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)

Ergot derivative dopamine agonists, e.g. pergolide, bromocriptine, dihydroergocriptine used in treatment of Parkinson's disease can cause pleural, pericardial, retroperitoneal and valvular fibrotic changes. Case No 1: A 56-year-old woman with PD was treated with pergolide 3mg/24h since July 2002. In June 2003, edema of lower extremities was first noticed and echocardiography found a minor mitral regurgitation without any morphological changes of the valve. In January 2004, left- sided cardiac failure rapidly developed and echocardiography revealed multivalvular insufficiency with predominating severe mitral regurgitation. Mitral valve replacement was performed and pergolide was changed to ropinirole. Until now, neither cardiac functions nor motor status are sufficiently compensated. Case No 2: A 66-year-old-man with PD since 1996 was treated with pergolide 3 mg/day since 1999. In the beginning of 2004, leg edema appeared. On examination, bilateral hydronephrosis with ureteric strictures and incipient renal insufficiency was found. Bilateral ureteroplasty was performed and the histology showed periureteric fibrosis. Treatment with steroids was initiated and pergolide was changed to pramipexole. Despite the treatment, the fibrosis progressed, requiring ureteral stenting. Based on the literature review and on our own experience, we propose following guidelines to minimize the risk of complications: A. Not to use EAD as the first-line dopamine agonists. B. Regularly follow all patients treated with EAD, especially monitor the majorsymptoms: dyspnea, cough, fatigue, leg edema (also asymmetric), symptoms of urinary outflow obstruction, cardiac insufficiency, chest pain, heart murmur. An elevated ESR, C-reactive protein or anemia support the diagnosis. C. All symptomatic patients should undergo workup for serosal fibrosis (according to type of complication): chest X-ray or CT scan, spirometry, renal functions, renal ultrasound, CT of retroperitoneum. D. Before the introduction of EAD therapy, examine the renal functions, perform chest X-ray and echocardiography. Screening echocardiography should be performed in 3-6 months and subsequently in every 6-12 months.
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PMID:[Organ changes induced by ergot derivative dopamine agonist drugs: time to change treatment guidelines in Parkinson's disease?]. 1580

The etiology of community-acquired pneumonia (CAP) in a children's hospital was studied among 209 previously healthy children treated from August 1, 2001 to July 31, 2002. A total of 26 children (12.4%) with a diagnosis of chlamydial infection were included in this study. The diagnosis of chlamydial infection was based on either a positive immunofluorescent assay result for chlamydial antigen in sputum, or positive serologic results for immunoglobulin M (IgM), an IgG titer >/=1:640 or a 4-fold rise in IgG titer by microimmunofluorescence test. Fourteen patients (53.8%) were female and 20 (76.9%) were less than 5 years of age. The onset of infection occurred between August and January in 21 cases (80.7%). Twenty one patients (80.8%) had other pathogens identified. Fever and cough were the most common presenting symptoms. The signs and symptoms were similar for the children with and without coinfection except for tachypnea and wheezing sound, which were significantly more common in patients with mixed infection. None of the laboratory parameters seemed to be specific for chlamydial infection; however, serum C-reactive protein level was significantly higher in cases with mixed infection. Among the 26 children, 12 (46.2%) needed respiratory therapy, and most of them (91.7%, 11/12) had coinfection. Two patients (7.7%) with mixed infection were admitted to the pediatric intensive care unit. One had lobar pneumonia with pleural effusion and the other had necrotizing pneumonia requiring surgical intervention. None of the patients died. In conclusion, Chlamydia sp. was identified in 12.4% of children with CAP in this series, and mixed infections were common (80.8%) among these patients. The clinical course of chlamydial pneumonia was not serious in most patients, but alertness is needed to the possibility of developing severe pneumonia in cases with bacterial coinfection.
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PMID:Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome. 1584 56

We report a case of sphenoid sinusitis which could be diagnosed by orbital CT after detecting Strepotococcus pneumoniae from blood culture. A previously healthy 47 year-old Japanese male was admitted to our hospital with severe left-sided headache of 2 days duration. From 9 days before hospitalization (1st day), the patient complained of cough and sputum. On physical examination, his neck was supple and his temperature was 38.3 degrees C. The rest of the examination was normal. A chest radiograph, sinus radiograph, and head computed tomographic (CT) scan without contrast material disclosed no abnormalities. Lumbar puncture was done and cerebrospinal fluid was clear and cell counts and the levels of glucose and protein were normal. The peripheral white blood cell count was 14,400/fl, and the C-reactive protein level was 9.6 mg/dl. After blood, urine, pharyngeal mucus and cerebrospinal fluid cultures were obtained, empirical antibiotic therapy with 2 gms of piperacillin twice daily was begun. He complained sever left-sided retro-orbital headahe on the next day too. The lumbar puncture and head CT scan with contrast material was done again but gave no diagnostic clues. The examinations by the otolaryngologist, ophthalmologist and dentist found no abnormal findings. On the 3rd hospitalized day, Strepotococcus pneumoniae was detected from the blood culture taken on the 1st hospitalized day. A CT scan focused on orbita was done and revealed a low density area of the left sphenoid sinus. The dose of piperacillin was increased to 4 gms twice daily and continued for 24 days. The patient's headache improved and piperacillin was changed to oral levofloxacin 100 mg, three times daily on the 26th day. The medication was stopped on the 73th day. Isolated sphenoid sinusitis is rare, but crtitical complications such as cranial nerve involvement, brain abscess, and bacterial meningitis may happen. It is necessary to also think of sphenoid sinusitis in practices of patients with severe headache.
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PMID:[A case of sphenoid sinusitis which could be diagnosed by orbital computed tomography after detected Strepotococcus pneumoniae from blood culture]. 1597 60

We report a case of lasting fever and cough with pulmonary infiltrates progressing 4 months after adjuvant radiotherapy following surgery for breast cancer. Chest radiography and computed tomography demonstrated alveolar opacities outside the irradiated pulmonary area. Laboratory data revealed neutrophilia and increased levels of C-reactive protein. Bronchoalveolar lavage fluid displayed increased lymphocyte counts, and transbronchial lung biopsy revealed histological patterns compatible with cryptogenic organizing pneumonia (COP). Corticosteroid therapy resulted in marked clinical improvement. From the histological and clinical findings, this case was judged to be a case of COP induced after radiotherapy for breast cancer, similar to those reported recently.
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PMID:Cryptogenic organizing pneumonia after radiotherapy for breast cancer. 1611 Feb 98

Sirolimus inhibits human fibroblast cell proliferation in cell cultures from transbronchial biopsies of lung transplant recipients. However, a few cases of interstitial pneumonitis and bronchiolitis obliterans organizing pneumonia have been recently described in solid organ transplant recipients, including a fatality in a heart transplant recipient. We studied the patterns of pulmonary adverse effects associated with sirolimus in 4 renal transplant recipients who developed pulmonary opacities on chest radiograph, which were proved to be noninfectious in origin. Lung biopsy was performed to obtain histological diagnosis (3 interstitial pneumonitis, 1 necrotizing vasculitis). Symptoms were dyspnea (4), cough (2), hemoptysis (1), fever (1) and eyelid edema (1). Those with interstitial pneumonitis had bilateral basal opacities on chest X-ray, and histopathology showed mild lymphoplasmocytic interstitial inflammation, scattered intraalveolar epitheloid granulomas and a focal pattern of organizing pneumonia. Serum C-reactive protein (CRP) was elevated and bronchoalveolar lavage revealed lymphocytosis (77, 79.5 and 31%). The fourth patient had an opacity localized in the upper lobe, which progressed to both the lower lobes, and histopathology showed multifocal necroses of lung tissue with lymphoplasmocytic vasculitis and scattered granulomas. In this patient, the serum CRP level was not elevated and bronchoalveolar lavage was normal. Pulmonary symptoms and opacities on chest radiograph resolved and the serum CRP level became normal after sirolimus was stopped in all patients. Sirolimus may be a cause of interstitial pneumonitis or pulmonary vasculitis, and withdrawal of sirolimus is therapeutic.
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PMID:Patterns of pulmonary complications associated with sirolimus. 1716 40

The purpose of our retrospective 3-year study was to analyse and compare clinical and epidemiological characteristics in hospitalized patients older than 6 years with community-acquired pneumonia (CAP) caused by Chlamydia pneumoniae (87 patients) and Mycoplasma pneumoniae (147 patients). C. pneumoniae and M. pneumoniae infection was confirmed by serology. C. pneumoniae patients were older (42.12 vs. 24.64 years), and were less likely to have a cough, rhinitis, and hoarseness (P<0.001). C. pneumoniae patients had higher levels of C-reactive protein (CRP), and aspartate aminotransferase (AST) than M. pneumoniae patients (P<0.001). Pleural effusion was recorded more frequently in patients with M. pneumoniae (8.84 vs. 3.37%). There were no characteristic epidemiological and clinical findings that would distinguish CAP caused by M. pneumoniae from C. pneumoniae. However, some factors are indicative for C. pneumoniae such as older age, lack of cough, rhinitis, hoarseness, and higher value of CRP, and AST.
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PMID:Chlamydia pneumoniae and Mycoplasma pneumoniae pneumonia: comparison of clinical, epidemiological characteristics and laboratory profiles. 1631 95

A 70-year-old man with liver cirrhosis and previous gastrectomy admitted for fever, coughing, and bloody sputum soon after convalescing from pulmonary tuberculosis had a peripheral white blood cell count of 9,900/microL, C-reactive protein of 14.1mg/dL, serum albumin of 2.0g/dL, and serum positive for antiaspergillus and beta-D glucan antibodies. Chest radiography showed thickening of the walls of the large residual cavities with previous tuberculosis lesions and infiltrates around them. On day 2 of hospitalization, Aspergillus fumigatus without other bacillus was detected in sputum culture taken on admission. Despite immediate treatment with intravenous micafungin and oral itraconazole and improved brief initial improvement, his general condition abruptly deteriorated into frequent massive hemoptysis and he developed of shock, respiratory failure, and severe malnutrition, dying 30 days later. Autopsy findings showed pulmonary aspergillosis in and around the large cavities and on the other side of the lungs. Pulmonary aspergillosis without hematological malignanciy and immunosuppression can thus be abruptly severe and fatal due to malnourishment stemming from pre-existing conditions such as chronic hepatitis despite prompt, ordinarily adequate medical treatment.
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PMID:[Autopsy case of pulmonary aspergillosis soon after convalescence from pulmonary tuberculosis]. 1644 78

Pulmonary involvement in Sweet's syndrome (SS) is rare. We report a case of SS with severe respiratory involvement responding to corticosteroid therapy. A 82-year-old man presented fever of 39 degrees C associated with cough and dyspnea, and crackles in the left lung. The infection work-up was negative. Chest X-ray showed cardiomegaly and left lower lobe pulmonary infiltrates. Pulmonary signs did not improve on treatment with antibiotics, and after 1 week maculopapular lesions appeared, localized on the knees, the periombilical area and the back. The antibiotics were changed without improvement. A skin biopsy revealed infiltration by neutrophilic granulocytes and marked edema in the dermis, consistent with SS. The patient's condition progressively worsened, requiring high oxygenotherapy, and he was transferred to an intensive care unit. Chest X-ray revealed an important alveolar and interstitial syndrome. Bronchoalveolar lavage found 170 leukocytes with 30% neutrophils (N < 5%), 7% lymphocytes and 63% macrophages. A search for bacteria, viruses or parasites in bronchoalveolar lavage was negative. The patient was treated with antibiotics, a high dose of furosemide and steroids for 4 days. Because the patient improved dramatically within 5 days, with a negative infection work-up and a dramatic decrease of C-reactive protein, the antibiotics were stopped. Steroids were secondarily tapered very slowly. A chest computed tomography (CT) scan showed a substantial improvement of pulmonary lesions. We also review the 22 cases of pulmonary involvement of SS reported in the literature.
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PMID:Pulmonary involvement in Sweet's syndrome: a case report and review of the literature. 1679 26

We report the case of a 55-year-old male patient who presented with non-specific pulmonary symptoms (cough, haemoptysis, fever up to 39 degrees C, night sweats and weight loss). After empirical antibiotic therapy prescribed by his primary care physician, the patient showed no improvement in symptoms. Laboratory findings were: elevated C-reactive protein and C-ANCA, leukocytosis and thrombocytosis, and anaemia. Chest radiography showed disseminated nodules bilaterally. On multidetector-row computed tomography (MDCT), the bronchial walls showed a significant thickening and extensive peribronchiolar consolidations. Bronchoscopy revealed diffuse erythema of the tracheobronchial mucosa with diffusely scattered white plaques. Histopathology described a multifocal ulcerative bronchitis with underlying chronic bronchitis. These findings in combination with the laboratory data lead to the diagnosis of Wegener's granulomatosis. Consequently, we started with an immunosuppressive therapy. Chest radiography after 10 days showed marked resolution of the infiltrates. Within 1 month, the patient became asymptomatic.
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PMID:Atypical bronchial thickening and ulceration: a rare radiological finding in Wegener's granulomatosis. 1776 50

This study clinically and molecularly characterizes an adenovirus epidemic that broke out in Taiwan in April 2004. Clinical data on 325 children diagnosed with acute illness were collected between April 2004 and April 2005, and a diagnosis of adenovirus was confirmed by viral isolation. Polymerase chain reaction and restriction fragment length polymorphism were used to identify the adenovirus genotypes in 267 patients. There was a seasonal variation, with a peak incidence between November 2004 and January 2005 (p < 0.001). The median age was 52 months, range 1-210 months. Most cases (90.8%) were younger than 7 years old. Male-to-female ratio was 1.56:1. The most common clinical diagnosis was exudative tonsillitis (50.8%), followed by bronchitis/bronchiolitis (29.9%), conjunctivitis or pharyngoconjunctival fever (22.5%), and acute otitis media (16.3%). Adenovirus type 3 was found in 215 patients (80.5%). The other 52 patients had other genotypes: type 2 (10.1%), type 1 (6.0%), type 5 (1.9%), type 7 (0.7%), type 4 (0.4%), and type 6 (0.4%). Patients with type 3 were significantly older [age >52 months, adjusted odds ratio (OR) 8.55, 95% confidence interval (CI) 1.84-40, p = 0.006), their family members had a higher incidence of illness (adjusted OR 8.77, 95% CI 1.55-50, p = 0.01), they coughed (adjusted OR 6.37, 95% CI 1.54-26.3, p = 0.01), and they had a higher C-reactive protein (CRP) level (>2.87 mg/dL, adjusted OR 3.64, 95% CI 1.06-12.3, p = 0.04) than the 52 cases with other genotypes. In conclusion, this adenovirus outbreak, from late autumn to winter, was predominately caused by adenovirus type 3. Patients with this genotype were significantly older, had a higher incidence of cough and family transmission, and had higher CRP levels than those with other genotypes.
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PMID:Molecular and clinical characteristics of adenoviral infections in Taiwanese children in 2004-2005. 1787 5


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