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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bronchopulmonary infections with Aspergillus give rise to three different pathological entities. Allergic bronchopulmonary aspergillosis, found in patients with an atopic predisposition, is marked by dyspnea of the asthmatic type associated with labile radiologically detectable infiltrates, blood hypereosinophilia, enhanced total IgE levels, specific IgG fractions, and positive immediate reactions to skin tests. The long-term risk is the development of proximal bronchiectasis. Dosage and duration of corticotherapy are function of eosinophilia and total IgE levels. Pathogenicity is similar to that of extrinsic allergic alveolitis, probably involving disturbances in immune complexes from a type I reaction. Intracavital pulmonary aspergillosis involves mycotic development within a cavity or a complicating parenchymatous lesion. Severe hemoptysis may occur. Medical treatment is ineffective, and radical surgery is necessary in patients able to support operative procedures, which vary as a function of the condition of the patient. Diffuse aspergillosis occurs in immunodeficient patients, usually during the acute phase of chemotherapy induction. Spread of the disease is either from the upper respiratory tract or through the blood as septicemia. A nosocomial origin is frequent. Diagnosis depends more on the presence of hyphae in tissue biopsy specimens than cultures or serological tests which are too unreliable. Treatment is with amphotericin B preferably associated with 5 fluorocytosin.
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PMID:[Bronchopulmonary aspergillosis (author's transl)]. 708 69

Three Laotian refugee children with chronic pulmonary complaints and findings were found to have pulmonary paragonimiasis during a one-year period in Chicago. These patients ranged from 8 to 11 years of age and the diagnosis was delayed five to six months in two children because of the unfamiliarity of American physicians with signs and symptoms of this disorder. Clinical manifestations included chronic cough for up to two years, apparent hemoptysis in two patients, lack of fever or sweats, and family history negative for tuberculosis. Physical findings included rales and dullness to percussion, clubbing (one patient), and lack of fever or respiratory distress. All three patients showed interstitial infiltrates on chest roentgenogram whereas two had multiple small cystic areas. Moderate eosinophilia was present. Paragonimus westermani ova were found in stools of two patients, in sputum of two patients, and in bronchoscopic specimens in one patient. All patients demonstrated striking clinical and radiologic improvement following treatment with bithionol (50 mg/kg every other day for 15 doses), which was well tolerated. Lung fluke infestation must be considered in Indochinese refugee children with apparent hemoptysis or chronic pulmonary symptoms, and sputum and stool should be examined for P westermani ova.
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PMID:Pulmonary paragonimiasis in Laotian refugee children. 709 90

A 60-year-old woman was admitted because of hemoptysis and dyspnea on exertion, which began one month before admission and gradually increased. Chest X-ray film taken on admission showed an infiltrative shadow in and around the left posterior basal segment. Chest CT disclosed peripheral and patchy consolidation with some air bronchograms and interstitial thickening in the left basal segments. Bronchoalveolar lavage fluid contained many red blood cells and abnormally high numbers of eosinophils and lymphocytes. The specimen obtained by CT-guided lung biopsy revealed epithelioid cell granulomas, hemosiderin-laden macrophages, diffuse infiltration of small round cells with a few eosinophils and monocytes in the alveolar septa, and many eosinophils in the intraalveolar exudates. No pathogens of pulmonary eosinophilia were identified and there was no secondary pulmonary eosinophilia. Therefore, we diagnosed eosinophilic pneumonia with no obvious cause. Hemoptysis may have been due to alveolar hemorrhage of eosinophilic pneumonia. The hemoptysis and chest infiltrative shadow disappeared rapidly after the start of treatment with oral prednisolone.
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PMID:[A case of eosinophilic pneumonia presenting as hemoptysis, with epithelioid cell granuloma on lung biopsy]. 779 Dec 71

We identified eight patients (six women and two men) who had pulmonary infiltrates during treatment with minocycline hydrochloride between 1989 and 1992 in French referral centers for drug-induced pulmonary diseases. Clinical files, chest roentgenograms, computed tomographic scans, pulmonary function, and bronchoalveolar lavage data were reviewed. Minocycline treatment was given for acne (n = 4), genital infection (n = 3), and Lyme disease (n = 1). The duration of treatment averaged 13 +/- 5 days (mean +/- SE); the total dose, 2060 +/- 540 mg. Patients presented with dyspnea (n = 8), fever (n = 7), dry cough (n = 5), hemoptysis (n = 1), chest pain (n = 2), fatigue (n = 3), and rash (n = 3). Chest roentgenograms showed bilateral infiltrates in all cases. Pulmonary function was measured in five patients; four had airflow obstruction and two had mild restriction. Blood gas tests demonstrated hypoxemia in seven patients (58 +/- 3 mmHg). Seven patients had blood eosinophilia (1.76 +/- 0.2 x 10(9)/L). Bronchoalveolar lavage (performed in seven patients) showed an increased proportion of eosinophils (0.30 +/- 0.07). The Cd4+/CD8+ ratio was determined in four cases and was low in three. Transbronchial lung biopsy, performed in two patients, showed interstitial pneumonitis in both patients, with marked infiltration by eosinophils in one patient. The outcome was favorable in all patients. Because of severe symptoms, steroid therapy was required in three patients. Rechallenge was not attempted. We conclude that minocycline can induce the syndrome of pulmonary infiltrates and eosinophilia, that presenting symptoms may be severe and may culminate in transient respiratory failure, and that the disease has a favorable prognosis.
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PMID:Minocycline pneumonitis and eosinophilia. A report on eight patients. 803 Dec 12

We evaluated 20 patients with pulmonary strongyloidiasis for risk factors, clinical and imaging manifestations, complications, treatment, and outcome. Eighteen (90%) had risk factors for strongyloidiasis including steroid use, age greater than 65, chronic lung disease, use of histamine blockers, or chronic debilitating illness. Pulmonary signs and symptoms, including cough, shortness of breath, wheezing, and hemoptysis, were present in 19 (95%); adult respiratory distress syndrome (ARDS) developed in 9 (45%). Pulmonary infiltrates occurred in 18 (90%). Gastrointestinal signs and symptoms were also common. Peripheral blood eosinophilia occurred in 15 (75%). Twelve (60%) had secondary infection, and 3 (15%) had bacterial lung abscesses. All were treated with thiabendazole, 25 mg/kg twice daily; on average, patients without ARDS were treated for 3 days, versus 7 days for those with ARDS. Seventy percent responded to therapy; 30% died. Preexisting chronic lung disease and ARDS were statistically significant predictors of a poor prognosis.
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PMID:Clinical and imaging features of pulmonary strongyloidiasis. 854 86

Ascariasis and hookworm (ancylostomiasis) remain the most common intestinal nematodes in the world with significant economic, social, and medical impact. An understanding of the transmission and pathogenesis of ascariasis and hookworm are necessary to recognize their clinical manifestations and to manage the pulmonary sequelae of infection. Transmission occurs predominantly in the tropics and rural areas where there is suboptimal sanitation, personal hygiene, and education regarding these parasites. Ascariasis generally occurs through hand-to-mouth ingestion of agricultural products or food contaminated with parasite eggs. Hookworm is transmitted through larval penetration of the skin. Larval pulmonary migration generally is asymptomatic. However, symptomatic pulmonary disease may occur with fever, cough, chest pain, hemoptysis, dyspnea, and wheezing due to (1) Loffler's syndrome, (2) the effects of larval tissue migration, (3) airway reactivity or bronchospasm, (4) infectious bacterial complications from parasitic migration and associated aspiration, and rarely (5) chronic eosinophilic pneumonia, transdiaphragmatic penetration, or symptoms of upper airway obstruction. Clinical evaluation shows pulmonary opacities on chest radiograph, peripheral blood eosinophilia, and larvae in respiratory or gastric secretions. Symptomatic treatment may be necessary with bronchodilators and systemic steroids or antibiotics for bacterial complications. The drug of choice is mebendazole (Vermox) 100 mg twice a day for 3 days. Alternatives include a single dose of pyrantel pamoate (Antiminth) 11 mg/kg (maximum dose, 1 g) or albendazole (Zentel) 400 mg orally once. Invermectin (Mectizan) is available through the World Health Organization, and, in the United States, through the manufacturer on a compassionate-use basis. Ivermectin is as effective as currently available drugs against Ascaris but shows only partial efficacy against hookworms, which infest humans. Preventive measures, improvement of sanitary facilities, education, and school screening may be important in the endemic areas to control these parasitic infections.
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PMID:Ascariasis and hookworm. 919 78

Systemic vasculitides are potentially life-threatening diseases. Early and appropriate diagnosis based on case history, clinico-pathological features, and laboratory parameters, such as the presence of anti-neutrophil cytoplasmic antibodies (ANCA), is crucial for starting appropriate and, often, life-saving therapeutic measures. We report a 50-year-old female patient who presented with fever, arthralgias and hemoptysis. Skin signs included disseminated hemorrhagic pustules, ulcerations of oral and genital mucosa, subcutaneous nodules on arms and legs, and a pyoderma gangrenosum-like lesion on the right leg. Laboratory investigations revealed a peripheral eosinophilia and a positive cANCA titer. Histopathologic analysis of various biopsy specimens showed a granulomatous vasculitis in the subcutis, a nongranulomatous vasculitis with massive eosinophil infiltration in the lungs, and a segmental, necrotizing glomerulonephritis in the kidneys. Differential diagnosis included Wegener's granulomatosis, microscopic polyangiitis (MPA) and Churg-Strauss syndrome. MPA was diagnosed based on clinical and histopathological criteria. An interesting feature of this case was marked peripheral and tissue eosinophilia. Therapy consisted of cyclophosphamide and methylprednisolone. The patient went into a long-lasting clinical remission one month after starting therapy.
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PMID:[Microscopic polyangiitis with eosinophilia--an overlap syndrome or separate disease entity? A case report and review of the literature]. 930 8

An 84-year-old man was admitted to Yonezawa City Hospital with fever, cough, hemoptysis and progressive dyspnea. He had complained of wheezing asthmatoid and exertional dyspnea for the previous 10 years, regardless of the season. On admission, chest radiographs revealed a diffuse ground-glass shadow, fibrotic change, and volume reduction. Arterial blood gas analysis showed extreme hypoxemia. A computed tomographic (CT) scan of the chest showed not only faint ground-glass opacities and dense patches in the whole lung field, but also central bronchiectasis. Laboratory tests revealed that both total serum levels of IgE and specific IgE for Candida albicans were elevated. In the bronchoalveolar lavage fluid, lymphocyte, neutrophil and eosinophil percentages were high, and the CD4/CD8 ratio was low. We diagnosed the fibrotic stage of allergic bronchopulmonary candidiasis. During treatment with hydrocortisone and fluconazole, eosinophilia in the peripheral blood was observed, and serum candida antigen was positive. In addition, high serum levels of soluble interleukin 2 receptors were observed in this patient.
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PMID:[A patient with allergic bronchopulmonary candidiasis showing a high serum level of soluble interleukin 2 receptors]. 949 58

A 77-year-old woman was admitted to our hospital with hemoptysis and weight loss. She had eaten 15 raw freshwater crabs about 5 months before the onset of her clinical symptoms. Chest X-ray films obtained on the first admission showed left pleural effusion. After 1 week of chemotherapy with SBTPC, the pleural effusion disappeared. Two months later, the patient was re-admitted with recurrent hemoptysis. Chest X-ray films showed a solitary nodular lesion in the right lung. Eosinophilia and increased serum IgE levels were detected. The solitary nodular lesion moved from the middle to upper field of the right lung during the patient's 3-week stay in the hospital. Serologic tests yielded a conclusive diagnosis of Paragonimiasis miyazakii infection. Praziquantel administration relieved the patient's symptoms.
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PMID:[Paragonimiasis Miyazakii with variable X-ray shadows]. 1054 Aug 38

We encountered seven cases of pulmonary paragonimiasis. All patients were adult males and 6 of 7 cases were over 50-year-old. Except for one case of chronic pleural empyema, 6 patients were referred to the department of surgery because of having a mass lesion on chest roentgenography which was indistinguishable from malignancy. Although 3 patients had mild hemoptysis, none of them showed classical rusty sputum. Only one patient had high level of eosinophilia, whereas others showed normal or marginal level of eosinophilia. Paragonimus eggs were detected in transbronchial lung biopsy specimens from 4 patients. All patients' sera were positive for Paragonimus-specific IgG antibody by immunodiagnosis. Surgical option was undergone only for one patient with chronic pleural empyema which was not cured by repeated chemotherapy. In the present series, we could avoid surgical options due to an erroneous diagnosis. When a pulmonary mass lesion or empyema is detected in patients who live in paragonimiasis endemic areas, paragonimiasis should always be included in the different diagnosis of lung diseases.
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PMID:Pulmonary paragonimiasis referred to the department of surgery. 1117 34


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