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)

Mycoplasma pneumoniae-associated mucositis is a rarely described complication of M. pneumoniae infection presenting with ocular, oral, and genital involvement but without the typical skin lesions seen in Stevens-Johnson syndrome. A 27-year-old man with a past history of asthma presented at the emergency room with a 1-week history of cough (initially non-productive but subsequently associated with non-bloody mucopurulent sputum), fever, myalgias, headache, and progressive dyspnea. Two days before admission he had commenced amoxicillin/clavulanic acid with no improvement. The patient reported bilateral conjunctival injection and hemorrhagic ulcers on the lips commencing the day prior to admission. Physical examination revealed fever (39 degrees C), bilateral exudative conjunctivitis, painful hemorrhagic ulcers on the lips, tongue, and oral mucosa, small scrotal erosions, erythema of the penile meatus, and small erythematous bullae on the dorsum of each hand; subsequently, the patient developed bullae at the venipuncture site on his right arm. Laboratory tests revealed positive IgM serology for M. pneumoniae, with titer elevation. The patient was successfully treated with levofloxacin and prednisolone. Our case appears to be the first adult patient described with M. pneumoniae-associated mucositis, which has previously been reported only in pediatric patients. This is also the first reported instance of a case of M. pneumoniae-associated mucositis treated with levofloxacin and prednisolone. M. pneumoniae infection should be considered in all cases of mucositis, and treatment of this condition with levofloxacin and prednisolone seems to be effective.
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PMID:Mycoplasma pneumoniae-associated mucositis with minimal skin manifestations. 1897 8

Amyopathic dermatomyositis (ADM) is a clinical subtype of dermatomyositis, characterized by the absence of motor weakness and the presence of normal muscle enzyme levels. ADM is sometimes accompanied by neoplasm or interstitial pneumonia that shows a rapid progressive course both of them are associated with a poor prognosis. A 56-year-old woman with no medical history was referred to the department of medicine because of arthralgia with a remarkable weight loss. She also complained of rapidly progressive dyspnea, cough and photosensitivity. Physical examination on admission showed scaly erythema on the dorsum of the hands (Gottron sign) and periorbital edema with a purplish appearance (heliotropic rash), arthritis, but no muscle weakness. Auscultation of the chest identified audible fine crackles on the lower aspects of both lungs. Results of laboratory findings on admission revealed a lymphopenia. The serum creatine kinase and serum lactate dehydrogenase concentration were normal. IRM muscle and electromyography were normal. Antinuclear antibody was positive 1:80 and anti-Jo-1 antibody and other autoantibodies to specific antigens were all negative. High resolution computed tomographic chest scans also revealed diffuse ground-glass opacities in both lungs with basilar predominance. Arterial blood gas analysis revealed hypoxia and hypocapnia. LBA was not performed because of the deterioration of respiratory symptoms. There was no neoplasm associated. The diagnosis of ADM complicated with ADM rapidly progressive interstitial pneumonia was made. Despite of IV methylprednisolone pulse therapy (1g*day-1 for 3 days) and cyclophosphamide, she died by respiratory failure.
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PMID:[Interstitial pneumonia complicating amyopathic dermatomyositis: a case report]. 1999 56

Butterfly rash is characterized by symmetrical erythema and erythematous papules and plaques grouped on the bilateral cheeks and nose, commonly found in lupus erythematosus. Measles is a highly contagious viral disease, characterized by high fever, cough, coryza, conjunctivitis, and Koplik spots, which precede generalized maculo-papular rashes. We report an adult case of measles, accompanied by butterfly rash. A 20-year-old woman came to our hospital with a butterfly rash-like eruption on the face, high fever, and arthralgia. The eruption had appeared on the nose and both cheeks three days before admission. The oral mucosa was not involved. On the basis of the three criteria for a diagnosis of lupus eruthematosus, we first made a tentative diagnosis of lupus eruthematosus and performed blood tests. However, anti-DNA antibodies, scl-70, anti-Ro and La, anti-Sm and rheumatoid factor were all negative. Two days after admission, a Koplik macule appeared along with multiple erythematous macules and papules that were scattered through the trunk. Laboratory tests were positive for anti-measles immunoglobulin M and G. Therefore, we reached a diagnosis of measles. Within a week, all of the clinical symptoms disappeared. Physicians should be aware that, in rare cases, measles may present with a butterfly-like rash.
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PMID:Letter: Adult measles with a butterfly rash-like appearance. 2023 73

We report a complication of the novel H1N1 influenza A viral infection not yet described during this 2007-2009 pandemic. Pulmonary hemorrhage is a known complication of influenza pneumonia, including well documented reports from previous pandemics. A 57-year-old African American female presented with fevers, progressive shortness of breath, and cough. After being admitted with an initial diagnosis of myocardial infarction, hemoptysis developed. Nasopharyngeal swabs rapid testing was negative for influenza A and B antigen, but a polymerase chain reaction test for influenza A type H1N1 was positive. A fiberoptic bronchoscopy for ongoing hemoptysis demonstrated diffuse erythema and bleeding, and bronchoalveolar lavage was consistent with alveolar hemorrhage. Progressive hypoxemic respiratory failure ensued, eventually leading to her demise. Our case highlights one of the more feared complications that may have been more common in prior outbreaks, such as the 1918 "Spanish Flu." Autopsy studies from the 1918 influenza pandemic found severe tracheobronchitis (oftentimes hemorrhagic), septal edema, necrotizing bronchiolitis, alveolitis, and extensive hemorrhage, as opposed to the more benign laryngitis and tracheobronchitis that is commonplace in other influenza infections. Similar pathology appearances, including pulmonary hemorrhage, have also been described in H5N1 outbreaks in China and Thailand. It is crucial for pandemic preparedness planning that additional careful and complete autopsy study of this present pandemic influenza infection be performed and reported to answer questions regarding the natural history, pathology, and pathogenesis of this novel H1N1 influenza.
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PMID:Novel H1N1 influenza A viral infection complicated by alveolar hemorrhage. 2042 Jul 34

Lyme disease which is caused by the spirochete Borrelia burgdorferi, is a multisystemic disease that involves skin, joints, cardiovascular and central nervous system, leading to chronic inflammatory response and late complications. First lyme cases have been reported after 1990's in Turkey and the spirochete was isolated from the tick vectors. In this case series three human Lyme cases confirmed with not only serological tests but also growth in Barbour-Stoenner-Kelly medium were presented for the first time in Turkey. Two of these three cases were residents in Istanbul while the third one has acquired the infection in USA (imported case). First case was a previously healthy 46 years old male, admitted to the state hospital with the complaints of diarrheae, chills, nausea, vomiting, cough, sputum production and widespread myalgias. The patient was a chronic alcohol consumer with a history of frequent visits to the forest areas. The laboratory test results revealed hepatonephritis-like clinical picture and pulmonary involvement. Leptospira IgM and Borrelia IgM antibodies were detected in the serum by ELISA and both of the agents were isolated in the blood cultures of the patient. This case was then diagnosed as Lyme disease with leptospirosis co-infection. The second case was a 32 years old female who suffered from Bell's palsy for the last 15 days. Cranial magnetic resonance imaging showed a nodular lesion at globus pallidus. Since the patient had a history of tick-bite, further testing was done for Lyme disease. Borrelia IgM and IgG antibodies were found negative, however, Borrelia was isolated from the cerebrospinal fluid sample. The third patient was a 68 years old female who had recently travelled to USA and exposed to a tick-bite in a recreational area. She suffered from nausea, vomiting, myalgia and cutaneous lesions compatible with erythema chronicum migrans. Samples taken from the skin lesions revealed growth of Borrelia. As far as the current literature is concerned, these were the first three culture proven cases of Borrelia in Turkey. These three cases supported the presence of Lyme disease in Turkey and indicated that the disease could present itself in various clinical pictures.
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PMID:[First report of three culture confirmed human Lyme cases in Turkey]. 2045 10

Laryngopharyngeal reflux (LPR) is associated with symptoms of laryngeal irritation such as throat pain, cough, and voice change. Currently, the two main diagnostic tools are laryngoscopy and reflux monitoring. On laryngoscopy, the signs most commonly used to diagnose LPR are erythema and edema of the larynx; however, these signs are not specific for LPR, may be associated with other causes, and may even be found in healthy individuals. In addition, pH testing has low sensitivity in diagnosing gastroesophageal reflux disease-related laryngeal findings. Proton pump inhibitor (PPI) therapy remains the cornerstone of treatment. The current management recommendation for this group of patients is empiric therapy with twice-daily PPIs for 1 to 2 months. In the majority of those who are unresponsive to such therapy, other causes of laryngeal irritation are considered. Surgical fundoplication is most effective in those who are responsive to acid-suppressive therapy.
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PMID:Evaluation of patients with suspected laryngopharyngeal reflux: a practical approach. 2136 69

A 28-year-old woman presented with reddish raised, shiny lesions over the face and ears present for the past 3 years. Four years ago, she developed in her left axilla a nodule that became fluctuant and tender, which ruptured to discharge seropurulent material. It subsided after the patient had received antibiotics for 6 months, leaving puckered scarring. There was no history of antituberculous treatment. After 1 year, she developed papulonodular lesions on her face, nose, and ears. There was now a history of malaise, fever, dry cough, and anorexia and weight loss for the past 2 months. The patient was fully vaccinated in childhood, including against varicella infection. The general physical examination revealed lymphadenopathy involving cervical, axillary, and inguinal lymph nodes 0.5 x 0.5 cm to 1 x 1.5 cm, firm in consistency, and nontender. They were discrete except in the left axilla where multiple matted lymph nodes were present with overlying scarring and a papule. Her systemic examination was normal. Cutaneous examination showed a shiny erythematous plaque 3x2 cm with central atrophy and scarring on the face (Figure). It was comprised of multiple shiny nontender soft papules arranged in annular configuration. Similar discrete papules and nodules with adherent fine scaling were seen bilaterally on the alar prominence of the nose, lower lip, and post-auricular area. On diascopy, apple jelly nodules were seen. The hemogram, liver function tests, and renal function tests were normal, except for an elevated erythrocyte sedimentation rate. The Mantoux test showed erythema and an induration of 20 x 20 cm. A posteroanterior view on the chest x-ray showed fibrotic changes suggestive of pulmonary tuberculosis. Ultrasonography of the abdomen and pelvis showed no tubercular foci. Human immunodeficiency virus serology by enzyme-linked immunosorbent assay with 3 different kits was nonreactive. Histopathology from a nodule showed a focally thinned-out epidermis with follicular plugging and multiple epithelioid cell granulomas, rimmed by lymphocytes in the deeper portion of the dermis, mainly peri-appendageal. Stain for acid-fast bacteria was negative. Cultures from the skin lesions were negative. The patient was diagnosed as having lupus vulgaris with multiple lesions of varying morphology at different sites with pulmonary tuberculosis and healed lymph node involvement.
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PMID:Disseminated lupus vulgaris. 2154 22

Introduction. The objective was to evaluate the toxicity of poisoning by metam sodium, a dithiocarbamate fumigant, the breakdown products of which are methyl isothiocyanate (MITC), carbon disulphide (CS2), and dihydrogen sulphide (H2S). Methods. This is a retrospective, observational case series of metam sodium exposure cases reported to the Angers Poison and Toxicovigilance Centre from 1992 through 2009. Results. A total of 106 cases of metam sodium exposure were recorded and 102 cases were included in this study. All cases of exposure were unintentional. Occupational poisoning occurred in eight cases. The most common route of exposure was inhalation (n = 96). In 79 cases, the patients were people living near fields where metam sodium had recently been applied. Most of the reported symptoms involved irritation of the eyes (n = 76), throat and nose (n = 65), attributable to MITC. Cough and dyspnoea occurred in four cases but no persistent, irritant-induced asthma or persistent exacerbation of asthma was observed. Sixteen patients at two different sites of pollution were exposed to emanations from the drainage system in their homes following the illicit discharge of metam sodium into the sewers. Most presented with nausea and headaches, but only four experienced eye or throat irritation. A breakdown product other than MITC was involved: air analysis at one site revealed the presence of CS2 (337 mg/m(3)) and no H2S. Two of these patients, who had consumed some alcohol, experienced dysgeusia but no disulfiram-like reaction. The only lethal case recorded was a truck driver who was found dead of acute lung injury after falling into a tank that had previously contained metam sodium. Two patients who ingested a dilute solution, presented with mild epigastric pain. Four skin exposures caused erythema (n = 2), moderate burns (n = 1), and urticaria (n = 1). According to the poisoning severity score, their symptoms were minor in 99% of cases. Conclusion. Acute metam sodium exposure usually causes minor symptoms. They vary as a function of the circumstances of exposure, which determine the degradation product that forms. On contact with moist soil, metam sodium decomposes into MITC and causes irritant symptoms. Under specific conditions, such as a spillage in the drainage system, metam sodium can degrade into CS2 and cause neurological signs.
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PMID:Metam sodium intoxication: the specific role of degradation products--methyl isothiocyanate and carbon disulphide--as a function of exposure. 2174 Jan 40

Pertussis is a rare condition in adults. This report describes a 65-year-old man presenting to the otolaryngology service with hoarseness secondary to pertussis. He had a history of worsening cough and hoarseness occurring over several weeks. Laryngoscopy showed significant erythema at the medial edges of the vocal folds. Stroboscopy demonstrated bilateral decreased amplitude and decreased mucosal wave of the vocal folds. Polymerase chain reaction testing of the sputum revealed Bordetella pertussis. The patient was started on azithromycin, and he reported gradual resolution of the chest and laryngeal symptoms over the next few months. Pertussis, or whooping cough, is not common in the United States because of childhood vaccination protocols. Nevertheless, otolaryngologists need to be aware of this condition as a possible cause of hoarseness.
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PMID:Pertussis presenting as hoarseness in an adult. 2235 41

Stevens-Johnson syndrome (SJS) is an uncommon occurrence in Mycoplasma pneumoniae (M. pneumoniae) infection (1-5%) and has been mainly reported in children and young adults. We present a case of SJS in a 32-year-old male induced by M. pneumoniae infection. This patient presented with fever, cough, and massive occupation of mucus membranes with swelling, erythema, and necrosis accompanied by a generalized cutaneous rash. He clinically responded after treatment with antibiotics and IVIG. SJS is usually a drug-induced condition; however, M. pneumoniae is the commonest infectious cause and should be considered in the differential diagnosis.
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PMID:Mycoplasma pneumoniae-Induced-Stevens Johnson Syndrome: Rare Occurrence in an Adult Patient. 2295 78


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