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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight documented cases of pulmonary zygomycosis were analyzed retrospectively with regard to radiographic and clinical features. Predisposing factors were diabetes mellitus in six cases, lymphoblastic lymphoma in one case, and surgery to correct a tracheoesophageal fistula in one case. Two of the patients with diabetes had also undergone renal transplantation for diabetic nephropathy and were immunosuppressed. The more usual radiographic findings of pulmonary zygomycosis represent a spectrum that comprises a normal chest radiograph, a lung abscess, subacute or chronic pneumonia that often evolves into a lung abscess, and rapidly progressive fatal pneumonia. Awareness of the various presentations of pulmonary zygomycosis is important because early diagnosis and appropriate therapy clearly have been shown to improve the survival rate of these patients. Zygomycosis should be included in the differential diagnosis when patients with diabetes mellitus, patients with leukemia or lymphoma, or immunocompromised patients present with or develop perplexing pulmonary abnormalities.
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PMID:Pulmonary zygomycosis: a radiographic and clinical spectrum. 140 48

Three cases of pulmonary actinomycosis are reported. Case 1 was a 33-year-old man complaining of hemosputum. A large mass lesion was noted in the right upper lobe and surgically resected. Actinomycosis was diagnosed pathologically. The second case was a 41-year-old man with lung abscess. An actinomyces species was cultured by percutaneous aspiration biopsy. He was effectively treated with clindamycin. The third case was a 46-year-old man with a chronic cough and cavitary lesion. Gram staining of sputum revealed sulfur granules. Piperacillin was administered with prompt response. All three cases had dental disease and two had diabetes mellitus. In patients with a mass lesion or those with lung abscess not effectively treated by cephem antibiotics, actinomycosis should be suspected especially when diabetes mellitus and/or dental disease coexists. Adequate treatment may not always require long-term antibiotics.
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PMID:[Three cases of pulmonary actinomycosis]. 146 91

An analysis of 500 consecutive pulmonary tuberculosis cases shows that lower lungfield tuberculosis occurs in 6.8 percent of the negroid population studied and therefore shows no racial predelection. The ratio of female to male involvement was 3:1. A clear association with young women and with pregnancy with or without other infections was demonstrated. Affected men were in the much older age group. Some association with diabetes and heart failure were also observed. The initial diagnosis of most of these patients was basal pneumonia or lung abscess. Therefore, the most useful clinical pointers were productive cough with or without haemoptysis unresponsive to various conventional antibiotics. The right base was most favoured and cavitation with fluid levels were frequent. We believe that the aetiological factors would include stress as could occur with pregnancies and poor basal tissue oxygenation due to diminished basal expansion in abdominal distension or cardiac failure.
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PMID:Lower lungfield tuberculosis in a rural African population. 206 90

We studied community acquired pulmonary infections in general hospital. Forty-seven outpatients (group I) and 107 inpatients (group II) were analyzed respectively. The mean age of group I was 43.4 years old and that of group II was 57.4 years old. Significant underlying diseases were present in 45% of group I and 62% of group II. In group I, the underlying diseases were chronic respiratory diseases, and in group II, chronic respiratory diseases and other significant diseases such as diabetes mellitus, cardiovascular diseases, malnutrition or malignancy. All of group I and 81 cases of group II were pneumonia. Pleuritis with pneumonia (11), lung abscess or cavitary infection (11), and pyothorax (4) were included in group II. Etiologic organisms were determined in 48.6% of the cases in group I, and 44.0% in group II. Invasive methods such as transtracheal aspiration and percutaneous lung puncture aspiration were very useful for isolation of the pathogen. The pathogens isolated included H. influenzae (17), S. pneumoniae (10), M. pneumoniae (4), C. psittaci (4) in total cases. In group I, H. influenzae was mostly isolated and in group II, S. pneumoniae was mostly isolated and opportunistic pathogens were also isolated. The form of pneumococcal pneumonia was almost always focal pneumonia in this study. There were 8 fatalities (5.2%), all of which were very old or had other serious diseases.
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PMID:[Community acquired pulmonary infections in a general hospital]. 274 72

Lung abscess and empyema are rare in healthy people. They usually occur when such predisposing factors as alcoholism, diabetes mellitus, immunodepression, neurological disorders, previous chest surgery and bronchial stenosis are present. Evacuation of pus and antibiotic therapy form the basis of treatment. Anaerobic bacteria are the most common causative agents, and they are particularly suspected in patients with putrid sputum or pleural fluid. The penicillin-metronidazole combination is used in these anaerobic infections. In every case, a careful search for the responsible organism has to be made in order to choose the best antibiotic.
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PMID:[Pleuro-pulmonary suppurations]. 274 49

To our knowledge, Haemophilus parainfluenzae lung abscess has not been described previously. Such a case is presented in the setting of diabetes mellitus. The implications of diagnosis and management are discussed.
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PMID:Haemophilus parainfluenzae lung abscess. 639 41

Zygomycosis is an uncommon, but frequently fatal, fungal infection caused by members of the class Zygomycetes. The risk factors include diabetes mellitus, uremia, leukemia and use of deferoxamine as an iron-chelating agent; healthy persons also are occasionally infected. Those fungi, spread by their ubiquitous spores, most frequently involve the respiratory system. Rhinocerebral zygomycosis occurs predominantly in patients with uncontrolled diabetic ketoacidosis. Pulmonary zygomycosis most frequently is observed in granulocytopenic and corticosteroid-treated patients. Other clinical manifestations are gastrointestinal, cutaneous, disseminated and miscellaneous. This report concerns a previously robust farmer who suffered from left upper lung abscess caused by Rhizopus spp.-one member of the order Mucorales. Initially, it was intended to administer amphotericin B to a total dose of 2,000 mg; however, the patient could not tolerate such side effects as nausea, vomiting and refused further management when the cumulative dose was 948 mg. However, he did recover without further fever and cough. Chest X-ray, followed every three months, disclosed satisfactory improvement.
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PMID:Zygomycotic lung abscess: a case report. 755 21

A 56-year-old man with bronchial asthma and diabetes was admitted with massive hemoptysis and thick-walled cavity in the right middle lung field on chest X-ray films. He had been treated with antibiotics for eight months under the diagnosis of lung abscess before his admission. After occlusion of the bronchial arteries with metallic coils, bronchofiberscopy was performed disclosing the obstruction of right B3b. Microscopic examination of bioptic material and bronchial brushing smear taken from right B3b yielded numerous broad, nonseparate hyphae. Right middle and lower lobectomy were performed under a diagnosis of chronic pulmonary mucormycosis. The patient was recovered and discharged on 55 th days after operation.
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PMID:[Chronic pulmonary mucormycosis diagnosed by bronchoscopy: a case report]. 837 21

The bacteriology of empyema fluid and the clinical background of 23 cases from July 1987 through July 1992 were studied. Nineteen cases were male and 4 female, with a mean age of 59.6 years (range; 33 to 84 y.o.). There were 15 cases of community-acquired infection and 8 of nosocomial infection. Acute pneumonia and/or lung abscess developed into empyema in 19 cases. Sixteen cases had associated predisposing conditions, such as diabetes, chronic bronchitis, disorders with dysphagia, and excess alcohol intake. Forty-one strains were isolated from empyema in 22 cases. The predominant organisms, in order of prevalence, were "Streptococcus milleri" group (11 strains), Peptostreptococcus spp. (6), Prevotella spp. (6), Fusobacterium spp. (5) and other viridans streptococci (3). The majority of streptococcal infections, which were primarily caused by "S. milleri" group, were mixed with anaerobes and/or aerobes/facultatives. These results demonstrate that oral streptococci, especially "S. milleri" group, and anaerobes play a significant role as pathogens in empyema.
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PMID:[Bacteriological and clinical studies in 23 cases of thoracic empyema--the role of oral streptococci and anaerobes]. 851 22

We report an atypical case of lung abscess occurring in a 73-year-old female who suffered from diabetes for more than 20 years. In 1993 she had a total gasterectomy for gastric cancer. In 1995 she was admitted to our hospital complaining of a mild cough and a small amount of sputa. A CT scan of the chest revealed a huge abscess in the left lung. Streptococcus sanguis was cultured from the intrathoracic fluid. It is possible that the severe lung abscess in spite of the few symptoms occurs in the compromised host, such as this patient who suffered from diabetes for long time. Oral streptococci in close relationship to misswallowing should be taken into consideration as one of the causes of this condition.
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PMID:[Atypical lung abscess occurring in an elderly female suffering from diabetes mellitus--a case report]. 912 12


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