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)

Cryptococcus neoformans is emerging as an important etiologic agent of disseminated infection in patients with the acquired immunodeficiency syndrome (AIDS). Little attention has been placed on the pulmonary expression of this systemic infection. We report five patients with AIDS and cryptococcosis with primary pulmonary involvement. Patients usually presented with fever, cough, dyspnea, and pleuritic chest pain. Chest x-ray findings varied from localized and diffuse infiltration to lymphadenopathy and pleural effusions. All patients developed disseminated disease despite antifungal therapy. Pulmonary cryptococcosis is a frequent presentation of this infection in patients with AIDS.
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PMID:Pulmonary cryptococcosis in AIDS. 330 48

Of the Legionellaceae family, Pittsburgh pneumonia agent (Tatlockia micdadei, Legionella micdadei) is second only to Legionella pneumophila in causing human pneumonia. In nosocomial infection, the patients tend to be immunosuppressed. The clinical presentation is nonspecific, although in immunosuppressed hosts the presentation may mimic that of pulmonary embolus (pleuritic chest pain, nonproductive cough, pleural-based densities on chest rontgenogram). The reservoir for the organism is water, and prevention of nosocomial infections can be accomplished by disinfection of the water supply. Diagnosis is best established by isolation of the organism from respiratory secretions by using selective, dye-containing buffered charcoal-yeast extract agar. The organisms can be acid-fast when clinical specimens are stained. Erythromycin is the antibiotic of choice, although tetracyclines, trimethoprim-sulfamethoxazole, and rifampin have also proved to be efficacious.
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PMID:Infections caused by the Pittsburgh pneumonia agent. 332 96

Fourteen patients in whom air-fluid levels developed in pre-existing emphysematous bullae were prospectively identified and followed. Although two patients were asymptomatic, 12 patients presented with one or more symptoms of fever, dyspnea, cough, pleuritic chest pain, and/or purulent sputum. Three patients had focal pulmonary abnormalities on physical examination; three patients had elevated leukocyte counts. Exudative fluid with an elevated leukocyte count was aspirated from the bullae of two patients; one aspirate grew Bacteroides melaninogenicus on culture. Bronchoscopy in seven patients influenced neither the diagnosis nor therapy. Thirteen patients received either oral penicillin (11 patients) or oral tetracycline (two patients). Complete resolution of symptoms and air-fluid levels on chest roentgenography occurred in all patients over two to 32 weeks (mean, 12).
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PMID:Lung bullae with air-fluid levels. 356 32

Chest pain is a relatively common complaint in adolescents and is most often attributed to anxiety or musculoskeletal conditions. Pleuritic chest pain in association with fever and cough are frequently reported in adults with primary pulmonary coccidioidomycosis. We describe three cases in which chest pain mimicking costochondritis was the predominant initial presenting symptom of pulmonary coccidioidomycosis. In addition, in each case, recent tuberculin skin test reactivity complicated the diagnostic assessment and treatment. We conclude that, in endemic areas, coccidioidomycosis should be considered in the differential diagnosis of acute chest pain in teenagers as well as in adults.
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PMID:Coccidioidomycosis in adolescents presenting as chest pain. 361 Jul 43

Epidemics of pulmonary blastomycosis have rarely been reported. The following epidemic occurred in a Minnesota family and several of their acquaintances after a canoeing trip in northwestern Wisconsin. The common exposure area was most likely a campsite, located along the upper reaches of the Namekagon River. The Namekagon River Valley is a known endemic area of Namekagon fever (blastomycosis) in dogs. Approximately one month after returning home, five of the eight members of the group had positive direct microscopic examinations and cultures of Blastomyces dermatitidis from their sputa, as well as abnormalities on their chest roentgenograms. Among these five patients, four were symptomatic, with fever, cough, and pleuritic chest pain. Of the three others, one had pleuritic chest pain with a transient lung infiltrate, the second was asymptomatic with a transient lung infiltrate, and the third was asymptomatic with a normal chest roentgenogram. Results of acute serologic tests (complement fixation and immunodiffusion) were negative in all five patients evaluated. None of the patients received antifungal therapy. Follow-up five years after the epidemic revealed that all eight were in excellent health, and none had evidence of continuing pulmonary or extrapulmonary disease.
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PMID:Epidemic of pulmonary blastomycosis (Namekagon fever) in Wisconsin canoeists. 648 3

Two cases of pleuritis by radiation, diagnosed by cytology studies of the pleural fluid, are reported. The clinical picture was that of a respiratory infection, with nonproductive cough and pleuritic chest pain. Chest x-ray studies showed a small pleural effusion that was confirmed by a thorax puncture. The aspirated fluid was hemorrhagic, and Papanicolaou studies were negative for tumor cells. However, multiple reactive mesothelial cells with vacuole formation within the cytoplasm and nuclei were seen. The differential diagnosis of pleuritis by radiation should include infectious pleuritis as well as pleural metastasis. A history of previous radiation and the typical findings in cytologic studies are important to confirm the diagnosis.
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PMID:Pleuritis by radiation: reports of two cases. 694 10

Meigs' syndrome is a rare entity in women under age 30 years. It is characterized by a benign fibrous ovarian tumor, ascites, and hydrothorax. Complete resolution of symptoms occurs with removal of the tumor. The case of a 20-year-old woman with a fibroma and dermoid cyst is presented and the literature reviewed. The etiology of the fluid accumulations remains unclear, although it appears to be related to lymphatic obstruction. Presenting symptoms may include abdominal distension and pain, menstrual irregularities, cough, pleuritic chest pain, and weight gain. Meigs' syndrome and pseudo-Meigs' syndrome should be included in the different diagnosis in young women presenting with a pleural effusion. Resolution of the fluid accumulation usually occurs within 2 weeks of tumor removal.
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PMID:Meigs' syndrome in a young woman. 733 35

Mycobacterium xenopi infections have rarely been reported among patients infected with the human immunodeficiency virus (HIV). We recently treated two HIV-infected men, neither of whom had a history of pulmonary disease or AIDS-defining conditions, and who had M. xenopi lung infections. Both patients presented with night sweats, cough, and pleuritic chest pain. Chest radiographs showed an upper-lobe nodule in the first patient and a perihilar cavitary infiltrate in the second patient. Both patients were initially believed to have pulmonary tuberculosis and were treated accordingly; however, only M. xenopi grew on cultures of multiple respiratory specimens. This diagnosis was confirmed by cultures of biopsied lung tissue from the first patient and of fluid from a peritracheal abscess in the second patient. Both patients' clinical conditions improved after multidrug therapy (isoniazid, rifampin, pyrazinamide, ethambutol, and ciprofloxacin in the first case; isoniazid, rifampin, and pyrazinamide in the second case). The second patient's condition improved despite in vitro resistance of his isolate to isoniazid and rifampin.
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PMID:Mycobacterium xenopi infection masquerading as pulmonary tuberculosis in two patients infected with the human immunodeficiency virus. 762 33

A 39-year-old housewife who underwent intramammary injections of a proprietary silicone fluid mixture showed clinical and novel transbronchial lung biopsy (TBLB) findings. She presented with complaints of progressive dyspnea, dry cough, and pleuritic chest pain 2 days after the last silicone injections. The chest X-ray and CT scan showed diffuse interstitial infiltrates. TBLB demonstrated translucent, presumably silicone globules embolized within the pulmonary capillaries. The documentation of intramammary injections, the clinical and radiographic features of acute pneumonitis, and the histopathologic evidence by TBLB, may support the causal relationship between illicit injections and the silicone embolism. We discuss the pathogenesis and urge that this potentially toxic source of pulmonary embolism be removed.
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PMID:Acute pneumonitis presumed to be silicone embolism. 780 15

We studied 196 patients with suspicion of pulmonary embolism (PE) to evaluate the role of clinical pattern, with special reference to gender and age, in raising the suspicion. Results are that clinical and instrumental patterns, although not specific for PE, may show highly frequent symptoms and signs such as dyspnea (52%), chest pain (60%), enlargement of descending pulmonary artery (49%), diaphragmatic elevation (41%), enlargement of azygos vein (46%) and hypoxia (mean value 68 +/- 13 mm Hg) that allow to suspect PE in most patients and, therefore, to recruit more patients for diagnosis. Moreover, this study shows that gender and age may only partially influence the possibility of raising the suspicion of PE. Indeed, only hemoptysis is significantly (p < 0.02) more frequent in males; only pleuritic chest pain is significantly (p < 0.02) more frequent in youngs; few instrumental findings, such as 'sausage-like' descending pulmonary artery (p < 0.001), enlargement of cardiac shadow (p < 0.01), and hypoxia (p > 0.03) are significantly more frequent in elderly patients. Finally, a characteristic clinical and instrumental pattern of PE may allow to select a subset of patients at higher risk; in fact, previous PE, prolonged immobilization (p < 0.01) and thrombophlebitis (p < 0.001), sudden dyspnea and cough (p < 0.05), 'sausage-like' descending pulmonary artery (p < 0.001), diaphragm elevation (p < 0.02), enlargement of heart shadow, pulmonary infarction and Westermark sign (p < 0.001), S-T segment depression (p < 0.001), and hypoxia (p < 0.001) are findings significantly more frequent in patients with confirmed PE.
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PMID:Gender, age and clinical signs in patients suspected of pulmonary embolism. 817 65


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