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

One hundred and eighty eight outpatients with community acquired pneumonia have been treated by spiramycin in general practice. Community acquired pneumonia was defined by the association of fever > or = 38 degrees C, respiratory symptoms as cough, sputum production, dyspnea or thoracic pain, and pulmonary opacity on the chest X-Ray. The mean age of patients was 44.7 +/- 16.6 and few of them had concomitant chronic illness, as cardiovascular (9%) or bronchopulmonary disease (9%). Twenty one percent of patients have been included after a previous antibiotherapy failure. In 92% on these cases, prior antibiotherapy was a beta lactam. At inclusion, the fever was greater than 39 degrees C in 56% of patients, 58% had localized crepitations at the chest auscultation. The chest X-Ray was performed 1.4 +/- 2.1 days after inclusion and showed a lobar consolidation in 77%. One third of patients presented a clinical picture evoking acute bacterial pneumonia. One hundred and seventy one patients have been reviewed for a second evaluation 4 +/- 1.5 days after inclusion. One hundred and eighty seven patients have visited for the long term follow up 19 +/- 6.5 days after the onset of treatment. Ninety six per cent of them have consulted with a control chest X-ray. At this visit, the antibiotherapy was changed in 2 other patients with of failure. Overall, 83% of patients were clinically and radiologically cured by Spiramycin 3 MU twice a day for 13 +/- 3.5 days. Fourteen percent of patients were improved without necessity of changing the antibiotic regimen. This study confirms the efficacy of spiramycin in the management of community acquired pneumoniae in general practice, either in first line therapy of after the failure of beta lactam.
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PMID:[Community-acquired pneumonia in healthy adults: 188 patients treated with spiramycin in private practice]. 130 46

Mycoplasma pneumoniae is a common causative agent of community acquired pneumonia. To assess its epidemiological, clinical and evolutive features in our area, we retrospectively analyzed 88 instances which occurred during 10 years. Both sexes were similarly involved, with a higher incidence in younger patients (mean age: 22 years). A clear seasonal predominance was not detected during the study period. In nearly one half of instance there were similar respiratory episodes in the same household. Cough was a constant symptom, followed by fever and headache. The absence of leukocytosis and the presence of cryoagglutinins were suggestive data. Pulmonary infiltration in the chest radiogram was unilateral in most cases, with a segmental distribution and predominating in the lower lobes. Hilar lymph nodes, pleural effusion and cavitation were present in a limited number of instances. All patients were cured without sequelae. The occurrence of particular epidemiological, clinical and laboratory data may be very helpful in suggesting the diagnosis of pneumonia due to Mycoplasma pneumoniae.
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PMID:[Pneumonia caused by Mycoplasma pneumoniae]. 249 Apr 46

Seventy nine cases of sporadic, community acquired legionnaires' disease have been reviewed. Annual and seasonal variation in incidence was noted. The mean age of the patients was 53 years and 50 (63%) were male. Pre-existing chronic diseases were present in only 23 (29%), including two patients receiving immunosuppressive treatment. Common symptoms included unproductive cough, dyspnoea, chest pain, headache, confusion, nausea, vomiting, and diarrhoea. Respiratory symptoms were absent, however, in 17 (22%). Localising chest signs were present in 74 (95%) cases. Frequent laboratory findings included lymphopenia, high erythrocyte sedimentation rate, hyponatraemia, raised urea and creatinine concentrations, abnormal liver function, hypophosphataemia, hypoalbuminaemia, proteinuria, and haematuria. Thirteen patients died (16%), including nine of 20 who received assisted ventilation. The mortality rate in patients treated with erythromycin (11%) was lower than in those who received other antibiotics (23%), but this difference was not statistically significant. Of the features noted on admission, only a high plasma urea concentration was significantly associated with death. Sporadic community acquired legionnaires' disease is a not uncommon disorder, which with appropriate treatment has a prognosis similar to that of other forms of community acquired pneumonia.
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PMID:Legionnaires' disease: a review of 79 community acquired cases in Nottingham. 378 45

We prospectively studied 110 adult patients coming to Black Lion Hospital between August 1987 and July 1989 with community acquired pneumonia (CAP) for various etiologic agents and clinical and radiographic presentation. Streptococcus pneumoniae was the most common offending pathogen in 72% and 67.5% from sputum and lung aspirate (LA) Gram stain respectively, and in 41% by pneumococcal serotyping of sputum. Blood and LA culture grew Streptococcus pneumoniae in 4 (6%), Staphylococcus aureus in 4 (6%), Enterobacteriaceae in (3%), Pseudomonas, Klebsiella and Streptococcus viridans in one case each. Non-bacterial pathogens included Mycoplasma pneumoniae in 3 (3%), Influenza A in 4 (4%), Influenza B in 3 (3%) and psittacosis/LGV in 4 (4%). Fever, cough, chest pain, tachypnea and coarse crepitations/bronchial breathing were the most common presenting signs and symptoms. Thirty per cent had associated diarrhoea and vomiting initially and 9% had altered state of consciousness at admission. Six patients came in a state of shock. Thirty-nine per cent had underlying illnesses. Ninety-three per cent had either segmental or lobar consolidation. Parapneumonic effusion occurred in 14%. The mortality was 11%. Tachypnea, the presence of underlying illness, altered state of consciousness, extreme leucocytosis and the presence of bilateral and multilobar lung involvement were found to be signs of poor prognosis. Our finding is similar to those from other African countries, except that we are reporting psittacosis/LGV for the first time in Africa.
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PMID:Community acquired pneumonia in adults in Addis Abeba: etiologic agents, clinical and radiographic presentation. 803 77

Legionella pneumophila is the second cause of severe community acquired pneumonia. In Chile, however, there are few reports of pneumonia caused by Legionella. We report eight patients (6 men, aged 42 to 72 years old) with community-acquired pneumonia caused by Legionella pneumophila serogroup 1, confirmed by the measurement of urinary antigen. Clinical presentation was characterized by fever or hypothermia (in one case), cough, dyspnea and neurological abnormalities in four patients. Cigarette smoking was the most frequently identified risk factor. All patients had at least one American Thoracic Society severity criteria. Complications observed were acute hypoxemic respiratory failure in seven patients, shock in four, renal failure in four and need for mechanical ventilation in three. No patient died.
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PMID:[Community acquired pneumonia. Report of 8 cases of severe pneumonia by serogroup 1 Legionella pneumophila in Chile]. 1204 74

Bronchiolitis obliterans organising peumonia BOO) is an uncommon inflammatory lung condition involving the terminal bronchioles and alveoli, which is responsive to treatment with corticosteroids. Patients usually present with dyspnoea, cough and fever. Two cases are described here; both had haemoptysis and were initially treated as community acquired pneumonia. Diagnosis was made on lung biopsy and there was rapid resolution after a course of prednisolone.
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PMID:Bronchiolitis obliterans organising pneumonia: a treatable condition. 1611 65

Community acquired pneumonia in adults is an acute disease characterized by worsening in general conditions, fever, chills, cough, mucopurulent sputum and dyspnea; associated with tachycardia, tachypnea, fever and focal signs in pulmonary examination. The probability of pneumonia in a patient with acute respiratory symptoms depends on the disease prevalence in the environment where it is acquired and on clinical features. It is estimated that pneumonia prevalence is 3-5% in patients with respiratory disease seen in outpatient facilities. Clinical diagnosis of pneumonia without radiological confirmation lacks specificity because clinical presentation (history and physical examination) does not allow to differentiate pneumonia from other acute respiratory diseases (upper respiratory infections, bronchitis, influenza). Diagnosis must be based in clinical-radiological findings: clinical history and physical examination suggest the presence of pulmonary infection but accurate diagnosis is established when chest X ray confirms the existence of pulmonary infiltrates. Clinical findings and chest X ray do not permit to predict with certainty the etiology of pulmonary infection. Radiology is useful to confirm clinical suspicion, it establishes pneumonia location, its extension and severity; furthermore, it allows differentiation between pneumonia and other diseases, to detect possible complications, and may be useful in follow up of high risk patients. The resolution of radiological infiltrates often ensues several weeks or months after clinical recovery, especially in the elderly and in multilobar pneumonia cared for in intensive care units.
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PMID:[Clinical and radiological diagnosis of community-acquired pneumonia in adults]. 1616 16

A 41-y-old male had been diagnosed as having community acquired pneumonia (CAP) with consolidations in the chest radiograph, fever and cough. Since clarithromycin and ss-lactam agents were not effective, bronchoscopic examination was performed. Indian ink staining of bronchial wash smears revealed yeast-like cells with a thick capsule, and Cryptococcus neoformans was isolated several d later. Serum glucuronoxylomannan antigen was > or = x 1024. The patient was treated with itraconazole for 16 weeks.
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PMID:Community acquired pneumonia (CAP) caused by Cryptococcus neoformans in a healthy individual. 1630 37

A previously healthy 29-year-old male presented to the emergency department with pleuritic chest pain, nonproductive cough, and dyspnea. He was treated empirically for community acquired pneumonia and discharged to home. Two days later, the patient presented with respiratory distress along with neutrophilia, thrombocytopenia, elevated liver function tests, and hemoconcentration. Radiographs of his chest showed bilateral lung infiltrates and pleural effusions. He was admitted to the hospital and developed cardiopulmonary failure and died the following day. Serologic tests for hantavirus pulmonary syndrome confirmed the diagnosis.
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PMID:Case report of hantavirus pulmonary syndrome and review. 1769 39

A 55-year-old man presented to his primary care provider after a two-week history of worsening cough. He was admitted to the hospital and treated for community acquired pneumonia due to progression of symptoms and an abnormal chest radiograph. Chest computerized tomography demonstrated a large consolidation in the right upper lobe with areas of cavitation consistent with necrosis. Blood and sputum cultures were obtained, and the patient was subsequently diagnosed with pulmonary Salmonella typhimurium infection. The organism was isolated from a sputum specimen only. The patient had a history of chronic alcoholism, bronchitis, and esophageal dysmotility but no evidence of severe immunosuppression or malignancy. The patient responded well to antibiotic therapy with both symptomatic and radiologic improvement. As pulmonary Salmonella infection is exceedingly rare in the immunocompetent patient, a review of the literature is presented.
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PMID:Salmonella typhimurium pulmonary infection in an immunocompetent patient. 1861 Jul 17


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