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)

An acute pulmonary syndrome possibly representing acute graft-versus-host disease (GVHD) involving lung interstitium occurred in a patient given an allogeneic bone marrow transplant for haematological malignancy. He presented at day 34 with acute GVHD of skin and bowel, and this was associated with cough, dyspnoea and an asymmetrical change on chest X-ray. Lung biopsy demonstrated an interstitial and peribronchial lymphocytic infiltrate and acute bronchial epithelial degeneration. He responded symptomatically to high dose intravenous methylprednisolone. The radiological change resolved completely. This case, thought to represent GVHD involving lung interstitium, emphasizes the need for tissue procurement in the management of non-bacterial lung disease after marrow transplantation.
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PMID:An acute pulmonary syndrome possibly representing acute graft-versus-host disease involving the lung interstitium. 195 5

From 1982 to 1987, 22 patients with proven Pneumocystis carinii pneumonia were diagnosed at Wellington Hospital. Patients comprised 15 males and 7 females aged 15-76 years and included seven with AIDS, eight with haematological malignancy and seven with renal disease. Two distinct clinical prodromes occurred. In renal patients a classic fulminating pneumonitis developed over 24 to 72 hours. In patients with AIDS a more indolent illness occurred lasting 3 or more weeks and was characterised by fever, dry cough and breathlessness. Haematology patients showed no specific duration of prodrome. At the time of diagnosis all had an abnormal chest radiograph and the arterial PO2 was reduced in all but one case. An invasive diagnostic procedure was performed in all except one case where the diagnosis was made at post mortem. Two patients required a second procedure to establish the diagnosis. Procedures performed included bronchoalveolar lavage [14], open lung biopsy [7] and transbronchial lung biopsy [2]. All patients were treated with high dose cotrimoxazole and 18 survived to leave hospital. A review of the approach to the diagnosis and treatment of Pneumocystis carinii pneumonia is presented.
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PMID:Management of Pneumocystis carinii pneumonia in the immunocompromised host. 326 Jun 63

Trichosporon beigelii is a causative agent of hypersensitivity pneumonia in immunocompetent individuals and of invasive pneumonia in immunocompromised patients. The actual incidence and clinical manifestations of T beigelii pneumonia are obscure because the diagnosis is sometimes difficult. We studied eight patients with T beigelii pneumonia diagnosed by immunohistochemical investigation of lung tissue sections and/or isolation of the organism from the lung, sputum, or blood. All patients had underlying hematologic malignancies for which they had received cytotoxic chemotherapy, resulting in profound neutropenia. The clinical manifestations were persistent fever unresponsive to broad-spectrum antibiotic therapy, cough, bloody sputum, and rapidly progressive dyspnea. The chest radiographs showed diffuse alveolar infiltrates in four patients, diffuse interstitial infiltrates in one, patchy reticulonodular infiltrates in one, and focal alveolar infiltrates in two. Histopathologic examination demonstrated numerous centrally necrotic foci with minimal cellular inflammatory reaction, intra-alveolar hemorrhage, and edema. Trichosporon beigelii consisting of both yeast and hyphal forms was located predominantly in the alveolar vessels. In neutropenic patients with hematologic malignancies, this fungus appears to enter the lung not only through the airways but also via the hematogenous route. In vitro susceptibility testing indicated borderline susceptibility to amphotericin B and showed that some azoles were active against T beigelii at safely achievable serum concentrations.
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PMID:Trichosporon beigelii pneumonia in patients with hematologic malignancies. 760 57

A 49-year-old woman with acute lymphocytic leukemia (ALL) who had been intermittently treated with chemotherapy during a 3-year period developed cough and expectoration of increasing severity. Chest X-ray film revealed miliary shadows and bilateral hilar enlargement. Milky fluid was obtained by bronchoalveolar lavage. The intensity of these shadows showed temporary decrease, but thereafter progressively increased until the time of the patient's death. Autopsy findings were consistent with pulmonary alveolar proteinosis and systemic aspergillosis. Secondary alveolar proteinosis is rare, and in most reported cases is associated with hematological malignancy. To our knowledge, only 45 cases in which it was associated with hematological disorders have been reported. The examination of a patient with any hematological disorder, however, should include differential diagnosis of chest X-ray abnormalities to exclude secondary alveolar proteinosis, which can be lethal if left untreated.
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PMID:[An autopsy case of acute lymphocytic leukemia associated with secondary pulmonary alveolar proteinosis and systemic aspergillosis]. 831 8

A retrospective study of 37 patients with haematological malignancy (21 acute myeloid leukaemia, 11 acute lymphoid leukaemia, two lymphoma, two hairy cell leukaemia, one Hodgkin's disease) and histologically documented mucormycosis was conducted to evaluate the clinical characteristics and ascertain the factors which influenced the outcome from mycotic infection. Patients were admitted to 18 haematology divisions in tertiary care or university hospitals in Italy between 1987 and 1995. Fever, thoracic pain, dyspnoea and cough were the most frequent presenting symptoms. At the onset, 89% patients were neutropenic (neutrophil counts < 0.5 x 10(9)/l) with a median duration of previous neutropenia of 14 d (range 6-60). The most frequent sites of infection were lungs (81%), CNS (27%), sinus (16%), liver (16%) and orbital space (10%). Only three patients were asymptomatic. A correct in vivo diagnosis was made in only 13 (35%) patients. When performed, thoracic and cranial CT scan were the most useful diagnostic investigations. Despite the fact that 26 febrile patients were treated with empirical antifungal treatment, 28 of the 37 patients (76%) died from fungal infection at a median time of 17 d from the onset of clinical symptoms. Nine patients were cured by antifungal therapy plus, in five cases, radical surgery procedures. An analysis of factors influencing outcome demonstrated that the resolution of chemotherapy-induced neutropenia and prolonged treatment with amphotericin B and, if feasible, radical surgical debridement treatment, were significantly correlated with recovery from infection. Mucormycosis, a rare filamentous fungal infection that occurs most frequently in neutropenic acute leukaemia patients, is characterized by a high mortality rate. Extensive and aggressive diagnostic and therapeutic procedures are essential to improve the prognosis in these patients.
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PMID:Mucormycosis in patients with haematological malignancies: a retrospective clinical study of 37 cases. GIMEMA Infection Program (Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto). 937 50

A 53-year-old woman with refractory acute myeloid leukemia had a cough and chest pain. Chest X-ray and computed tomography demonstrated a cavity for which antibiotics, antituberculosis and antifungal agents were not effective. A diagnosis of pulmonary aspergillosis and pulmonary alveolar proteinosis (PAP) was made on the basis of the detection of aspergillus using transbronchial lung biopsy and PAS-positive materials in the sputum. Even though some cases with PAP in hematological malignancy have been reported, the diagnosis of PAP was obtained in most of them at autopsy. In our experience three of seven cases of hematological malignancy had concomitant occurrence of aspergillosis and PAP. We should therefore pay particular attention to the possibility of PAP in patients with hematological neoplasia exhibiting pulmonary fungal infection, especially aspergillosis.
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PMID:[Invasive aspergillosis and pulmonary alveolar proteinosis in acute myeloid leukemia]. 1241 96

The aim of the study was a comparative assessment of clinical and laboratory findings characterizing the course of pneumonia or bronchitis in patients with hematological malignancy (HM) and neutropenia. The course of the respiratory infections (RI) was studied in 47 HM patients. RI in HM were found to develop in patients with a large tumor, in bone marrow involvement, in patients without a complete remission, more frequently pneumonia arises in acute leukemia, bronchitis--in patients with lymphoproliferative diseases. Among causative agents Gram-negative and Gram-positive microorganisms were detected at the same rate (44.2 and 45.9%, respectively), fungi were diagnosed in 9.8% cases. Enterobacteriaceae microorganisms were found more often in patients with pneumonia. Gram-positive agents occurred more frequently in bronchitis. Such clinical markers in neutropenic patients as dyspnea, dullness in the lung, weakened respiration, moist rales in the lungs and fever 39 degrees C and higher point to pneumonia. If the above markers are absent but there is cough, fever 38-39 degrees C, tough respiration, dry rales both pneumonia and bronchitis are possible.
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PMID:[Clinical characteristics of respiratory infection in patients with hematologic malignancy and neutropenia]. 1502 95

A 47-year-old male had symptoms of coughing and with fever and was admitted to our hospital where tests revealed he had anemia and thrombocytopenia. Following the results obtained from a bone marrow aspiration, he was diagnosed as having acute myeloid leukemia (AML). A chest radiograph and a CT scan demonstrated nodular shadows and pleural exudate in both lungs. We suspected atypical pneumonia, or fungal pneumonia, and he was subsequently given antibiotics and antifungal agents, which were, however, ineffective. On the third day after admission, he was put on mechanical ventilation, and a bronchoalveolar lavage examination revealed no germs. His respiration, however, progressively worsened and he died on the twelfth day after admission. Although the autopsy findings revealed no infectious lesions in his lungs, a PAS-positive intra-alveolar eosinophilic material, which was positive for surfactant apoprotein A staining, was present. As a result of the autopsy findings, a diagnosis of secondary pulmonary alveolar proteinosis (PAP) associated with AML was made. Among the reported cases of PAP in hematological malignancy, there has not been one case detected at the time AML was diagnosed. If there is evidence of an unknown cause of lung infiltration when AML is diagnosed, attention should be paid to the possibility of the presence of PAP.
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PMID:[Acute myeloid leukemia complicated with pulmonary alveolar proteinosis at presentation]. 1644 Jul 46

Invasive pulmonary aspergillosis is a serious infectious complication in immunocompromised especially neutropenic patients. Despite improvements in early diagnosis and effective treatment, invasive pulmonary aspergillosis is still a devastating opportunistic infection. These infections also interfere with the anticancer treatment. We report our experience in the diagnosis and therapeutic management of sinopulmonary aspergillosis in 4 children with hematologic malignancy. All patients except the first were neutropenic when sinopulmonary aspergillosis was diagnosed. Clinical signs included fever, cough, respiratory distress, swallowing difficulty, headache, facial pain-edema and hard palate necrosis. Radiodiagnostic methods showed bilateral multiple nodular infiltrations, soft tissue densities filling all the paranasal sinuses, and bronchiectasis. Diagnosis of aspergillosis was established by bronchoalveolar lavage in one case, tissue biopsy, positive sputum and positive cytology, respectively, in the other 3 cases. One patient was treated with liposomal amphotericin B and other 3 cases were treated with liposomal amphotericin B + itraconozole. Outcome was favorable in all cases except the one who died due to respiratory failure. Early diagnosis, appropriate treatment and primary disease status are important factors on prognosis of Aspergillus infections in children with hematological malignancy.
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PMID:Sinopulmonary aspergillosis in children with hematological malignancy. 1683 39

Pulmonary mucormycosis is a rare, frequently fatal, fungal infection. It is usually seen in the presence of various immunocompromised states, such as diabetes mellitus, haematological malignancy or renal transplantation. In the absence of underlying predisposing conditions, presentation with infiltrates, consolidation, cavitation and mass lesion have been reported. We describe a 50-year-old man who presented with cough and chest pain for six months. Chest radiograph and computed tomography showed bilateral multiple pulmonary nodules. Surgical lung biopsy revealed angioinvasive mucormycosis. He had complete recovery with amphotericin therapy.
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PMID:Angioinvasive pulmonary mucormycosis presenting as multiple bilateral pulmonary nodules in a patient without obvious predisposing factors. 1894 95


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