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

Bronchiolitis obliterans organizing pneumonia (BOOP) is increasingly recognized as an important cause of diffuse infiltrative lung disease. It is a diagnostic consideration in patients with a febrile flu-like illness of a few weeks' duration and a roentgenogram showing bilateral patchy infiltrates that are not responsive to a typical course of antibiotics. It is defined as granulated tissue plugs within lumens of small airways that extend into alveolar ducts and alveoli. Clinically, a flu-like illness, cough, and crackles are common. Pulmonary function studies of patients show a decreased vital capacity, normal flow rates (except in smokers), and a decreased diffusing capacity. It is generally idiopathic, but it may occur during the resolution of a viral or mycoplasma pneumonia. It is also associated with a variety of systemic illnesses and clinical settings. These include the connective tissue disorders, antineoplastic and other drugs, and immunological disorders, as well as bone marrow and lung transplantation. There are numerous related disorders, including human immunodeficiency virus infection, radiation therapy, thyroiditis, and alcoholic cirrhosis. In idiopathic BOOP, complete resolution occurs in 65% to 85% of patients treated with corticosteroid therapy. This type of therapy is often effective in patients with associated systemic disorders or in other clinical settings, but there may be limited or no response in patients with dermatomyositis, immunosuppression, or interstitial opacities at the lung bases. Respiratory failure leading to death may occur in 5% of patients. It is important to add BOOP to the differential diagnosis of febrile, noninfectious illnesses that are mimics of pneumonia.
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PMID:Bronchiolitis obliterans organizing pneumonia. 756 1

Hypersensitivity pneumonitis or extrinsic allergic alveolitis is an immunologically mediated lung disease caused by repeated inhalations of organic antigens. The basic histological lesion consists of a diffuse mononuclear cell infiltration of alveolar wall, alveoli, terminal bronchioles, and neighboring interstitium. The inflammation is often followed by granulomas, which then may progress to fibrosis. Unlike other infectious and noninfectious granulomatous disorders, hypersensitivity pneumonitis is limited to the lung. The disease occurs more frequently in men than in women and children. The acute form of hypersensitivity pneumonitis, characterized by fever, chills, myalgias, cough, and dyspnea, may be confused with acute pneumonitis. Although there is no single radiological, physiological, or immunologic test specific for hypersensitivity pneumonitis, the diagnosis can often be suspected on the basis of a compatible temporal relationship between pulmonary symptoms and a history of environmental or occupational exposure. Once the diagnosis is suspected, the presence of serum precipitating antibodies (immunoglobulin [lg] G), suppressor cytotoxic lymphocytosis in bronchoalveolar lavage (BAL) fluid, and granulomatous alveolitis in lung biopsy specimens is extremely helpful in confirming the diagnosis. For patients in whom the diagnosis is confirmed, avoidance of the causative antigen is the best therapy, although corticosteroids are used to suppress inflammation. Once the fibrosis has developed, the patient may gradually develop respiratory failure or cor pulmonale, possibly resulting in death.
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PMID:Hypersensitivity pneumonitis: a noninfectious granulomatosis. 756 4

Cryptogenic organizing pneumonia (COP), also known as bronchiolitis obliterans organizing pneumonia (BOOP), is an uncommon lung disease characterized by the presence of granulation tissue within the alveolar ducts and alveoli. Because of the limited published literature on this topic and limited information on outcome we reviewed our own experience over an 8-year period and also critically evaluated the literature. We reviewed all cases of COP diagnosed from 1985 through 1992 at Vancouver General Hospital: 25 patients (14 male, 11 female) aged 20-77 years (mean, 49 yr, SD +/- 17 yr). Nine patients had myeloproliferative disorder, including 6 who had allogenic bone marrow transplants; 2 patients had connective tissue disease; and 14 patients had no underlying disease (idiopathic). Data retrieved retrospectively from clinical records included demographics, risk factors, symptoms, chest radiographs, computerized tomograms, lung function tests, therapy prescribed, and response to therapy. Symptoms included dyspnea and cough (n = 15) (60%), cough only (n = 10) (40%), and fever (n = 15) (60%). Twenty-two patients were diagnosed by open lung biopsy and 3 by transbronchial biopsy. Lung imaging showed bilateral patchy airspace consolidation or nodular opacities as the main finding in 22 patients. Pulmonary function tests showed a combined restrictive and obstructive pattern. All patients received prednisone therapy except 1 patient whose idiopathic findings resolved completely with minimal treatment. Eight patients died, including 4 of the 9 patients with myeloproliferative disorder--2 from a combination of respiratory failure due to COP and graft-versus-host disease. One of 2 patients with connective tissue disease died, and 3 of 14 patients with idiopathic COP died. COP is an uncommon condition but should be considered in patients with bilateral airspace disease, especially those who fail to respond to antibiotics for presumed pneumonia. Although pulmonary function tests and CT scan findings in conjunction with the clinical features usually suggest the diagnosis, definite confirmation usually requires either open lung biopsy or transbronchial biopsy. Histologic confirmation of the diagnosis is particularly warranted as therapy with corticosteroids is usually needed for a number of months. The prognosis is excellent with idiopathic cases but more guarded especially when COP is associated with lymphoproliferative or connective tissue disease.
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PMID:Cryptogenic organizing pneumonia. A report of 25 cases and a review of the literature. 762 55

We report a case of lung cancer producing CA19-9 and amylase. A 58-year-old woman was admitted with dry cough and right chest pain. Chest X-ray and CT showed a mass shadow in the right lung field and right pleural effusion. Histological examination of a lung specimen obtained by TBLB and cytological examination of pleural effusion showed adenocarcinoma. The diagnosis of lung adenocarcinoma was made. CA19-9 values in serum and pleural effusion were very high. Amylase value was high in pleural effusion, but that in serum was normal. The amylase isozyme pattern was salivary-type. No abnormality was detected on abdominal CT and ultrasonography. In spite of treatment of the pleural effusion, the patient's condition gradually deteriorated and she died of respiratory failure. Histological examination of lung specimens obtained at necropsy showed moderately differentiated papillary type adenocarcinoma. Immunohistochemically, the tumor cells stained positively for both CA19-9 and amylase. We conclude that the lung cancer produced both CA19-9 and amylase.
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PMID:[A case of lung cancer producing CA19-9 and amylase]. 768 38

A 51-year-old man, known to have chronic-aggressive hepatitis B, HIV infection and exertional dyspnoea, was hospitalized because of acute physical deterioration, cough with whitish exudate and dyspnoea at rest. Despite a CD4/CD8 ratio of 0.16 no prophylactic measures against Pneumocystis carinii had been taken. On examination the lungs were unremarkable, but the liver was enlarged and there were petechiae over all parts of the body. Laboratory tests showed impaired liver functions and a rise in lactate dehydrogenase activity (538 U/l). Chest radiogram demonstrated small to very small infiltrates in the lung. As Pneumocystis carinii pneumonia was suspected but bronchoscopy was too risky, he was at first treated with trimethoprim/sulphamethoxazole (four times 320/1600 mg/24 h intravenously). When this failed, he received pentamidine (4 mg/kg, after 4 days 2 mg/kg intravenously), and finally cefotiam (twice 2 g daily), tobramycin (three times 40 mg daily) and corticoids (100 mg). Despite this treatment he died after 10 days from respiratory failure. Autopsy revealed interstitial pneumonia throughout the lung as well as focal mucor infiltrations in the wall of middle-calibre lung veins. Mucor is a ubiquitous, facultatively pathogenic mold fungus.
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PMID:[Pulmonary mucormycosis in an HIV-infected patient]. 783 42

Five hundred and twenty-six cases of bacterial pneumonia in adults admitted to Chulalongkorn Hospital during the period January 1987 to December 1991 were studied, comparing the elderly aged > or = 60 years (241 cases) with the nonelderly < 60 years of age (285 cases). The study indicates that there was a significantly increased number of community and hospital-acquired pneumonia in the elderly than previously reported. Pneumonia in the elderly might present with no fever, no cough no signs of parenchymal infiltration, but significant mental changes. There was a higher incidence of pleural involvement, but lower incidence of septic shock in the non-elderly than the elderly, which suggests that the nonelderly had better systemic resistance against bacterial infection than the elderly. There was no significant difference in complete blood count between the two groups. However, sputum specimens to be collected through endotracheal tube and Gram-negative bacilli on Gram stain were found more in the elderly than the non-elderly. The elderly had more respiratory failure requiring mechanical ventilation, septic shock, and had higher mortality than the non-elderly. They also required longer duration of treatment and hospitalization. There were parameters which indicated the high-risk factors for mortality among the elderly. These included hospital-acquired pneumonia, bronchopneumonia, Gram-negative pneumonia, abnormal status of host, sputum specimens requiring collection by suction, respiratory failure and septic shock.
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PMID:Bacterial pneumonia in the elderly. 784 90

Bronchiolitis obliterans with organizing pneumonia (BOOP) is a distinct clinical pathologic syndrome. Most patients experience a good response to therapy, and death from progressive BOOP is uncommon. This report describes the clinical features, etiologic factors, pathologic findings, and outcome of 10 patients with rapidly progressive BOOP that was characterized by severe respiratory failure. The major clinical manifestations were dyspnea, cough, fever, crackles on chest examination, and hypoxemia at rest. Underlying conditions or exposures included connective-tissue disease, exposure to birds, and chronic nitrofurantoin therapy. All patients had the characteristic histopathologic findings of BOOP. However, at autopsy in six patients, the predominant histologic pattern was that of alveolar septal inflammation and fibrotic honeycombing. Seven patients died and three patients survived but had persistent pulmonary dysfunction despite aggressive care. In two patients BOOP has progressed, with severe chronic respiratory decompensation. Thus, there is a subset of patients with BOOP who present with a fulminant course leading to death or chronic severe fibrosis and marked impairment of lung function. In addition, the histologic picture of BOOP may be a manifestation of early lung injury that can resolve or progress rapidly to alveolar septal inflammation, end-stage fibrosis, and honeycombing.
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PMID:Rapidly progressive bronchiolitis obliterans with organizing pneumonia. 800 28

Accidentally occurring hydrocarbon poisoning during early childhood is a frequent and in most cases benign event. Nevertheless there is a potential risk of more serious consequences. We describe such a case. Respiratory symptoms are of the greatest concern. They include cough, tachypnoea, and in the more serious cases cyanosis and respiratory failure. Moreover, symptoms from the gastrointestinal tract are common. Treatment includes prevention of aspiration, symptomatic treatment and in more serious cases respiratory support.
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PMID:[Poisoning with petroleum preparations--again!]. 801 70

We identified eight patients (six women and two men) who had pulmonary infiltrates during treatment with minocycline hydrochloride between 1989 and 1992 in French referral centers for drug-induced pulmonary diseases. Clinical files, chest roentgenograms, computed tomographic scans, pulmonary function, and bronchoalveolar lavage data were reviewed. Minocycline treatment was given for acne (n = 4), genital infection (n = 3), and Lyme disease (n = 1). The duration of treatment averaged 13 +/- 5 days (mean +/- SE); the total dose, 2060 +/- 540 mg. Patients presented with dyspnea (n = 8), fever (n = 7), dry cough (n = 5), hemoptysis (n = 1), chest pain (n = 2), fatigue (n = 3), and rash (n = 3). Chest roentgenograms showed bilateral infiltrates in all cases. Pulmonary function was measured in five patients; four had airflow obstruction and two had mild restriction. Blood gas tests demonstrated hypoxemia in seven patients (58 +/- 3 mmHg). Seven patients had blood eosinophilia (1.76 +/- 0.2 x 10(9)/L). Bronchoalveolar lavage (performed in seven patients) showed an increased proportion of eosinophils (0.30 +/- 0.07). The Cd4+/CD8+ ratio was determined in four cases and was low in three. Transbronchial lung biopsy, performed in two patients, showed interstitial pneumonitis in both patients, with marked infiltration by eosinophils in one patient. The outcome was favorable in all patients. Because of severe symptoms, steroid therapy was required in three patients. Rechallenge was not attempted. We conclude that minocycline can induce the syndrome of pulmonary infiltrates and eosinophilia, that presenting symptoms may be severe and may culminate in transient respiratory failure, and that the disease has a favorable prognosis.
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PMID:Minocycline pneumonitis and eosinophilia. A report on eight patients. 803 Dec 12

An 8-year-old girl was admitted because of high fever and cough for seven days. The physical examination on admission revealed diffuse moist rales over the left lung field. Her high fever persisted, and she subsequently developed hepatosplenomegaly, lymphadenopathy, skin rashes, subconjunctival hemorrhage, diffuse pulmonary infiltrates, abnormal liver function, anemia, thrombocytopenia, leukocytosis, and hypoalbuminemia. A bone marrow study revealed increased numbers of macrophages with apparent hemophagocytosis. She developed respiratory failure and required artificial ventilation, but finally died despite resuscitative efforts. Serology for EB virus initially revealed negative findings, but on the 24th day after admission, showed IgG antibody to viral capsid antigen 320x (+), and IgM antibody to viral capsid antigen (+). This is a very unusual case of fatal EB virus pneumonia associated with hemophagocytic syndrome.
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PMID:Epstein-Barr virus pneumonia associated with hemophagocytic syndrome: report of one case. 808 55


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