ill patients, open-lung biopsy may be necessary to provide a rapid diagnosis. Current evidence suggests that erythromycin alone or in combination with rifampin is the treatment of choice. A 3-week course of therapy is recommended in order to prevent relapse.
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PMID:Legionnaires' disease: a review of the epidemiology and clinical manifestations of a newly recognized infection. 735 52

During a 16-month period children presenting to a pediatric outpatient facility from an area with a high tuberculosis incidence (> 400/100,000) and suspected of having respiratory tuberculosis (TB) were evaluated for close contact with adult pulmonary tuberculosis, weight loss, symptom duration, respiratory signs, lymphadenopathy and hepatosplenomegaly and by chest radiography and tuberculin testing (Mantoux or tine). Probable tuberculosis was diagnosed in 258 children and was confirmed in 109 (42%) patients with a mean age of 31 months by culture of Mycobacterium tuberculosis from gastric aspirate or another source. Eleven children with confirmed TB had a normal chest radiograph. After review of special investigations, clinical course and follow-up of the remaining 149 children, 86 children (58%) with a mean age of 32.4 months were considered to have probable TB and 63 (42%) with a mean age of 27 months not to have TB. Significantly fewer children in the "not TB" group than in the confirmed and probable TB groups had a close adult pulmonary tuberculosis contact (13 (21%) and 95 (49%), respectively; P < 0.01). There was no difference between the "not TB" group and the confirmed and probable TB groups in the proportion presenting with weight loss, cough or other respiratory symptoms, a symptom duration > 2 weeks, the presence of bronchial breathing, wheeze, hepatomegaly or splenomegaly or peripheral lymphadenopathy. Final diagnoses in the "not TB" group included bacterial or viral pneumonia or bronchopneumonia in 37, asthma often accompanied by segmental collapse in 9 and cavitating pneumonia in 3 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Respiratory tuberculosis in childhood: the diagnostic value of clinical features and special investigations. 776 Nov 83

Sputum cytology was performed to rule out primary lung carcinoma in a patient with a cough of recent onset, an infiltrate on chest roentgenography and a history of bladder and prostate carcinoma. The cytology was interpreted correctly as metastatic transitional cell carcinoma. Review of the cytology by other pathologists without the benefit of the previous history or histologic material resulted in interpretations of reactive/metaplastic tissue. A morphometric comparison of nuclear parameters between the cells in the sputum and the squamous metaplastic cells seen in the sputum of a patient with viral pneumonia from our archives was performed. Evaluation of the current sputum cytology without the benefit of clinical information or additional studies may have led to a false-negative diagnosis.
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PMID:Morphometric comparison of a metastatic transitional cell carcinoma simulating squamous metaplasia in sputum cytology. A case report. 819 32

Three manifestations of pneumonia that are associated with influenza are well recognized: primary influenza viral pneumonia, secondary bacterial pneumonia and mixed viral and bacterial pneumonias. In an outbreak of influenza, primary influenza viral pneumonia has occurred predominantly. After a typical onset of influenza, there is a rapid progression of fever, cough and dyspnea. Physical examination and chest roentgenography reveal bilateral findings but no consolidation. A Gram stain of the sputum fails to reveal significant bacteria, and bacterial culture yield sparse growth of normal flora, where as viral cultures yield high titers of influenza virus. Such patients do not respond to antibiotics. Secondary bacterial pneumonia often produces a syndrome that is clinically distinguishable from that of primary viral pneumonia. Recrudescence of fever is associated with symptoms and signs of bacterial pneumonia such as cough, sputum production, and an area of consolidation detected on physical examination and chest roentgenography. Gram staining and the culture of sputum reveals a predominance of a bacterial pathogen, most often H. influenzae, S. pneumoniae, B. catarrhalis, or S. aureus. Such patients usually respond to specific antibiotic therapy. During an outbreak of influenza many cases an observed that do not clearly fit into either of the aforementioned categories. The disease is not relentlessly progressive, and yet the fever pattern may not be biphasic. These patients may have primary viral, secondary bacterial, or mixed viral and bacterial infection of the lung.
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PMID:[Comparative features of pneumonia associated with influenza]. 936 Mar 92

An experimental respiratory model was used to investigate the interaction between Mycoplasma hyopneumoniae and swine influenza virus (SIV) in the induction of pneumonia in susceptible swine. Previous studies demonstrated that M. hyopneumoniae, which produces a chronic bronchopneumonia in swine, potentiates a viral pneumonia induced by the porcine reproductive and respiratory syndrome virus (PRRSV). In this study, pigs were inoculated with M. hyopneumoniae 21 days prior to inoculation with SIV. Clinical disease as characterized by the severity of cough and fever was evaluated daily. Percentages of lung tissue with visual lesions and microscopic lesions were assessed upon necropsy at 3, 7, 14, and 21 days following SIV inoculation. Clinical observations revealed that pigs infected with both SIV and M. hyopneumoniae coughed significantly more than pigs inoculated with a single agent. Macroscopic pneumonia on necropsy at days 3 and 7 was greatest in both SIV-infected groups, with minimal levels of pneumonia in the M. hyopneumoniae-only-infected pigs. At 14 days post-SIV inoculation, pneumonia was significantly more severe in pigs infected with both pathogens. However, by 21 days postinoculation, the level of pneumonia in the dual-infected pigs was similar to that of the M. hyopneumoniae-only-infected group, and the pneumonia in the pigs inoculated with only SIV was nearly resolved. Microscopically, there was no apparent increase in the severity of pneumonia in pigs infected with both agents compared to that of single-agent-challenged pigs. The results of this study found that while pigs infected with both agents exhibited more severe clinical disease, the relationship between the two pathogens lacked the profound potentiation found with dual infection with M. hyopneumoniae and PRRSV. These findings demonstrate that the relationship between mycoplasmas and viruses varies with the individual agent.
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PMID:Interaction between Mycoplasma hyopneumoniae and swine influenza virus. 1142 64

Two types of pneumonia are well recognized during influenza: primary viral pneumonia and secondary bacterial pneumonia. Primary viral pneumonia occurs after a typical onset of influenza with rapid progression of dyspnea and cough leading to acute respiratory distress syndrome. Treatment consists of respiratory assistance, but mortality is high. Secondary bacterial pneumonia occurs more frequently in the elderly and in patients with chronic pulmonary diseases. Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae are the most frequently isolated bacteria. After an initial phase of clinical improvement, manifestations of bacterial infection with pulmonary consolidation occur. The outcome is favorable with antibiotics but depends on the patient's underlying conditions.
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PMID:[Influenza pneumonia]. 1455 65

Viruses account for a substantial portion of respiratory illnesses, including pneumonia, in the elderly population. Presently, influenza virus A H3N2 and respiratory syncytial virus are the most commonly identified viral pathogens in older adults with viral pneumonia. As diagnostic tests such as reverse-transcription polymerase chain reaction become more widely used, the relative importance of additional viruses (such as parainfluenza, rhinoviruses, coronaviruses, and human metapneumovirus) will likely increase. Influenza virus should be considered as a cause of pneumonia during the winter months, especially during periods of peak activity. Patients with high-grade fever, myalgias, and cough should arouse the highest suspicion. Respiratory syncytial virus pneumonia should also be suspected during the winter in patients with coryza, wheezing, low-grade fever, and patchy infiltrates, especially if negative for influenza on rapid testing. Because clinical features and periods of activity for many viruses overlap, laboratory confirmation of influenza is recommended for cases involving seriously ill or institutionalized patients.
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PMID:Viral pneumonia in older adults. 1642 96


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