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

Because of its clinical polymorphism and the difficulties to made a bacteriological and/or serological diagnosis, leptospirosis is an affection always non-detected. Nevertheless it is daily met affection in French Polynesia. Based on a homogenous series of 120 observations gathered from 1984 to 1990, all of them bacteriologically and/or serologically confirmed, we studied the different clinical and evolutive features of that disease. Fever is present in 91.6 p.c., cephalgia in 79.16 p.c. and myalgia in 70.83 p.c. Admission was necessary once out of four times. The four syndromes we observed in Tahiti are: infections syndrome, meningeal syndrome (30 p.c.) associated to an hyperproteinic grade in the C.S.F. (40 p.c.) and a lymphocytic reaction (60 p.c.). Liver syndrome, with hepatalgia (58.33 p.c.) and pain at the mass motion of liver (65 p.c.), that is an important sign in the local context; jaundice (28.33 p.c.) on the presence of which we must not based a diagnosis of leptospirosis: Biological renal syndrome displayed by transitory renal insufficiency with proteinuria, hematuria and leucocyturia. Neurological complications are mainly of encephalitic manifestations (5.8 p.c.). Hemorrhagic syndrome is expressed in digestive hemorrhage (8.33 p.c.) epistaxis (6.66 p.c.) and hemoptysis (6.66 p.c.). Cardiovascular manifestations are expressed in collapsus in 5.83 of the cases. Pulmonary abnormalities are frequent: cough (26.66 p.c.) and non specific X Ray image (19.16 p.c.). All patients are treated by Penicillin G (10 to 20 millions per day) by parenteral route with enteral alternative for an average of 10 days. Recovery was fast (7 to 10 days). In 65.8 p.c., slower in 15 p.c. (15 to 20 days); failure at first stage was observed in 10 p.c. of the cases, and relapse at medium or long term occurred under treatment in 8 cases (6.66 p.c.). Three dead were deplored (mortality 2.5 p.c.).
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PMID:[Leptospirosis in French Polynesia: 120 case reports]. 160 50

Actinomycosis is an infectious disease distributed all over the world. Males are affected three times more than females; the incidence of the disease is higher in adults than in children. The main causative agent is Actinomyces israelii, which can be found in the oropharynx of healthy persons. Therefore actinomycosis represents always an endogenous infection, often in connection with other bacteriae. The thoracic manifestation amounts to approximately 15 percent of all cases. The main clinical symptoms are pain, fever, cough, fatigue, and weight loss. The blood picture shows an increased number of white blood cells with a left shift in the differential white blood cell count. Furthermore, there is a strongly raised erythrocyte sedimentation rate. Radiographs demonstrate no typical patterns of pulmonary abnormalities. For the diagnosis there is a need of anaerobic cultures, in second line histological examination of tissue specimens. Differential diagnosis of actinomycosis includes chronic pneumonias caused by other rare germs and neoplasms. After early onset antibiotic long term treatment a good prognosis may be expected. Penicillin represents the antibiotic of first choice.
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PMID:[Thoracic actinomycosis]. 268 57

Actinomycosis is a relatively rare infection. This is a report of 16 patients with pulmonary actinomycosis diagnosed from 1990 to 1997 at the Central Chest Hospital, Thailand. Twelve patients were male and 4 were female, with a mean age of 59 years and a mean duration of symptoms of 9 months. Common symptoms were cough and hemoptysis. Mass-like shadowing was the most common radiographic finding (37%). The diagnosis, based on findings of typical sulfur granules, was reached by bronchoscopy (10 cases), surgery (5 cases) and fine needle aspiration (1 case). Endobronchial mass with luminal occlusion was the most frequent bronchoscopic finding (56%). Coexistent bronchial carcinoma was present in one specimen. Penicillin was given in 10 patients, 2 of whom (20%) were cured, 5 (50%) are currently on treatment and have achieved clinical response, whereas, the other 2 patients (20%) did not respond. Surgical resection was performed in 8 patients, all of whom recovered. An awareness of the full spectrum of actinomycosis manifestations will expedite diagnosis and optimize treatment.
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PMID:Pulmonary actinomycosis: a study of 16 cases from Central Chest Hospital. 1044 73

The purpose of this article is to define the distinguishing characteristics of food-borne streptococcal pharyngitis by reviewing the literature. The main cause of this infection lies in poor handling and preservation of cold salads, usually those which contain eggs and are prepared some hours before serving. A shorter incubation period and a higher attack rate (51-90%) than in transmission by droplets was noted. The epidemics tend to occur in warm climates and in the hottest months of the year. Streptococcus pyogenes seems to originate from the pharynx or hand lesions of a food handler. In comparison to airborne transmission symptoms such as sore throat, pharyngeal erythema, and enlarged tonsils, submandibular lymphadenopathy are more frequent than coughing and coryza. Seven out of 17 reports revealed an M-untypeable serotype, which may possess virulent characteristics. Penicillin prophylaxis was shown to limit additional spread of the infection. There were no non-suppurative sequels, and suppurative sequels were very rare. We assume that the guidelines for the prevention of food poisoning would apply to food-borne streptococcal pharyngitis. Food handlers should be supervised to ensure they comply with strict rules of preparation and storage of food. Cold salads, especially those containing eggs, should not be left overnight before serving.
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PMID:Streptococcal contamination of food: an unusual cause of epidemic pharyngitis. 1169 94

Our objective was to describe incidence, clinical, radiographic and microbiological features of bacteremic pneumococcal pneumonia (BPP) in our environment. A total of 101 patients (7 were treated as outpatients), older than 18 years of age suffering BPP were prospectively evaluated. The incidence was 2.8 cases per 1000 admissions, 50 were males, mean age was 59.9 years (19-97), mortality was 11.8%. Eighty three percent of fatalities occurred within 3 days of admission. Mortality rate increased with advancing age. Fever, cough and chest pain were the commonest presenting symptoms and 44% of patients had extrapulmonary manifestations. Cigarette smoking, chronic obstructive lung disease, alcoholism and congestive heart failure (CHF) were the commonest underlying conditions. CHF was more frequent in non-survivors (p = 0.002). A lobar pattern at chest radiograph predominated in survivors and a diffuse pattern in non-survivors (p = 0.007). Pleural effusion (20.7%), empyema (7.9%) and respiratory failure (7.9%) were the main complications. Underlying diseases were present in 100% of non-survivors (p = 0.03). Ninety four percent of patients were treated with beta-lactam antibiotics. Streptococcus pneumoniae was isolated from sputum in 6 cases. Three out of 101 S. pneumoniae isolates recovered from blood samples (one from each patient) presented organisms resistant to penicillin. We observed an incidence of BPP that is similar to the observed in other countries. There are clinical and radiographic differences between survivors and non-survivors. Penicillin-resistant S. pneumoniae is still an unusual problem in our area.
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PMID:Adult bacteremic pneumococcal pneumonia acquired in the community. A prospective study on 101 patients. 1267 54

The World Health Organization (WHO) recommends that children with severe pneumonia (characterized by cough or difficult breathing, as well as lower chest wall indrawing) be hospitalized and treated with parenteral penicillin. Oral amoxicillin, if equally effective for treating severe pneumonia, would address challenges associated with providing parenteral therapy, including risk of transmission of bloodborne pathogens from contaminated needles, exposure to nosocomial pathogens during hospitalization, inadequate access to health care facilities, and cost. The recently completed multicenter international trial of oral amoxicillin versus parenteral penicillin for treatment of severe pneumonia demonstrated the equivalency of these agents in children with severe pneumonia. This article focuses on the challenges of designing an equivalence study and the threats to the validity of the trial results, particularly the implications of the bias toward finding equivalence when subjects are unlikely to respond to either study therapy. These considerations have implications for use of the Amoxicillin Penicillin Pneumonia International Study (APPIS) results in clinical practice and for potential modification of WHO treatment guidelines.
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PMID:Challenges in the design of antibiotic equivalency studies: the multicenter equivalency study of oral amoxicillin versus injectable penicillin in children aged 3-59 months with severe pneumonia. 1535 16

Common signs and symptoms of streptococcal pharyngitis include sore throat, temperature greater than 100.4 degrees F (38 degrees C), tonsillar exudates, and cervical adenopathy. Cough, coryza, and diarrhea are more common with viral pharyngitis. Available diagnostic tests include throat culture and rapid antigen detection testing. Throat culture is considered the diagnostic standard, although the sensitivity and specificity of rapid antigen detection testing have improved significantly. The modified Centor score can be used to help physicians decide which patients need no testing, throat culture/rapid antigen detection testing, or empiric antibiotic therapy. Penicillin (10 days of oral therapy or one injection of intramuscular benzathine penicillin) is the treatment of choice because of cost, narrow spectrum of activity, and effectiveness. Amoxicillin is equally effective and more palatable. Erythromycin and first-generation cephalosporins are options in patients with penicillin allergy. Increased group A beta-hemolytic streptococcus (GABHS) treatment failure with penicillin has been reported. Although current guidelines recommend first-generation cephalosporins for persons with penicillin allergy, some advocate the use of cephalosporins in all nonallergic patients because of better GABHS eradication and effectiveness against chronic GABHS carriage. Chronic GABHS colonization is common despite appropriate use of antibiotic therapy. Chronic carriers are at low risk of transmitting disease or developing invasive GABHS infections, and there is generally no need to treat carriers. Whether tonsillectomy or adenoidectomy decreases the incidence of GABHS pharyngitis is poorly understood. At this time, the benefits are too small to outweigh the associated costs and surgical risks.
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PMID:Diagnosis and treatment of streptococcal pharyngitis. 2052 48