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

Mycoplasmal pneumonia, tularemic pneumonia, Q fever pneumonia, psittacosis, and Legionnaires' disease are the most frequently encountered treatable atypical pneumonias. Mycoplasmal pneumonia, the most common, is often accompanied by nonexudative pharyngitis, conjunctivitis, or otitis. The nonproductive cough is characteristic. Tularemic pneumonia is characterized by substernal chest pain, bloody pleural effusion, and bilateral hilar adenopathy. Although the clinical presentation is mild, roentgenographic findings are impressive. Q fever pneumonia resembles psittacosis but is less serious; it may be accompanied by subacute bacterial endocarditis, hepatitis, or both. Psittacosis is characterized by prominent headache, bloody sputum, and relative bradycardia. Tetracycline is the drug of choice for either. In Legionnaires' disease, pneumonia is accompanied by prominent extrapulmonary symptoms. The most important diagnostic clues include diarrhea and mental confusion. Relative bradycardia and laboratory abnormalities are also helpful. Erythromycin is the drug of choice unless doubt exists as to the diagnosis.
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PMID:The atypical pneumonias: a diagnostic and therapeutic approach. 47 55

Pneumonia is one of several clinical syndromes that results from inhalation of Coxiella burnetii. This microorganism, the etiologic agent of "Q" (query) fever, infects a wide range of animals and insects. Cattle, sheep, goats, and cats are the reservoirs whereby this agent is spread to humans. High concentrations of C burnetii are present in the placenta and at parturition, the organism is shed into the environment to be inhaled by humans. Following an incubation period that ranges from four to 30 days (mean 14 days), fever, headache, malaise, and cough ensue. The clinical presentation of pneumonia may range from a mild to a severe illness--the latter with the clinical picture of rapidly progressive pneumonia. There are no characteristic features of Q fever pneumonia but the severe headache and the epidemiological history should serve as clues. Treatment with tetracycline or rifampin for two weeks usually results in cure. Many cases of Q fever pneumonia remit without antibiotic therapy. The diagnosis is usually confirmed serologically using a complement fixation or microimmunofluorescence test.
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PMID:Q fever pneumonia. 271 Oct 56

One hundred and sixty four cases of Q fever pneumonia are reviewed. Coxiella burnetti is responsible for 18.8% of pneumonias acquired in the community in our region with an extremely high seasonal variation. 91% of the cases occur between January and June. 88.5% of the patients are less than 40 yrs of age and 77% are male. The most common clinical symptoms are high fever, cough, cephalalgia and myalgias. 46.5% of the patients have no respiratory symptoms although 34% of the cases report pleural pain. The radiological signs are nonspecific. With regard to laboratory data, it is often observed that the white blood cell count (WBC) is normal and the liver enzymes are abnormal (45%). Treatment with doxycycline reduces the fever more quickly than erythromycin.
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PMID:Q fever pneumonia: a review of 164 community-acquired cases in the Basque country. 273 5

Pneumonia is one manifestation of acute Q fever following infection with Coxiella burnetii. Fever, headache, and myalgia dominate the clinical picture of Q fever pneumonia. Cough is nonproductive and may be absent despite the presence of pneumonia. While in most instances pneumonia results in an illness of mild-to-moderate severity, on occasion it is rapidly progressive and results in respiratory failure. Infection occurs as a result of inhalation of contaminated aerosols. Infected cattle, sheep, and goats are the usual reservoirs for this zoonosis. In some areas, infected parturient cats serve as the reservoir, and in such instances, rounded opacities are seen on the chest radiograph. The diagnosis of C. burnetii pneumonia is usually confirmed by demonstration of a fourfold or greater rise in antibody titer. Treatment is usually with a tetracycline or rifampin for 7 to 10 days.
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PMID:Coxiella burnetii (Q fever) pneumonia. 874 74

We report four cases of Q fever pneumonia diagnosed using PanBio Coxilla burnetii ELISA. The patients, a 21-year-old woman, a 53-year-old man, a 74-year-old man and a 87-year-old man, were among 284 with community-acquired pneumonia who were treated as inpatients from March 2001 till March 2003. The frequency of Q fever pneumonia in community-acquired pneumonia was 1.4%. The 21-year-old woman was a typical case of Q fever pneumonia, since her clinical features showed 1. the breeding of cats, 2. development from a fever and non-productive caught in March, 3. multiple soft consolidations in the chest radiograph, 4. normal WBC count, 5. cure by administration of clarithromycin. The pneumonias of the other 3 cases were considered to be mixed infections, with bacteria such as Streptococcus pneumoniae and Haemophilus influenzae. Their clinical features were 1. elderly male patients with underlying diseases, 2. development from fever and cough with purulent sputum in winter, 3. coarse crackle on auscultation, 4. consolidation with pleural effusion in chest radiograph, 5. leukocytosis, elevation of BUN, hyponatremia, 6. a few cases with unfavorable prognoses despite medication with carbapenem and minocycline. These findings suggested that two types of pneumonia exist; one with the usual features of atypical pneumonia, and the other presenting the clinical features of bacterial pneumonia of the elderly due to a mixed infection including C. burnetti.
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PMID:[Clinical features of Q fever pneumonia]. 1472 47

The aim of the study was to assess the clinical features of Q fever pneumonia in Japan. Four cases of Q fever pneumonia (a female aged 21 and males aged 53, 74 and 87 years) who were diagnosed using the PanBio ELISA test kit, were assessed and their clinical features are described. The frequency of Q fever pneumonia among our cases of community-acquired pneumonia was 1.4% (4/284). A 21-year-old female had a typical case of the disease with (i) a history of owning a cat, (ii) onset with fever and dry cough, (iii) multiple soft infiltrative shadows on CXR, (iv) a normal white blood cell count, and (v) good response to clarithromycin. The pneumonias in the other three cases were considered mixed infections with bacteria such as Streptococcus pneumoniae and Haemophilus influenzae. Their clinical features included the following: (i) an elderly person with an underlying disease, (ii) onset with fever and purulent sputum, (iii) coarse crackles on auscultation, (iv) infiltrative shadows and pleural effusion on CXR, (v) increased white blood cells with elevated BUN and hyponatraemia, and (vi) modest responses to combined therapy with carbapenem and minocycline. Our observations suggest that two types of pneumonia caused by Coxiella burnetti exist; one with the usual features of atypical pneumonia, and the other presenting with the clinical features of bacterial pneumonia in the elderly due to mixed bacterial infection.
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PMID:Clinical features of Q fever pneumonia. 1518 83

A retrospective study was undertaken to investigate the clinical aspects of Q-fever pneumonia. Six sporadic cases, 5 men and 1 woman, aged between 36 and 81 years were diagnosed by testing paired serum samples using an indirect immunofluorescence assay from July 2004 to June 2007. Of these, 5 suffered from concomitant or chronic disease. The predominant clinical features were fever, cough, sputum, and chest pain. The WBC count was within normal values in half of the patients. C-reactive protein was elevated in all patients. Liver dysfunction was noted in 2 patients. Chest computed tomography revealed air space consolidation and small nodules in all patients and pleural effusion in 1 patient. Anti-phase II IgG titers of paired serum samples were elevated, but anti-phase II IgM titers were within normal limits in all the patients. Antibiotics were given to all the patients, and, beta-lactum agents were prescribed for 3 patients. The outcome was favorable in all the patients. These patients demonstrated nonspecific clinical, radiological, and laboratory manifestations, and we were able to distinguish Q-type pneumonia from other forms of community-acquired pneumonia only by testing anti-phase II IgG titers of paired serum samples.
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PMID:[Clinical features of Q-fever pneumonia]. 1919 95

The most common cause of nonzoonotic atypical community-acquired pneumonia (CAP) is Mycoplasma pneumoniae. M. pneumoniae CAP is most common in young adults but may occur at any age. Like other atypical CAPs, M. pneumoniae is associated with a characteristic pattern of extrapulmonary organ involvement and nonspecific laboratory tests. M. pneumoniae CAP is frequently accompanied by gastrointestinal manifestations (eg, loose stools/diarrhea), nonexudative pharyngitis, or skin involvement (ie, erythemamultiforme). Central nervous system involvement with M. pneumoniae is rare and accompanied by highly elevated cold agglutinin titers. Cardiac, hepatic, and renal involvement are not features of M. pneumoniae CAP. Because M. pneumoniae CAP is most frequent in ambulatory young adults, it is an easily overlooked diagnosis in elderly patients hospitalized with CAP. The hallmark clinical finding of M. pneumoniae CAP is protracted nonproductive cough. The characteristic nonspecific laboratory test finding uniquely associated with M. pneumoniae CAP is elevated cold agglutinin titers. Seventy-five percent of patients with M. pneumoniae infection have elevated cold agglutinin titers. However, the absence of elevated cold agglutinin titers does not argue against the diagnosis of M. pneumoniae. If cold agglutinins are present in a patient with CAP, the higher the cold agglutinin titer is (>1:64), the more likely the cold agglutinins are due to M. pneumoniae. Q fever is the only other atypical CAP that is rarely associated with cold agglutinins. We present a hospitalized patient with CAP in whom all microbiologic and serologic diagnostic test results were negative during the first week of her hospitalization. M. pneumoniae CAP was not suspected because of her age. Her initial M. pneumoniae immunoglobulin-M and cold agglutinin titers were negative. During the second week of hospitalization, an increased platelet count was noted. It is a common misconception that acute thrombocytosis is an acute phase reactant. Her acute thrombocytosis increased and persisted. The diagnostic clue to the cause of this hospitalized patient with CAP was acute thrombocytosis. In a patient with CAP, acute thrombocytosis is usually associated with Q fever pneumonia and less commonly with M. pneumoniae. If Q fever can be excluded on the basis of a recent/proximate zoonotic vector contact history, then acute thrombocytosis is an important clue to M. pneumoniae CAP. Acute thrombocytosis due to M. pneumoniae and Q fever occurs during weeks 1 and 2 of the infection. In patients with CAP, acute thrombocytosis that occurs during weeks 1 and 2 of the illness should suggest M. pneumoniae in patients without recent zoonotic vector contact history.
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PMID:Mycoplasma pneumoniae community-acquired pneumonia (CAP) in the elderly: Diagnostic significance of acute thrombocytosis. 1975 96

Q fever is serologically cross-reactive with other intracellular microorganisms. However, studies of the serological status of Mycoplasma pneumoniae and Chlamydophila pneumoniae during Q fever are rare. We conducted a retrospective serological study of M. pneumoniae and C. pneumoniae by enzyme-linked immunosorbent assay (ELISA), a method widely used in clinical practice, in 102 cases of acute Q fever, 39 cases of scrub typhus, and 14 cases of murine typhus. The seropositive (57.8%, 7.7%, and 0%, p<0.001) and seroconversion rates (50.6%, 8.8%, and 0%, p<0.001) of M. pneumoniae IgM, but not M. pneumoniae IgG and C. pneumoniae IgG/IgM, in acute Q fever were significantly higher than in scrub typhus and murine typhus. Another ELISA kit also revealed a high seropositivity (49.5%) and seroconversion rate (33.3%) of M. pneumoniae IgM in acute Q fever. The temporal and age distributions of patients with positive M. pneumoniae IgM were not typical of M. pneumoniae pneumonia. Comparing acute Q fever patients who were positive for M. pneumoniae IgM (59 cases) with those who were negative (43 cases), the demographic characteristics and underlying diseases were not different. In addition, the clinical manifestations associated with atypical pneumonia, including headache (71.2% vs. 81.4%, p=0.255), sore throat (8.5% vs. 16.3%, p=0.351), cough (35.6% vs. 23.3%, p=0.199), and chest x-ray suggesting pneumonia (19.3% vs. 9.5%, p=0.258), were unchanged between the two groups. Clinicians should be aware of the high seroprevalence of M. pneumoniae IgM in acute Q fever, particularly with ELISA kits, which can lead to misdiagnosis, overestimations of the prevalence of M. pneumoniae pneumonia, and underestimations of the true prevalence of Q fever pneumonia.
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PMID:High seroprevalence of Mycoplasma pneumoniae IgM in acute Q fever by enzyme-linked immunosorbent assay (ELISA). 2414 43