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)

Respiratory syncytial virus (RSV) infection, a common lower respiratory infection in infants, is now recognized in the USA as a significant problem in elderly adults. RSV infection has rarely been reported in adults in Japan. Nasal samples from 77 patients with influenza-like illness (ILI) and negative for influenza in a rapid antigen detection kit were also tested by polymerase chain reaction (PCR) to identify RSV. A clinical trial was also conducted using a new antigen detection test kit for RSV based on immunochromatography. RSV was detected by nested RT-PCR in samples from nasal swabs of 10 patients--3 children and 5 adults--and nasal aspiration samples in 2 children. The frequency of RSV detection by nested RT-PCR in ILI patients with a negative response for influenza virus using the rapid detection kit was 27.3% (3/11) for children aged 0 to 1 year and 33.3% (2/6) for children aged 2-3 years. The frequency was 10% (1/10) for adults aged 30-39 years, 25% (1/4) for those aged 70-79 years, and 60% (3/5) for those aged 80-89 years. By month, the frequency was 25% (2/8) for December, 27.3% (6/22) for January, and 4.4% (2/45) for February. The main clinical symptoms of the 10 patients with RSV were: peak body temperature during the clinical course of 37.2-39.7 degrees C, cough, and rhinorrhea in 9. Stridor was observed in all five children, but not in the five adults. Clinical examination showed CRP to be 0.2-3.4 (mean 1.3) mg/dL and WBC to be 3070-8000 (mean 5584) /microL for nine patients. Lymphocytopenia was observed in the four adults from whom WBC fraction data was obtained. Chest X-ray was within normal limits. RSV was detected by the new rapid antigen detection kit in 9 of the 10 patients in whom RSV was detected by PCR, but not in any of the 67 patients in whom RSV was not detected. The diagnostic accuracy of the new antigen detection kit for RSV was thus excellent at 98.7% compared to PCR. RSV was detected from nasal swab specimens of a substantial number of elderly Japanese by PCR or the antigen detection kit.
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PMID:[Detection of respiratory syncytial virus with nested RT-PCR and a new rapid detection test kit in patients with influenza-like illness, including elderly adults]. 1830 71

A 18-year-old man complaining of remittent fever and nonproductive cough visited a nearby clinic. He did not recover despite treatment of oral azithromycin. We admitted him because his chest radiograph showed consolidation in the left upper lung field. We diagnosed his pneumonia as co-infection by non-bacterial and bacterial pathogens, and initiated treatment with intravenous ampicillin and oral clarithromycin. On the 3rd day after admission his symptom had not improved, so his treatment was changed to intravenous panipenem/betamipron and erythromycin. Ciprofloxacin was administered intravenously because consolidative shadows with atelectasis increased on the chest radiograph on the 6th day. Clinical symptoms such as fever, CRP and chest radiograph findings were rapidly improved after the start of ciprofloxacin treatment. He was discharged on the 22nd hospital day. Since serum antibody titer against Mycoplasma pneumoniae was elevated to x 20,480 on the 13th hospital day, it is confirmed that causative pathogen was macrolide-ineffective Mycoplasma Pneumoniae.
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PMID:[Case of macrolide-ineffective Mycoplasma pneumoniae pneumonia successfully treated with intravenous ciprofloxacin]. 1831 53

Between November 2003 and January 2004 in the North of France a large outbreak of legionnaire's disease affected 85 patients. The clinical, biological and radiological characteristics of the patients were investigated to determine factors associated with mortality. Two populations were defined and compared: patients who died within 28 days and those who survived. Eighty-five patients were included in this study. The median age was 75 years. The median fever was 39.3 +/- 0.1 degrees. Fifteen patients (17.6%) had at least 3 underlying co-morbidities. Cough, dyspnoea, confusion and diarrhoea were found in respectively 46, 68, 47, and 15% of the patients. The median of urea was 0.7 +/- 0.05 g/L, creatinine 16 +/- 1.5 mg/L, CRP 332 +/- 15 mg/L. On the chest X-ray, lung infiltrates were present in 64% and multilobar in 40%. The overall mortality rate was 21%. In univariate analysis, diabetes mellitus, dyspnoea, urea>0.90 g/l and CRP>350 mg/l were predictive factors of mortality. In multivariate analysis, diabetes mellitus, urea>0.90 g/l, and bilateral infiltrates on chest X ray were retained as independent risk factors for death.
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PMID:[Factors predicting mortality during an outbreak of Legionnaire's disease in the north of France]. 1844 94

We report the case of a 58 year old male patient with nonproductive coughing, fever, vomiting and loss of appetite, beginning at the moment that he returned back home from a 2 week holiday in California. His symptoms were accompanied by increased inflammatory markers in his blood (leucocytosis, high CRP) and pulmonary sequelae, becoming more prominent shortly after admission. Eventually, the final diagnosis of coccidioidomycosis was made by histopathology and confirmed by serology. Coccidioidomycosis is a rare infectious disease. However, the incidence in the endemic areas of this fungal infection is increasing and the population travelling towards its specific endemic regions in the United States and Southern America is considerably growing. Clinicians facing patients with pulmonary infection with the appropriate travel history and persistent pulmonary or systemic infection (with or without eosinophilia) should be alert to the possibility of coccidioidomycosis. Therefore, we present an up to date overview of the epidemiology, microbiology, clinical features, diagnosis and treatment of patients with coccidioidomycosis.
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PMID:Fungal disease of the Western hemisphere: a patient with coccidioidomycosis. 1939 1

Scrub typhus is an endemic disease in eastern Taiwan. We conducted a study of scrub typhus cases among hospitalized pediatric patients. Twenty-eight pediatric cases were confirmed to be scrub typhus (either by immunofluorescence assay or polymerase chain reaction) from 2000 to 2005. The medical records of these patients were reviewed for demographics and clinical manifestations. The majority of the children (60.7%) diagnosed with scrub typhus were male. Approximately half the patients were < 5 years old and the mean age (SD) was 6.1 (3.66) years. Patients were more likely to live in rural rather than urban areas. The greatest number of cases was seen in the spring and summer. The primary clinical symptoms included fever (100%), cough (50%), eschar (50%), rash (35.7%), poor appetite (42.9%), lymphadenopathy (42.9%), headache (39.3%), and hepatomegaly (35.7%). AC-reactive protein (CRP) was elevated in 100%, an aspartate aminotransferase (AST) was elevated in 100%, an alanine aminotransferase (ALT) level was elevated in 91.3%, hypoalbuminemia was found in 88.9% and proteinuria in 50%. The mean (SD) duration of antibiotics was 11.0 (2.68) days and the mean (SD) duration for fever resolution after treatment was 2.8 (2.51) days. Meningoencephalitis was noted in 6 patients. Our case series had no mortalities. These results suggest that a diagnosis of scrub typhus should be suspected in children with fever and laboratory evidence of liver dysfunction who live in rural eastern Taiwan.
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PMID:Scrub typhus in children in a teaching hospital in eastern Taiwan, 2000-2005. 1984 16

Acute eosinophilic pneumonia is a disease of unknown etiology characterized by peripheral blood eosinophilia and pulmonary infiltrative shadows on radiography. Acute eosinophilic pneumonia follows an acute course within 1 week and the symptoms include fever, dyspnea, and cough. Acute eosinophilic pneumonia has a good prognosis and responds promptly to steroid treatments. Here we present a critical case of acute eosinophilic pneumonia during pregnancy, which led to emergency cesarean section because of fetal distress. The patient was a 24-year-old gravida at 34 + 6 weeks gestation, with fever, and an elevated CRP; thus antibiotics were started. At 35 + 1 weeks gestation, cardiotocography (CTG) revealed late decelerations, fetal distress was diagnosed, and an emergency cesarean section was performed. The pre-operative maternal blood gas analysis showed a low PaO(2) of 55.7 mmHg and a chest X-ray revealed ground-glass opacities and pleural effusions in the middle lower lung fields bilaterally. A male of 2,336 g in weight was delivered with Apgar scores of 8 and 8 at 1 and 5 min, respectively. Due to the clinical progress and the elevated eosinophil count (532/microl) in the peripheral blood differential leukocyte count, the diagnosis of acute eosinophilic pneumonia was made. With the administration of oxygen and steroid treatment, the patient's general condition recovered. Both the mother and the baby were discharged on the 10(th) post-operative day and the patient has been leading a normal life with no recurrence for > 3 years since delivery.
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PMID:Emergency cesarean section as a result of acute eosinophilic pneumonia during pregnancy. 1985 Oct 54

When considering a diagnosis of LRTI the main differentiation to make is between pneumonia and non-pneumonic LRTI. It is more difficult to make this distinction in the community because of access constraints to chest radiography and the lack of a quick, simple marker to identify patients with true pneumonia accurately. The diagnosis of pneumonia in the community, without a chest radiograph, is suggested by symptoms that include: cough; (purulent) sputum production; breathlessness; pleurisy; occasional haemoptysis along with new focal signs on chest examination (e.g. crepitations, bronchial breathing, and dullness to percussion); at least one systemic feature (e.g. sweating, fevers, shivers, aches and pains and/or temperature >38 degrees C); and no other explanation for the symptoms. A recent observational study of around 150,000 patients with LRTI in the UK found that the following factors were associated with increased respiratory infection-related mortality: increasing age; smoking; increasing Charlson co-morbidity index; prior antibiotic prescribing; frequent consultation and prior specialist referral or admission. Acute adult LRTI presenting to GPs is a predominantly viral illness most commonly caused by rhinoviruses and influenza viruses. The most common bacterial cause of pneumonia is Streptococcus pneumoniae but frequently no organism is identified. In patients where you suspect non-pneumonic LRTI, the evidence suggests that chest radiography and blood tests for CRP are not helpful in their management in the community. The BTS guidelines recommend that GPs, particularly those working in out-of-hours and emergency assessment centres, should consider using pulse oximeters. The CRB-65 is a helpful tool in the community. Patients scoring 0 or 1 have the lowest mortality risk, however, a score of 2 or more should be a cause for concern and the patient may need to be admitted to hospital for assessment.
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PMID:Managing LRTI in adults in the community. 2004 6

A 46-year-old man was admitted for the evaluation of a dry cough and dyspnea on exertion. Laboratory tests revealed anemia, elevated CRP, polyclonal hyperimmunoglobulinemia, and an elevated interleukin-6 level. Radiological examination of the chest showed peribronchovascular consolidations, ground glass opacities, small nodular opacities, and interlobular septal thickenings in the lungs, accompanied with hilar and mediastinal lymphadenopathies. A video-assisted thoracoscopic lung and mediastinal lymph node biopsy revealed plasmacytic and lymphocytic infiltration around the bronchovascular bundles of the lungs, and plasmacytic infiltration in the interfollicular areas of the nodes. Based on these findings, a diagnosis of multicentric Castleman disease was confirmed. The patient received a humanized anti-interleukin-6 receptor antibody, (tocilizumab, 8 mg/kg), every 2 weeks for 3 years, during which time, his PaO2 level improved from 64.1 Torr to 83.4 Torr, vital capacity increased from 2.53 L to 3.95 L, and radiological abnormalities in the lungs gradually improved, suggesting that tocilizumab is effective for interstitial pneumonia in patients with multicentric Castleman disease.
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PMID:[Long-term treatment with a humanized anti-interleukin-6 receptor antibody (tocilizumab), improving interstitial pneumonia in a patient with multicentric Castleman disease]. 2018 47

The purpose of the study was to determine the associations between dust, endotoxins and bacterial exposure, and health effects in sewage workers. Exposure of 19 workers handling dry sludge and 25 other sewage workers was measured. Controls were office workers from compost and sewage plants. Spirometry, acoustic rhinometry and nitric oxide in exhaled air were performed before and after exposure were measured. CRP was measured in blood samples. It was found that workers handling dry sludge were exposed to higher levels of dust and endotoxins than other workers and reported more airway and systemic symptoms than controls. Compared to controls, FEV(1)/FVC was 0.12 lower in workers handling dry sludge and 0.05 lower in other sewage workers. Nose irritation, cough and headache were more prevalent in workers handling dry sludge (ORs 2.3-23), and together with unusual tiredness associated with endotoxins and/or dust, ORs 2.9-34 for-10-fold increases in exposure. Cross-shift decreases of nasal dimensions were larger in workers handling dry sludge than controls and were associated with dust and endotoxin exposure. It was concluded that workers handling dry sludge were higher exposed to endotoxins and dust than other sewage workers and also reported more respiratory and systemic symptoms. Exposure-response relationships were found for nasal dimensions, nose irritation and systemic symptoms.
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PMID:Exposure, symptoms and airway inflammation among sewage workers. 2118 69

We assessed the clinical efficacy of tebipenem pivoxil (TBPM-PI) in 30 children with pneumonia who, despite having received oral administration of beta-lactam antibiotics at the standard dose for at least 3 days, had no relief of symptoms and showed an abnormal shadow on the chest X-ray and elevated serum CRP levels of 3.0 mg/dl or more between December 2009 and November 2010. TBPM-PI was administered at a single dose of 4 mg/kg twice a day for 3 days. The children ranged in age from 8 months to 5 years. The serum CRP level ranged from 3.05 to 12.9 mg/dl. In 28 of the 30 children, either Streptococcus pneumoniae or Haemophilus influenzae or both were detected. Of the 28 children, 7 carried penicillin resistant S. pneumoniae; 9 carried beta-lactamase nonproducing ampicillin resistant H. influenzae; and 3 carried both. In all children, defervescence was observed within 48 hours of the start of TBPM-PI administration, and the severity of coughing/wheezing reduced significantly by the 3rd to 5th day. Thus, TBPM-PI was determined to be effective. Diarrhea or loose stool was observed as an adverse reaction in 4 children (13.3%).
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PMID:[Clinical efficacy of tebipenem pivoxil treatment in children with pneumonia, who had no relief despite having administered oral beta-lactam antibiotics]. 2186 8


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