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

During a 2-year period from January 1988 to December 1989, 125 patients (68 boys, 57 girls), aged 30 days to 9 years, were diagnosed as rotavirus gastroenteritis at this hospital. Diagnosis was made by identification of the rotavirus antigen in stool samples by latex agglutination assay. Ninety-nine (79.2%) of them were under 2 years of age. The seasonal peak in incidence was from January to March. The most common clinical characteristics were watery diarrhea (100%), followed by vomiting (68.8%), fever (68.0%), cough (42.4%), rhinorrhea (17.6%), convulsions (6.4%) and moderate to severe dehydration (1.6%). Fecal occult blood was positive in 4 patients and fecal leukocytes were positive in one patient. Stool cultures revealed concomitant infections with enteropathogenic Escherichia coli in 4 patients. Of the 106 patients who underwent serum electrolyte examinations, serum sodium concentrations ranged from 135-145 meq/L in 81.9% (86/106) and serum potassium concentrations ranged from 3.5-5.0 meq/L in 86.8% (92/106). Leukocyte counts greater than 15,000/mm3 were found in 10.8% (13/120) of the patients. All 125 patients recovered from the diarrheal illness on follow-up. Our results showed a different seasonal distribution of this disease from that of a previous observation between 1983-1984 in Taipei City and provides original clinical information on rotavirus gastroenteritis in children living in an area of Taipei County. Using the simple and rapid latex agglutination assay, we can make early diagnosis of rotavirus gastroenteritis. Thus, early treatment and early isolation of patients to prevent nosocomial infection among hospitalized patients is possible.
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PMID:Rotavirus gastroenteritis in children: a clinical study of 125 patients in Hsin-Tien area. 206 88

Of the Legionellaceae family, Pittsburgh pneumonia agent (Tatlockia micdadei, Legionella micdadei) is second only to Legionella pneumophila in causing human pneumonia. In nosocomial infection, the patients tend to be immunosuppressed. The clinical presentation is nonspecific, although in immunosuppressed hosts the presentation may mimic that of pulmonary embolus (pleuritic chest pain, nonproductive cough, pleural-based densities on chest rontgenogram). The reservoir for the organism is water, and prevention of nosocomial infections can be accomplished by disinfection of the water supply. Diagnosis is best established by isolation of the organism from respiratory secretions by using selective, dye-containing buffered charcoal-yeast extract agar. The organisms can be acid-fast when clinical specimens are stained. Erythromycin is the antibiotic of choice, although tetracyclines, trimethoprim-sulfamethoxazole, and rifampin have also proved to be efficacious.
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PMID:Infections caused by the Pittsburgh pneumonia agent. 332 96

A study was made of the clinical features and therapeutic response of 144 patients from whose sputum Branhamella catarrhalis was isolated. Typically, features of bronchopulmonary infection with cough productive of moderate amounts of purulent sputum, fever and dyspnoea were present. Of 74 patients who were infected in the community, 50 required hospital admission. Nosocomial infection occurred in the remaining 70 patients. Most patients had chronic pulmonary diseases or carcinoma bronchus; pneumonia occurred in 12 patients. Acute tracheobronchitis developed in 4 healthy non-smokers after viral illnesses. B. catarrhalis contributed to the death of 8 patients. Overall, 59% of isolates produced beta-lactamase but the proportion had risen to 70% by the end of the study; half of these were community acquired. 41% of patients who were treated initially with ampicillin did not respond. Clavulanic acid plus amoxycillin, co-trimoxazole, erythromycin, tetracycline, cefuroxime and cefotaxime are useful alternative antibiotics. All strains of B. catarrhalis were resistant to trimethoprim.
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PMID:Bronchopulmonary infection due to B. catarrhalis. Clinical features and therapeutic response. 373 80

Three cases of presumed respiratory syncytial virus (RSV) pneumonia in immunocompromised adults are described. Two patients had symptoms of cough, fever, and malaise, following completion of a course of combination chemotherapy for the treatment of acute lymphoblastic leukemia. The third patient, a juvenile onset diabetic, developed similar symptoms while hospitalized for severe hyperglycemia. Chest roentgenograms showed lower lobe infiltrates in both leukemic patients and a bilateral non-confluent bronchopneumonia in the diabetic patient. All patients had a marked rise in complement-fixing antibody titres to RSV, suggesting a concurrent infection with the virus. Extensive microbiological investigations failed to reveal any other etiologic agent. Nosocomial infection was considered possible. RSV is not considered a cause of pneumonia in compromised adults. Our three cases suggest that there may be a higher incidence of RSV pneumonia in compromised patients, than previously recognized.
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PMID:Presumed respiratory syncytial virus pneumonia in three immunocompromised adults. 684 93

In the wake of a community outbreak of bronchiolitis in northern Israel from December 1993 to March 1994, we conducted a retrospective study of 108 infants aged 2 weeks to 14 months with proven respiratory syncytial virus (RSV) infection (diagnosed by a rapid RSV antigen test in nasopharyngeal secretions). 47% of the infants were less than 8 weeks old. Mean hospital stay was 6.6 days (range 1-60). The characteristic clinical findings were: cough in all patients, dyspnea in 96%, rhinitis in 95% and fever in 55%. In those younger than 8 weeks, or in those with underlying diseases, hospitalization was longer, the disease was more serious and complications more frequent (p < 0.002). 4 children (3%) died, 3 of whom had severe congenital heart defects. All children were treated with oxygen and beta-agonist inhalations. The 33% who also received corticosteroids were older and most had a history of pulmonary diseases, such as asthma or bronchopulmonary dysplasia. There was no difference between those who did or did not receive corticosteroids with regard to severity of disease or rate of complications. Ribavirin was used to treat 19 (17.5%), most of whom had underlying lung disease. The others were otherwise healthy infants younger than 8 weeks. 13 were cared for in the intensive care unit, 11 of whom required mechanical ventilation. A rapid test for detection of RSV infection enabled prompt isolation of infected patients so that the risk of nosocomial infection was reduced and Ribavirin therapy could be started early, if required.
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PMID:[An epidemic of respiratory syncytial virus bronchiolitis among infants in northern Israel]. 868 91

The second most common nosocomial infection in the United States is pneumonia, with the highest rates seen in patients requiring mechanical ventilation. Nosocomial pneumonia is a serious disease associated with significant morbidity and mortality; crude mortality rates have been estimated at 20% to 50%. The rapid institution of appropriate antimicrobial therapy has been shown to improve mortality in patients with ventilator associated nosocomial pneumonia. Thus, the identification of nosocomial pneumonia with a timely microbiologic diagnosis is important for the management of these patients. However, the accurate diagnosis of nosocomial pneumonia, along with identification of the responsible organism(s), can be challenging. This task becomes even more difficult in patients who are mechanically ventilated. The presence of new pulmonary infiltrates along with clinical criteria including fever, cough, and purulent secretions are neither sensitive nor specific for the diagnosis of nosocomial pneumonia. The laboratory can enhance the accuracy of pneumonia diagnosis, as well as provide the identification of an etiologic organism(s). There are, however, many challenges which confront the laboratory including: the ability to identify organisms from an extensive microbiologic spectrum; distinguishing colonization from infection of predominately gram-negative oropharyngeal flora; and providing timely results. This article reviews the various diagnostic tests available for nosocomial lung infections, and in particular, ventilator associated pneumonia including: blood cultures; pleural fluid; expectorated sputum; endotracheal aspirates; and respiratory specimens obtained by more invasive techniques using bronchoscopy and transthoracic needle aspiration. Emphasis is placed on optimal specimen collection, the processing of samples in the laboratory, and on the evaluation of potential risks and benefits associated with the varying techniques.
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PMID:Laboratory diagnosis of nosocomial pneumonia. 1098 30

Severe acute respiratory syndrome (SARS) is a new disease that poses a threat to international health. The SARS epidemic earlier this year affected more than 30 countries and regions, with a cumulative global total of 8098 cases. It is caused by a novel coronavirus, probably of animal origin. The mean incubation period is 6.4 days (range 2-11 days). Patients usually present with high fever, chills, myalgia and dry cough, with or without chest X-ray evidence of pneumonia at the onset of disease. A history of contact with or travel to an area with local transmission is common. Diagnosis is based on clinical criteria, as a valid rapid diagnostic test is not yet available. There is no specific antiviral therapy for this disease, and no controlled clinical trial for any treatment modality has been conducted. In several retrospective studies steroids have been shown to be useful in a proportion of patients who deteriorated despite antibiotics and supportive treatment. SARS has a high morbidity (about 25% required intensive care) and fatality (9.6%). A high index of suspicion for the disease, isolation of patients, strict observation of infection control practices and compliance with use of personal protective equipment are necessary to prevent nosocomial infection. Contact tracing and quarantine are essential measures to prevent community spread of disease. Prevention of future outbreaks requires strengthening of infection control practices in hospitals, development of a rapid diagnostic test and a vaccine, and removal of any animal reservoir and environmental conditions that led to the spread of the disease.
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PMID:Severe acute respiratory syndrome. 1467 86

A descriptive epidemiology on an outbreak of tuberculosis (TB) in a long-term care unit of a mental hospital was conducted. A female inpatient of 60 years with pulmonary TB was reported to the local health department (LHD) from the hospital in July 1999. Her sputum was negative both by smear and culture. From then to Mar 2001, a total of ten TB cases were reported. All of them were inpatients or workers of the hospital. Among them, four cases turned out to be culture positive and for three out of them a Restriction Fragment Length Polymorphism (RFLP) analysis was performed. All three turned out to be the identical strain suggesting that the outbreak was derived from one index case. After November 1999, the active case findings were conducted by the LHD, however no case of possible source of the outbreak was found. On the other hand, the retrospective investigation revealed that a female inpatient (case Z) of 70 years must have been pulmonary TB. She had had respiratory symptoms such as severe cough and sputum for two years and consequently died of pneumonia in February 1999, five months before the onset of the TB outbreak. She had a thoracic CT scan test and a sputum PCR test just before her death in another outpatient clinic and turned out to have a cavity in a lung and to be PCR positive for Mycobacterium tuberculosis complex. However the result was never reported to the hospital nor to the LHD, because she died before the PCR test was completed. She had had close contact with all of the TB cases except one for over two years. Considering all these epidemiological results, case Z was suggested to be the source of this outbreak. To prevent this kind of TB outbreak, institutions like mental and/or long-term care units should carefully prepare a proper precaution plan against the nosocomial infection of TB. In addition, if two or more TB cases are reported from the same unit or institution, LHDs should pay special attention and investigate the possibility of nosocomial infection.
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PMID:[An outbreak of tuberculosis in a long-term care unit of a mental hospital]. 1563 Nov 10

Pertussis outbreaks have been reported in various settings, including sports facilities, summer camps, schools, and health-care facilities. Mild and atypical manifestations of pertussis among infected persons and the lack of quick and accurate diagnostic tests can make pertussis outbreaks difficult to recognize and therefore difficult to control. Outbreaks among health-care workers (HCWs) are of special concern because of the risk for transmission to vulnerable patients. This report describes three pertussis outbreaks among HCWs and patients that occurred in hospitals in Kentucky, Pennsylvania, and Oregon in 2003. These outbreaks illustrate the importance of complying with measures to reduce nosocomial infection when evaluating or caring for patients with acute respiratory distress or cough illness of unknown etiology.
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PMID:Outbreaks of pertussis associated with hospitals--Kentucky, Pennsylvania, and Oregon, 2003. 1567 85

Severe Acute Respiratory Syndrome (SARS) epidemic illustrated the crucial role of infection surveillance and control measures in the combat of any highly transmissible disease. We conducted an interview survey of 121 medical staff 145 doctors, 46 staff nurses and 30 medical assistants) in a state hospital in Malaysia three months after the end of SARS epidemic (from October to December 2003). Staff was grouped according to those directly involved in the care of suspected SARS patients [S+ group n=41] and those who were not [S- group; n=80]. On hand washing following sneezing, coughing and touching patients, the proportions of medical staff that reported an increase after the SARS crisis were 22.3%, 16.5% and 45.5% respectively. On wearing masks, gloves, and aprons when meeting potentially infectious patients, the proportions that reported an increase were 39.7%, 47.1% and 32.2% respectively. Significantly more staff in S+ than S- group reported these increases. Sixty percent of staff was aware of changes in hospital infection control policies after SARS; 93.4% was aware of notifying procedures, and 81.8% was aware of whom to notify in the hospital. Regarding infection isolation ward, Infectious Control Nurse and Infection Control Committee Chairman in the hospital, the proportions of staff that could correctly name them were 39.7%, 38.3% and 15.7% respectively. Significantly more in S+ than S- group could do so. However, more than half the staff claimed ignorance on the knowledge of infection isolation ward (56.2%), Infection Control Nurse (57.9%) and Chairman (65.3%). Our findings demonstrated that SARS crisis had some positive impact on the infection control practices and awareness of medical staff especially on those with direct SARS involvement. Implications for future control of infectious diseases are obvious.
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PMID:Change in infection control practices and awareness of hospital medical staff in the aftermath of SARS. 1588 69


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