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

Sixty-two cases of disseminated tuberculosis seen over a 6-year period in a large teaching hospital are reviewed. The commonest symptoms were cough, loss of weight and appetite, fever and general malaise. Headache, when present, was highly specific for meningeal involvement. Pyrexia, hepatomegaly, evidence of weight loss and adventitious chest sounds were the commonest physical signs. Hyponatraemia, hypo-albuminaemia and abnormal liver function were common. Severe haematological abnormalities were not present in any of the patients. The best diagnostic sources were sputum, bronchial brushings and biopsies of liver and bone marrow. Forty patients (64%) died, 31 deaths being directly attributable to disseminated tuberculosis. Twenty-five patients had associated diseases. More female patients and Black patients died than did males, Whites or Coloureds (mixed race). The duration of symptoms prior to admission was, in general, long in comparison with the interval between admission and death. We should like to re-emphasize the need to consider disseminated tuberculosis early in the differential diagnosis of a wasting pyrexial illness with chest symptoms and signs, even in the absence of a miliary or miliary-like chest radiograph.
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PMID:Disseminated tuberculosis. A study of 62 cases. 744 85

Disseminated toxoplasmosis in AIDS is a rare condition. We present an unusual case of a fulminant form of disseminated toxoplasmosis in a young male homosexual. He was a 30-year-old HIV-positive (diagnosed 4 months earlier), admitted with a 5-day history of diarrhea, vomiting, fever, and cough. He had been generally healthy except for an 8-week history of weight loss and malaise. On admission, except for a temperature of 37.6 degrees C, the physical examination was normal. He was treated symptomatically. Four days after admission he suddenly became short of breath. Despite intensive management, he continued to deteriorate and expired 6 h later. Postmortem examination revealed disseminated toxoplasmosis involving the heart, lungs, brain, stomach, small intestine, and colon. This is an unusual presentation of disseminated toxoplasmosis because of its rapid course with no prior indication of infection. To our knowledge, such an atypical and rapid downhill course of toxoplasmosis (with minimal clinical and laboratory features) has not been reported previously. Increased awareness of this infection in all HIV patients and its possibly rapid course is needed.
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PMID:Fulminant disseminated toxoplasmosis in an HIV patient. 766 88

Histoplasmosis is known to be endemic in various parts of the world, especially in North and Latin America. In Japan, Histoplasma capsulatum has rarely been isolated from the natural environment. To date, only seven cases of histoplasmosis have been reported in Japan including some that were contracted in foreign countries. Herein, we report the occurrence of acute histoplasmosis among Japanese travelers who were exposed to bat guano in a cave near Manaus, Brazil. A group of 8 Japanese travelers entered a cave for a total of 2 hours in March, 1993. All the visitors had been healthy and had no history of abnormal chest roentgenograms. From 10 to 20 days after the exposure, 7 (87.5%) of the 8 individuals developed abnormal symptoms including fever, malaise, loss of appetite, myalgia, arthralgia, chest pain and dry cough. Five (62.5%) had nodular infiltrative shadows with or without hilar lymphadenopathy in the chest roentgenograms. Eight (100%) of the individuals showed serologic evidence of histoplasmosis. Despite the small number of subjects, this high rate of infection may be related to the fact that the subjects stayed in an enclosed area where air exchange was minimal, at the end of a deep cave infested with numerous bats. The cave involved has never been documented as being endemic for histoplasmosis. The threat of H. capsulatum infection in bat-inhabited caves should be emphasized to travelers and also to physicians.
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PMID:[An outbreak of acute pulmonary histoplasmosis among travelers to a bat-inhabited cave in Brazil]. 775 54

An 18-year-old male who was admitted to hospital due to fever, skin rashes, cough, and malaise showed laboratory examination findings of leukopenia, thrombocytopenia, mild liver dysfunction, and hypoxia. Bone marrow aspiration revealed 2% histiocytes with hemophagocytosis. Chest X-ray showed bilateral diffuse interstitial pneumonia. The titer of anti-measles virus antibody was < 1:4, and that at convalescence stage was 1:64. He was diagnosed as having hemophagocytic syndrome and acute respiratory failure due to measles, and was treated with methylprednisolone pulse therapy. He promptly recovered from thrombocytopenia and acute respiratory distress. Steroid pulse therapy may be effective in these conditions due to measles.
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PMID:Virus-associated hemophagocytic syndrome due to measles accompanied by acute respiratory failure. 778 29

A health diary was administered for 28 consecutive days over 3 non-consecutive months to 53 children and adolescents with Cystic Fibrosis (age 11-17 years). Response rates were 96% for the first, 84% for the second and 58% for the third month. Ill health actions such as missing school or staying in bed, ranged from 0 to 21% of diary days and showed an apparent seasonal variation being highest in the month of May. Analysis of variance demonstrated significant association between health actions, use of additional medicines and disease severity although no such associations were found for worries and concerns and overall assessment of the day. Most were not very bothered by symptoms or complaints, the highest visual analogue score on a scale of 0-10 in a single patient was 2.4 for coughing. A striking finding was the disparity between perceived vulnerability and subsequent experience with predictions of common symptoms such as cough and shortness of breath scoring 4-5 times higher than actually experienced. These children and adolescents were coping very successfully with their disease although the disparity between perceived vulnerability and subsequent experience indicates some uncertainty about the effects of the disease and/or lack of understanding about medical therapy.
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PMID:Symptoms, health and illness behaviour in cystic fibrosis. 793 54

A 31 year old man from Gambia, resident in the United Kingdom for two years, presented with a two month history of unproductive cough, malaise, weight loss, non-specific abdominal pain, and episodic diarrhoea. Acid alcohol fast bacilli were identified in his sputum, together with Strongyloides stercoralis larvae and Giardia lamblia cysts in his stools. This case illustrates that latent strongyloidiasis can become overt in the presence of tuberculosis, and the diagnosis of strongyloidiasis must be borne in mind in patients who have previously resided in endemic regions.
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PMID:Interrelation of strongyloidiasis and tuberculosis. 806 5

A total of 4676 patients and 1759 patients were treated with lisinopril and nifedipine respectively in a post-marketing surveillance study conducted in general practice in the UK. Patients were followed up for 12 months. Most of the lisinopril patients had hypertension, but a small number (180) had heart failure. Most of the nifedipine patients had uncomplicated hypertension, but some (22.57%) had other cardiovascular disease with or without hypertension. Lisinopril and nifedipine were equally effective in reducing blood pressure. During the study, 1.5% of hypertensive patients assigned to lisinopril died compared with 1.8% of patients assigned to nifedipine, and 15.1% of lisinopril patients compared with 19.7% of patients in the nifedipine group withdrew because of adverse events. Cough, malaise and fatigue, nausea and vomiting were more frequent causes of withdrawal from lisinopril than nifedipine. Conversely, headaches, pallor and flushing, oedema and palpitations caused more frequent withdrawals from nifedipine. Anaemia was more often encountered on nifedipine treatment than on lisinopril. In hypertensive patients, the frequency of first-dose hypotension was similar on both treatments. Serious events occurred in 0.8% and 0.5% of patients given lisinopril and nifedipine respectively. Lisinopril was well tolerated by heart failure patients: 16 patients (8.88%) died and an incidence of 4.44% of serious adverse events was reported, a pattern to be anticipated in such patients; dizziness, giddiness, dyspnoea, cough, nausea and vomiting were the most frequent causes of withdrawal; the incidence of first-dose hypotension was low (2.22%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Post-marketing surveillance of lisinopril in general practice in the UK. 811 50

1. Oxitropium bromide (Oxivent), an anticholinergic bronchodilator, inhibits coughing induced by hypotonic aerosols in both asthmatic and non-asthmatic individuals. We have now extended this work to investigate whether this antitussive activity is reproducible in cough associated with viral infection. 2. The effect of oxitropium bromide (200 micrograms three times daily) on cough and pulmonary function has been studied in 56 non-asthmatic volunteers with upper respiratory tract infections (URTI) in a double-blind, randomised, parallel group, placebo controlled study over 10 days. 3. Lung function, symptom questionnaire and cough response to ultrasonically nebulised distilled water (UNDW) inhalation were initially recorded within 72 h of development of cough and again after the 10 day treatment period. By use of a diary card at home, frequency and severity of cough, nocturnal symptoms and general malaise were assessed daily throughout the treatment period using 5 cm visual analogue scales (VAS). Peak expiratory flow rate (PEFR) was recorded thrice daily before treatment over this 10 day period. 4. VAS scores of symptoms and UNDW-induced cough frequency all decreased over the 10 days of observation whether oxitropium bromide or placebo was administered. The mean PEFR showed a statistically significant fall in morning values during the early stages of infection which lessened with recovery but no effect of treatment with oxitropium bromide was observed (P > 0.05). 5. Oxitropium bromide, which inhibits the cough response to UNDW, does not offer an effective therapy for cough associated with an upper respiratory tract viral infection.
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PMID:The effect of anticholinergic bronchodilator therapy on cough during upper respiratory tract infections. 818 64

Aspiration is the leading cause of anaerobic lung infections. Risk factors for these infections include a depressed level of consciousness, a history of seizure, general anesthesia, central nervous system or neuromuscular disease, cerebrovascular accident, impaired swallowing and use of a tracheal or nasogastric tube. Clinical presentation includes fever, weight loss, malaise and cough productive of foul-smelling sputum. Diagnosis is based on radiographic findings, clinical features and a characteristic morphology of mixed flora on Gram stain of uncontaminated pulmonary specimens. The diagnosis is confirmed by isolation of organisms, usually polymicrobial, on culture. Treatment includes proper drainage, debridement of necrotic tissue and an antibiotic regimen (often initially empiric) with an agent active against anaerobic and aerobic organisms.
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PMID:Anaerobic lung infections. 820 19

A 77-year-old lady with malaise, cough, weight loss, an elevated ESR and bilateral patchy infiltrates on the chest X-ray is described. The symptoms progressed inspite of antibiotic treatment. On the basis of clinical findings, transbronchial biopsy, bronchoalveolar lavage and lung function tests the diagnosis of a bronchiolitis obliterans, organizing pneumonia (BOOP) was established. The clinicopathological entity of BOOP, its differential diagnosis and treatment are discussed.
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PMID:[Antibiotic-resistant pneumonia]. 821 Aug 73


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