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)

4 cases of Pneumocystis carinii pneumonia in HIV-infected patients studied at the University of Zambia Medical School, Lusaka, were verified by bronchoalveolar lavage. Pneumocystis is common in North American AIDS patients, but has been considered rare in Africa. One reason may be that facilities for diagnosis, bronchoscopy with bronchoalveolar lavage, are not usually available. 44 consecutive HIV seropositive patients who were unresponsive to a 10-day course of antibiotics, and whose sputum was negative for acid fast bacteria, underwent bronchoalveolar lavage from February 1990 to December 1990. HIV status was assayed with Welcozyme ELISA kits, and P. carinii was detected with toluidine blue O stain. The 1st case of confirmed P. carinii pneumonia was a 35-year old man who had a productive cough for 4 weeks, fever, and dyspnea. He was treated with co-trimoxazole and was symptom-free in 3 weeks, but developed severe Stevens-Johnson reaction. His cultures were positive for M. tuberculosis at week 8. He was lost to follow-up. The 2nd case was a 26-year old man with a 6-month history of cough and white sputum, treated without effect with antituberculous medication. He improved over 3 weeks with co-trimoxazole, but died of respiratory failure 2 months later. The 3rd case was a 30-year old woman being treated for pulmonary tuberculosis, who became progressively dyspneic 7 months later. She developed a generalized maculo-papular rash after taking co-trimoxazole, so was given dapsone 100 mg/day, prednisone 1 mg/kg/day, and trimethoprim 15 mg/kg for 1 week. She improve in 3 weeks. The 4th case was a 30-year old man with a 4-week history of dry cough and dyspnea and recent high fever. He was given co-trimoxazole, but developed generalized purpura after 5 days. His treatment was changed to Dapsone 100 mg/day, prednisone 1 mg/kg/day, and antituberculous medication. He improved after 3 weeks, and is being maintained on Fansidar 1 tablet/week. These cases are remarkable because 2 of them also had pulmonary tuberculosis, which is often the presumed diagnosis of pneumonia in African AIDS patients. Furthermore, 3 developed serious drug reactions to co-trimoxazole, also considered an uncommon occurrence.
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PMID:Pneumocystis carinii as a cause of pneumonia in HIV-infected patients in Lusaka, Zambia. 144 Aug 16

Bucillamine [N-(2-mercapto-2-methylpropionyl)-L-cysteine] is an anti-rheumatic drug which was developed in Japan. Interstitial pneumonia induced by bucillamine has been reported in two patients with rheumatoid arthritis. In this report, we describe another patient who developed bucillamine-induced interstitial pneumonia. In August 1990, a 53-year-old man was admitted because of fever, dry cough and dyspnea on exertion (DOE). Five months previously, he had noted polyarthritis, and treatment with bucillamine was started in May 1990. His polyarthritis improved about 2.5 months after starting bucillamine, but he developed fever, dry cough, and DOE in August 1990. Chest X-ray on admission showed diffuse acinar and interstitial shadows predominantly in the bilateral upper lung fields. Pulmonary function tests revealed decreased vital capacity and diffusing capacity. Arterial blood gas (ABG) analysis revealed moderate hypoxemia with PaO2 67 Torr. After stopping bucillamine, the fever, dry cough, and DOE improved gradually, and the abnormal shadows on chest X-ray and ABG analysis showed moderate improvements. Bronchoalveolar lavage studies showed that total cell counts and proportion of lymphocytes were increased, and CD4+/CD8+ ratio of T cell subsets was decreased to 0.56. Transbronchial lung biopsy specimen revealed lymphocytic alveolitis and mild interstitial thickening. Lymphocyte stimulation test to bucillamine was negative, but patch test with bucillamine was positive. From the patient's clinical course, laboratory data, and pathologic findings, we concluded that this is a case of bucillamine-induced interstitial pneumonia. After treatment with corticosteroid, his chest X-ray and pulmonary function test showed marked improvements.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of bucillamine-induced interstitial pneumonia]. 144 52

We report a 60-year-old man, who was admitted to the hospital with complaints of cough and sputum. His chest x-ray showed an abnormal mass in the right upper lobe. After admission he noticed the painful gingival tumor. Right upper lobectomy and resection of the gingival tumor were performed. Their histological features showed that the tumor consisted of a papillary and tubular adenocarcinoma mixed with a component of spindle cells. Immunohistochemical study demonstrated a positive reaction in the epithelial component for keratin and epithelial membrane antigen, and not only these epithelial markers but also vimentin were expressed in some spindle tumor cells. Electron microscopic study confirmed the biphasic pattern, showing gland formation and undifferentiated cells. We diagnose this case as adenocarcinoma of the lung with a spindle cell component and the gingival tumor was metastatic. Autopsy showed that metastatic lesions were found in the left adrenal gland and in the left kidney. The tumor cells in the left adrenal gland were composed of spindle cells and the tumor in the left kidney showed gland formation. Immunohistochemical and electron microscopic findings of surgical and autopsy specimen suggest that this tumor is of epithelial origin, and the spindle cells are derived from immature mesenchymal cell transformation of epithelial cells.
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PMID:A case of adenocarcinoma of the lung with a spindle cell component. 147 33

A 66-year-old male presented to our hospital in January 1990 with chief complaints of hemoptysis and cough. These symptoms had developed 10 months previously and had gradually increased. Fine crepitations were audible over the right lower lung field. There were no results suggesting an inflammatory process such as leucocytosis, elevation of ESR or positive CRP reaction. Chest X-ray film on the first visit showed fine nodular shadows in the right lower lung field, and chest CT revealed fine nodular shadows and mild dilatation of the right lower lobe bronchus. Transbronchial lung biopsy specimens showed granulomas with multinucleated giant cells, alveolitis and Masson bodies. The open lung biopsy specimens showed numerous macrophages and foreign body giant cells, and extensive organizing exudates in the bronchioles and alveolar spaces. Proliferation of smooth muscle and fibrosis around the dilated bronchioles were also seen. Thus, this patient demonstrated BOOP pattern, with granulomas and foreign body giant cells. His hemoptysis appeared to have resulted from inflammation of dilated bronchioles. His symptoms and abnormal shadows on chest X-ray improved without any therapy after admission. After treatment with corticosteroid, the diffuse fine nodular shadows disappeared. There has been no recurrence of symptoms to date, although this patient has continued living in the same environment as prior to admission. BAL findings during his prolonged follow-up revealed decrease in lymphocytes and elevation of CD4/CD8 ratio. Although the presence of granulomas suggests the possibility of an allergic reaction, no antigenic material could be identified in this case.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of interstitial pneumonitis with hemoptysis, BOOP (bronchiolitis obliterans organizing pneumonia) pattern, granulomas and foreign body giant cells in lung biopsy]. 150 90

Between 1984-1991, physicians at Hospital del Mar in Barcelona, Spain and the area with the highest prevalence of tuberculosis (TB) diagnosed active pulmonary nondisseminated TB in 57 HIV infected patients. 3 of these patients consistently had normal chest radiographs. All 3 patients had fever and cough. Case 1 was a 26 year old female intravenous (IV) drug user. She had generalized lymphadenopathy. Hematologic tests revealed an HIV positive status. Her CD4+ lymphocyte count was 782 x 10 to the 6th power/1. Her tuberculin skin test was negative. Mycobacterium tuberculosis in her sputum grew in Lowenstein medium. Acid fast bacilli were detected in her sputum with Ziehl-Nielsen stain. Physicians began antiTB therapy (isoniazid, pyrazinamide, rifampin, and ethambutol). She improved within a few weeks. Case 2 was an HIV positive IV drug user and 33 years old. The CD4+ lymphocyte count was 645 x 10 to the 6th power/1. Acid fast bacilli were detected in his bronchoalveolar lavage with Ziehl-Nielsen stain. M. Tuberculosis in the lavage grew in Lowenstein medium. The physicians started him on the same antiTB therapy as Case 1. His condition improved with therapy. Case 3 was a 50 year old bisexual man. Hematologic tests showed HIV positivity. His CD4+ lymphocyte count was 790 x 10 to the 6th power/1. Further his tuberculin skin test was negative. Fibre optic bronchoscopic samples were negative for acid fast bacilli, but M. tuberculosis grew in Lowenstein culture. Blood, urine, bone marrow and gastric aspirates tested negative for M. tuberculosis. He began the same antiTB therapy as Cases 1 and 2. His condition improved. In conclusion, physicians should aggressively pursue a diagnosis to TB in HIV infected patients presenting with fever and cough. Their rate of hospitalization should fall with early diagnosis and treatment which will in turn prevent the spread of TB among the population.
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PMID:Pulmonary tuberculosis in HIV-infected patients with normal chest radiographs. 154 71

A 39-year-old man developed paroxysmal cough, occasional vomiting after cough, and subconjunctival hemorrhage. His illness was complicated by episodes of seizure, with clonic movements of the arms and legs, brief loss of consciousness, and confusion. The episodes were triggered by mild, unremarkable coughing paroxysms. A diagnosis of pertussis was confirmed serologically by measurement of IgG, IgA, and IgM antibodies to pertussis toxin and filamentous hemagglutinin. Serologic studies confirmed the presence of Bordetella pertussis infection in the patient's 10-year-old daughter and suggested that his wife was infected as well. This case report illustrates the occurrence of typical pertussis with serious complications in an adult. Further research is required to determine the scope of this problem and the need for a program of adult immunization against pertussis.
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PMID:Pertussis encephalopathy in an adult: case report and review. 177 35

A 15-months-old boy underwent the intra-cardiac repair with a glutaraldehyde-preserved equine pericardium for total anomalous pulmonary venous connection (Darling's type IIb). Because of rapidly progressive dyspnea, tachycardia and respiratory acidosis, he required emergent reoperation at 234 postoperative days. The pseudointima was thickened heavily and detached from glutaraldehyde-preserved equine pericardium. New channel was created with a piece of EPTFE sheet to prevent obstruction of pulmonary venous flow. However, about four months after second surgery, cough and tachycardia progressed again remarkably. Intra-atrial channel was obstructed between EPTFE sheet and the partition from pulmonary venous orifice to the atrial septal defect in the third operation. The intra-atrial channel was enlarged by cut-back method using EPTFE sheet again. His postoperative hemodynamics were satisfactory
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PMID:[Recurrent surgery for pulmonary venous obstruction after total correction of TAPVC (IIb)]. 189 90

Miliary tuberculosis associated with cutaneous lesion has been rarely reported. We report a case of miliary tuberculosis in whom the cutaneous lesion was confirmed as tuberculosis by skin biopsy and bacterial examination. A 46-year-old man was admitted because of cough, fever, sore throat and abnormal shadow on the chest X-ray. Physical examination revealed an emaciated man with two ulcerous lesions overlying yellowed crust on the chest wall and fine crackles on the left side of the lung. Laboratory workup revealed a white blood cell count of 10,000 with 15% lymphocytes and positive CRP. Chest X-ray film showed the infiltration with cavity formation in left upper lung field and nodular dissemination. His tuberculin reaction was negative on admission. Sputum, urine and secrete from cutaneous lesion were positive for the acid-fast bacilli and the culture grew Mycobacterium tuberculosis. Examination of the skin biopsy specimen and bone marrow aspiration showed Langhans giant cells around necrotic lesion; therefore the diagnosis of miliary tuberculosis was made. After an initiation of antituberculosis therapy with combined regimen composed of streptomycin (SM), isoniazid (INH), ethambutol (EB) and rifampicin (RFP), this patient improved significantly. Although the case report of miliary tuberculosis tends to increase recently, the report of cutaneous lesion is relatively rare in association with miliary tuberculosis. We discussed this subject with reference to the literatures.
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PMID:[A case of miliary tuberculosis with cutaneous lesion]. 207 57

The paper is concerned with observations over 3 patients in whom unusual vasculitis lay at the basis of the clinicopathological manifestations. All the patients were men of the young age. The disease debut was marked by fever, weakness, dyspnea, palpitation, cough, hemoptysis, the articulation syndrome. In two cases, there was hemorrhagic rash on the leg skin. All the patients manifested liver and spleen enlargement, two patients had lymphoadenopathy. The leading clinical symptoms included dilated cardiomyopathy, complete blockade of the inferior peduncle of His bundle and reduction of myocardial contractility. Anemia belonged to iron deficient one. The clinical examples provided indicate that immunocomplex vasculitis with evident lesions of the lungs and myocardium, not going into criteria for the known diseases, is not likely to be a casuistic rarity. Those syndromes may be associated with more or less pronounced hemosiderosis of the lungs (and, probably, of the lymph nodes, spleen and liver), with transitory or steady derangements of myocardial conduction, which attests to diffuse lesions of the myocardium possibly with both immune complexes and hemosiderin. The pathology requires further studies.
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PMID:[Generalized immune-complex vasculitis combined with pulmonary hemosiderosis and dilated cardiomyopathy]. 214 20

A 69-year-old man was admitted to our hospital with a complaint of cough and hemoptysis. His chest X-ray showed an obstruction of the right intermediate bronchus and resultant atelectasis of the middle and lower lobes. Cytological examination by bronchoscopy showed squamous cell carcinoma. Although the cancer involvement of the left atrium could not be clearly defined by preoperative chest CT scan, the cancer invasion to the left atrial wall was recognized intraoperatively. Right pneumonectomy along with resection and patch reconstruction of the left atrium, right atrium and atrial septum was performed under extracorporeal circulation. Postoperative hemodynamic state was stable, and echocardiography showed normal volume of the left atrium. Histological examination of the resected specimen showed moderately differentiated squamous cell carcinoma with the involvement of the left and right atrial wall. The resected margins of the left and right atria were free of malignancy. Although he had been clinically in good condition and free from any sign of cancer recurrence, he died of aspiration pneumonia five months after the surgery.
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PMID:[Successful resection and reconstruction of the left atrium, right atrium and atrial septum under extracorporeal circulation in a patient with invasive pulmonary carcinoma]. 220 67


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