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

Details are given of all serologically confirmed Mycoplasma pneumoniae infections in children referred to Bristol hospitals during an epidemic lasting 18 months. 44 children, many below school age, had lower respiratory infections. The majority had cough and malaise which had failed to respond to antibiotics given before referral. Chest x-rays showed no pathognomonic features: segmental or patchy consolidation was common; 3 cases of lobar consolidation. Cold agglutinins were raised in 9 out of 12 cases. In the majority of cases the total leucocyte count was normal and the absolute neutrophil count raised. Mean duration of symptoms was 4.2 weeks (range 1-16). Treatment with erythromycin or tetracycline appeared to have little effect in most cases. Seven nonrespiratory manifestations were seen in 6 children. These were meningitis (2 cases), Stevens-Johnson syndrome (4 cases, 1 case complicated by toxic epidermal necrolysis), and acute haemolytic anaemia (1 case).
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PMID:Mycoplasma pneumoniae infections in children. 62 17

Twenty-four cases of Legionnaires' disease were diagnosed at the Wadsworth Veterans Administration Hospital during a 5-month period. All cases occurred in persons exposed to the hospital environment during the usual incubation period of Legionnaires' disease. The clinical illness was quite characteristic. All patients complained of weakness, malaise, anorexia, and cough. Rigors, diarrhea, and pleuritic pain were frequent symptoms. All patients had a maximum temperature of greater than or equal to 39.4 degrees C. Thirteen of 22 patients had relative bradycardia. Chest roentgenograms documented pneumonia in all patients. Leukocytosis, hyponatremia, hypophosphatemia, and abnormal liver-function test results were typical. Diagnosis was made by serologic criteria in 20 patients, postmortem examination of tissue in two, and both serology and tissue examination in two. Four patients in whom the disease was not suspected died of Legionnaires' disease. One patient died of unrelated causes. Fifteen of 19 survivors received erythromycin therapy. The presentation of Legionnaires' disease was characteristic enough to allow early, specific therapy.
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PMID:Legionnaires' disease: clinical features of 24 cases. 68 39

In addition to asking their patients about recent foreign travel, Canadian doctors need to be aware of what features to ask about in considering imported illnesses. Of these illnesses, malaria is one of the most common and serious. Because of its cerebral renal, pulmonary and intestinal complications, falciparum malaria must be distinguished from non-falciparum forms. Anyone with a fever who has arrived recently from an endemic area should be tested for malaria. In addition, headache, malaise, myalgias, arthralgias, low back pain, nausea, vomiting, diarrhea or cough should raise suspicion. Malaria should be remembered as a cause of coma. Persons taking any form of drug prophylaxis for malaria are not protected absolutely and those who are semi-immune can become severely ill occasionally.
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PMID:Symptoms and signs of malaria. 78 78

Chronic pulmonary histoplasmosis is best regarded as an opportunist or saprophytic infection of abnormal pulmonary spaces by a fungus of very low human pathogenicity. Tissue disease results from host immune response to dispersions of soluble antigen from these focal sources. There are two distinct types of clinical and radiological response. One is an acute or subacute illness manifested by often large segmental pneumonic lesions which tend to heal and are designated as early lesions. The other, usually developing as a complication of the first, is a chronic disease marked by persistent cavitation, low gard chronic illness, and a tendency to promote pulmonary fibrosis and often progressive pulmonary insufficiency. The early lesion is a segmental interstitial pneumonitis with central areas of infarct-like necrosis often adjacent to bullous disease and often outlining prominent emphysematous spaces which appear as radiolucencies. These radiological findings are further characterized by early clearing of the interstitial components, infarct-like contraction of the necrotic zones, obliteration of much of the contained emphysematous and bullous spaces, and healing attended by considerable loss of lung volume. Symptoms are variable but tend to be mild. Malaise, fatigability, low-grade fever, aching chest pain and mild cough lasting a few days to a few weeks are usual. Symptoms are ameliorated by rest. Rest and diminished activity are recommended as treatment. Under these circumstances, 80% of early lesions heal completely and probably most of these would heal spontaneously. Any subsequent course of the disease depends on whether or nor large air spaces, adjacent to or contained within the area of pneumonitis, become infected and persist as cavities. This occurs in 20% of early lesions. Once established, an infected cavity tends to persist and to be attended by symptoms of chronic bronchitis with chronic cough and sputum, fatigability, anorexia, and weight loss. Persisting thickwalled cavities often induce gradual development of pulmonary fibrosis, particulary in the lung bases, apparently from aspiration of antigenic material. This and the accelerated obstructive bronchopulmonary disease often lead to progressive pulmonary insufficiency. The use of amphotericin B is recommended for all persistent thick-walled cavities and in some circumstances surgical resection may be indicated.
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PMID:Chronic pulmonary histoplasmosis. 79 26

During the winter months 1974/75 we were able to observe a number of unusual respiratory tract infections particularly in children over 6 years of age which appeared as pneumonias. Characteristic clinical findings included a dry, hacky cough, refractive to the usual antitussives, starting 1--2 weeks prior to admission, fever up to 104, malaise, headache, anorexia, shortness of breath and cyanosis. Several Pts were treated prior to admission with a number of antibiotics and failed to respond. Laboratory findings showed a peripheral polymorphonuclear leucocytosis with toxic granulations of neutrophiles. A sedimentation rate above 40 in the first hour occurred in most Pts. X Ray of the lung revealed a characteristic mottled appearance with patchy infiltrations, atelectasis and nodular densities. Frequently a shift of the mediastinum towards the infiltrate was seen. One of the hallmarks on physical examination was the discrepancy between the severity of the clinical illness and the paucity of physical findings. Decreased breath sounds over affected lung areas were often the only findings on auscultation; find rales, rhonchi or dullness on percussion were less often heard. The combination of a typical history, physical examination, laboratory tests and X Ray findings enabled us to make a presumptive clinical diagnosis of Mycoplasma pneumonia before serologic test results were available and to start with the appropriate antibiotic (Erythromycin, Tetracycline) early in the course of the disease. Complement fixation tests with a titer of 1 : 20 and a fourfold rise over the next two weeks or an initial titer of 1 : 80 and above were considered significant for acute disease.
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PMID:[Mycoplasma pneumonias in childhood (author's transl)]. 83 54

Eighteen patients showing hypersensitivity to nitrofurantoin with symptoms like sudden fever, malaise, cough, pleuritis, leucocytosis and sometimes eosinophilia were analysed for immune reactions, i.e. lymphocyte transformation and specific antibodies. In addition, thirty-three individuals treated with the drug but with no clinical signs of the described reactions were included as controls. The lymphocyte transformation test (LTT) was found positive in ten out of the eighteen sensitive patients while one to three out of fourteen tested control patients were positive, depending on test conditions. An incubation period of 4 days in culture medium supplemented with autologous serum gave stimulation to a greater extent than did isologous serum and/or incubation for 6 days. The antibody determinations, with the enzyme-linked immunosorbent assay (ELISA), showed no IgE antibodies to nitrofurantoin in any of the patients. In contrast, most of the hypersensitive and even the control patients had specific IgG antibodies. The mean value of the antibodies of the sensitive group was higher than of the control group, but considerable overlapping between the groups was noted. In adverse reactions to nitrofurantoin a positive LTT and/or a high antibody titre to the drug favours an allergic mechanism and contributes to a more reliable diagnosis.
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PMID:Adverse reactions to nitrofurantoin in relation to cellular and humoral immune responses. 89 Oct 20

Daily saunas taken by a young man were followed by fever, chills, malaise, dyspnea, cough, and myalgia from six to eight hours later. Symptoms, which were related to pouring water from a sauna bucket over the heating element, progressed to chronic dyspnea and fatigue. Serial serum samples showed precipitin reactions to bucket water and extracts of bucket mold. IgG antibody activity, demonstrated by radioimmunoassay, suggested that Pullularia was a major antigen.
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PMID:Sauna-takers disease. Hypersensitivity pneumonitis due to contaminated water in a home sauna. 98 16

Hypersensitivity pneumonitis due to the inhalation of Shiitake mushroom spores was demonstrated in a 38-year-old woman. Symptoms of cough, nausea and malaise, and clinical findings of cyanosis, bibasilar crackles, reduced lung volumes, hypoxemia, leukocytosis, elevated ESR, positive C-reactive protein, and bilateral diffuse reticulonodular shadows on chest roentgenogram improved after the patient was removed from exposure. Alveolitis was demonstrated by transbronchial lung biopsy, as well as an increase in lymphocytes in bronchoalveolar lavage. Serum precipitins and specific IgG antibodies to an extract of Shiitake mushroom spores, but not to other common molds or mushroom body, were detected in serum. Provocative inhalation test with the extract of mushroom spores caused the same clinical symptoms and signs as experienced in the workroom. This is the first report of typical hypersensitivity pneumonitis induced by Shiitake mushroom spores. Mushroom spores as well as thermophilic actinomycetes must be considered a causative agents for mushroom worker's lung.
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PMID:Hypersensitivity pneumonitis induced by Shiitake mushroom spores. 128 27

An antiviral agent and two antiinflammatory compounds were used in a blinded, placebo-controlled study to treat experimental rhinovirus colds. Intranasal interferon-alpha 2b and ipratropium and oral naproxen were begun 24 h after rhinovirus inoculation. Treatment was continued three times a day for 4 days. Viral shedding (mean +/- SE) was 4.4 +/- 0.3 days for controls and 2.9 +/- 0.3 days for treated volunteers (P less than .003). Geometric mean virus titers were reduced in the treated group on all days (P = .02-.06). Serum antibody responses and postinfection geometric mean antibody titers were similar in both groups (P greater than .1). Colds developed in 6 of 16 treated and 7 of 8 control subjects (P = .05). Mean total symptom scores (P = .055), rhinorrhea (P less than .01), cough (P less than .01), and malaise (P less than .001) were reduced in treated subjects. Trends in reduction of nasal obstruction and sore throat also favored the treated group. Nasal secretion weights were 12.9 +/- 4.8 g in treated and 20.3 +/- 5.4 g in control subjects (P = .4). Medications were was tolerated.
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PMID:Combined antiviral and antimediator treatment of rhinovirus colds. 132 82

Complement evaluation was performed in two patients with active eosinophilic pneumonia and in one in remission, to determine the role of complement activation in the pathogenesis of this disorder. All three had cough, dyspnea, malaise, and blood eosinophilia; two patients also had pyrexia. In all 3 cases the pulmonary eosinophilic infiltrates (radiographic findings) and symptoms responded rapidly to steroid administration. The two patients with active eosinophilic pneumonia showed elevated CR3 but reduced FcrR on the PMN before and during steroid administration. In contrast PMN from four patients with bronchial asthma exhibited slightly elevated expression of both CR3 and FcrR during their asthma attack. It is suggested that clinical symptoms disappear soon after the beginning of steroid but changes of complement receptors on PMN may last for longer periods. On the basis of the combined results, this study indicates that estimation of complement activation may provide a useful indicator for disease activity in patients with eosinophilic pneumonia of unknown etiology.
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PMID:Evaluation of complement in patients with eosinophilic pneumonia. 138 33


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