Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tuberculosis (TB) is often mistaken for community-acquired pneumonia (CAP). To avoid missing the diagnosis, we recommend that any CAP patient with upper lobe infiltrate, cavitation, miliary pattern, hemoptysis or >1 month of any of cough, fever, malaise,weakness, night sweats, or significant weight loss, should have sputa submitted for Mycobacterium tuberculosis smear and culture. Any CAP patient failing or relapsing after empiric therapy should be investigated for TB. In the presence of HIV with low CD4 count (< or = 200 cells/mL), the presentation may be atypical, and therefore sputa should be submitted for M tuberculosis. Any HIV patient, regardless of CD4 count, with a known history of positive tuberculin skin test, previous TB, or recent exposure to TB, who presents with CAP, should be investigated for TB.
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PMID:Tuberculosis: still overlooked as a cause of community-acquired pneumonia--how not to miss it. 1576 19

This retrospective study was conducted at the National Tuberculosis Center (NTBC) where 252 HIV-positive patients coexisting with tuberculosis (TB/HIV) were examined. We found that patients with pulmonary (PTB) and extrapulmonary tuberculosis (EPT) had similar mean age. A higher sex ratio between male to female (10.7:1) was observed in patients with PTB. The other characteristics of patients with pulmonary and extrapulmonary tuberculosis were not statistically different from each other. Cough (88%) and hemoptysis were the most common presenting symptoms, significantly related to patients with PTB. Lymphadenopathy (33.5%) was the most common sign in patients with EPT. The majority of patients with pulmonary and extrapulmonary tuberculosis had CD4 cell counts of less than 200 cells/mm3 (range 0-1,179 with a median of 57 cells/mm3). Lung (89%) and miliary (55.6%) forms were the most frequent disease locations in patients with PTB and EPT, respectively. A higher percentage of patients with PTB (42%) were treated successfully with short-course (6 months) therapy, whereas in patients with EPT (43%) needed a longer period (9 months) for successful treatment. Of the patients who defaulted treatment, a higher proportion (87%) had PTB. No MDR-TB or relapse cases were found in this study.
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PMID:Tuberculosis in HIV/AIDS patients: a Malaysian experience. 1629 50

This prospective study was conducted at Bamrasnaradura Hospital from November 11, 2002, until January 5, 2003, in order to describe the clinical manifestations and determine the aetiologies as well as to assess the short-term outcome of interstitial pneumonitis in HIV/AIDS patients. 59 patients with interstitial infiltrates on chest radiographs were included in the study. Tuberculosis (TB) was the most common diagnosis (44%), followed by Pneumocystis pneumonia (PCP) (25.4%), bacterial pneumonia (20.3%) and fungal pneumonia (10.2%). In TB, compared to other diagnoses, a mild cough (p = 0.031), pallor (p = 0.021), lymphadenopathy (p < 0.001), an absence of skin lesions (p = 0.003), a higher mean body temperature (p = 0.004) and an absence of dyspnoea on exertion (p = 0.042) were significant findings. In PCP, compared to other diagnoses, dyspnoea on exertion (p = 0.014), nonpurulent sputum production (p = 0.047), a higher mean respiratory rate (p < 0.001), and an absence of lymphadenopathy (p < 0.001) were significant factors. In bacterial pneumonia, compared to other diagnoses, production of purulent sputum (p = 0.014), haemoptysis (p = 0.006), skin lesions (p = 0.002) and severe cough (p = 0.040) were significantly associated factors. In fungal pneumonia, compared to other diagnoses, headache and papulonecrotic skin lesions were common findings, but no factor showed a significant association. After four weeks, 59.3% patients were alive and 13.6% had died. Among those alive, 88.6% had clinically improved. The cumulative survival after 28 days was highest among PCP patients, followed by bacterial pneumonia, TB and fungal pneumonia, but these differences were statistically not significant (p = 0.453).
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PMID:Clinical features, aetiology and short-term outcome of interstitial pneumonitis in HIV/AIDS patients at Bamrasnaradura Hospital, Nonthaburi, Thailand. 1641 86

A prospective study was conducted at Bamrasnaradura Hospital, Nonthaburi Province, Thailand from November 11, 2002 to January 5, 2003. A total of 59 HIV/AIDS patients with interstitial infiltrates on chest radiographs were included in the study. The objectives of this study were to describe the clinical manifestations and determine the etiologies of interstitial pneumonitis, assess the short-term outcomes and determine the accuracy of the clinical diagnosis of the etiologies of interstitial pneumonitis in HIV/AIDS patients at Bamrasnaradura Hospital, Nonthaburi, Thailand. Tuberculosis was the most common diagnosis (44%), followed by Pneumocystis carinii pneumonia (25.4%), bacterial pneumonia (20.3%) and fungal pneumonia (10.2%). In tuberculosis, compared to other diagnoses, a mild cough (p = 0.031), pallor (p = 0.021), lymphadenopathy (p < 0.001), absence of skin lesions (p = 0.003), higher mean body temperature (p = 0.004) and an absence of dyspnoea on exertion (p = 0.042) were significant findings. On multivariate analysis, however, only an absence of skin lesions (p = 0.023) remained a statistically significant predictor of TB. In Pneumocystis carinii pneumonia compared to other diagnoses, dyspnea on exertion (p = 0.014), non-purulent sputum production (p = 0.047), a higher mean respiratory rate (p < 0.001), absence of lymphadenopathy (p < 0.001) and lack of purulent sputum (p = 0.030) were significant factors. By multivariate analysis, only an absence of lymphadenopathy were shown to be independently and statistically significantly associated (p = 0.040). In bacterial pneumonia, compared to other diagnoses, production of purulent sputum (p = 0.014), hemoptysis (p = 0.006), pallor (p = 0), skin lesions (p = 0.002) and a severe cough (p = 0.020) were significantly associated factors. On multivariate analysis, none of these factors were statistically significant. In fungal pneumonia, compared to other diagnoses, headache and papulonecrotic skin lesions were common findings, but no factor had a significant association. After four weeks, 59.3% of the patients were alive, 13.6% died and 27.1% were lost to follow-up. Among the alive patients 88.6% had clinically improved. On multivariate analysis, no factor was shown to be a statistically significant predictor of death. The cumulative survival after 28 days was highest among PCP patients, followed by bacterial pneumonia, tuberculosis and fungal pneumonia, but this difference was not statistically significant (p = 0.0453).
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PMID:Clinical features, etiology and short term outcomes of interstitial pneumonitis in HIV/AIDS patients. 1661 Jun 49

Tuberculosis (TB) is the preeminent manifestation of HIV infection and has become a leading cause of maternal mortality and morbidity in high HIV-prevalence settings. Active TB in pregnant women has potentially serious consequences for fetuses and newborns. In Soweto, South Africa, there is a more than 90% uptake of voluntary counseling and HIV testing during routine antenatal care, and almost one third of pregnant women are HIV-infected. The posttest counseling session of the prevention of mother-to-child transmission program provides an opportunity to screen HIV-infected pregnant women for TB. In this study, 370 HIV-infected pregnant women were screened for symptoms of active TB by lay counselors at the posttest counseling session. If symptomatic, they were referred to nurses who investigated them further. Eight women were found to have previously undiagnosed, smear-negative, culture-confirmed TB (2160/100,000). The mean CD4 count in those with active TB compared to those without TB was 276 x 10(6) cells per liter vs 447 x 10(6) cells per liter (P = 0.051). Symptoms most associated with active TB were hemoptysis and fever. We conclude that rates of TB in HIV-infected pregnant women are high, and screening for TB during routine antenatal care should be implemented in high HIV-prevalence settings.
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PMID:Combining PMTCT with active case finding for tuberculosis. 1664 48

The epidemic of type 2 diabetes in the United States prompted us to explore the association between diabetes and tuberculosis (TB) on the South Texas-Mexico border, in a large population of mostly non-hospitalized TB patients. We examined 6 years of retrospective data from all TB patients (n=5049) in South Texas and northeastern Mexico and found diabetes self-reported by 27.8% of Texan and 17.8% of Mexican TB patients, significantly exceeding national self-reported diabetes rates for both countries. Diabetes comorbidity substantially exceeded that of HIV/AIDS. Patients with TB and diabetes were older, more likely to have haemoptysis, pulmonary cavitations, be smear positive at diagnosis, and remain positive at the end of the first (Texas) or second (Mexico) month of treatment. The impact of type 2 diabetes on TB is underappreciated, and in the light of its epidemic status in many countries, it should be actively considered by TB control programmes, particularly in older patients.
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PMID:Type 2 diabetes and tuberculosis in a dynamic bi-national border population. 1686

The resurgence of tuberculosis (TB) in Estonia, a post-socialist Eastern European country, has coincided with delayed case detection suggested by increase in advanced forms of pulmonary tuberculosis among newly detected cases. We estimated the determinants of patient delay in conditions of negligible HIV infection, insignificant immigration and free access to medical care with TB. All newly-detected symptomatic culture-positive patients aged > or =16 y with pulmonary TB from southern Estonia during 2002-2003 (n=185) were interviewed. Intervals greater than the median (79 d) and the 75th percentile (140 d) between onset of the first symptom and the first medical visit were defined as prolonged and extreme patient delay, respectively. Male gender was associated with both prolonged and extreme patient delay (OR 2.12; 95% CI 1.06-4.23 and OR 3.28; 95% CI 1.30-8.26, respectively), whereas rural residence was associated with prolonged patient delay (OR 2.08; 95% CI 1.06-4.08). Median patient delay was shortest when the first symptom was fever (22 d) and greatest when it was cough with haemoptysis (196 d). The study shows that even in absence of barriers in accessing health care, the median patient delay can be longer than in most former studies, whereas males and rural residents are at greater risk.
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PMID:Factors related to patient delay in pulmonary tuberculosis in Estonia. 1714 70

We developed a clinical score to monitor tuberculosis patients in treatment and to assess clinical outcome. We used the WHO clinical manual to choose signs and symptoms, including cough, haemoptysis, dyspnoea, chest pain, night sweating, anaemia, tachycardia, lung-auscultation finding, fever, low body-mass index, low mid-upper arm circumference giving patients a TBscore from 0 to 13. We validated the score with data from a cohort of 698 TB patients, assessing sensitivity to change and ability to predict mortality. The TBscore declined for 96% of the surviving patients from initiation to end of treatment, and declined with a similar pattern in HIV-infected and HIV-uninfected patients, as well as in smear negative and smear positive patients. The risk of dying during treatment increased with higher TBscore at inclusion. For patients with a TBscore of >8 at inclusion, mortality during the 8 months treatment was 21% (45/218) versus 11% (55/480) for TBscore <8 (p< 0.001). TBscore assessed at end of treatment also strongly predicted subsequent mortality. The TBscore is a simple and low-cost tool for clinical monitoring of tuberculosis patients in low-resource settings and may be used to predict mortality risk. Low TBscore or fall in TBscore at treatment completion may be used as a measure of improvement.
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PMID:TBscore: Signs and symptoms from tuberculosis patients in a low-resource setting have predictive value and may be used to assess clinical course. 1785 7

This article reports a rare case of necrotizing pneumonia caused by Panton-Valentine leukocidin (PVL) positive Staphylococcus aureus in an HIV-infected patient presenting with severe back pain and rash. The back pain progressed to excruciating abdominal pain which was misleading, resulting in an investigation on intraabdominal conditions. He developed massive hemoptysis and died within 2 days of the first clinical symptoms. Recognizing the emergence of PVL-producing S. aureus is important in both immunocompetent and immunocompromised patients. This organism was transmitted from his wife.
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PMID:A rapidly fatal case of Panton-valentine leukocidin positive Staphylococcus aureus necrotizing pneumonia in an HIV-infected patient. 1788 8

The aim of the present study was to describe the clinical, biological and the chest-X ray presentations of newly diagnosed pulmonary tuberculosis. A retrospective study of 200 patients was performed from January to October 2004 in the respiratory diseases unit of Dakar's University Teaching Hospital. Among the 200 cases, 140 (70%) were male, giving a sex ratio of 2.3. The mean age of our patients was 35.5 years (range: 14-81 years). The group age of 20 to 39 years was the most affected (55,5% of patients). The median diagnostic delay was 4 months (range: 7 days to 2 years). Haemoptysis revealed the disease in 27% of cases. The chest X-ray showed bilateral lesions in 65% of cases. When they were unilateral, the right side was the most concerned. Of the 200 patients, the lesions interested all parts of at least one lung in 106 (53%). Among our patients, 153 (76.5%) had cavitations and 145 (72.5%) had infiltrates. A pleural effusion was associated to the lung lesions in 10% of the patients. Biologically, we reported 80% cases (n=160) of hypochromic microcytic anaemia. Of the 27 HIV tests done, 18 (66.7%) were positive all for HIV1. Delay in the diagnosis of pulmonary tuberculosis was very long and our data illustrate the need for improved education of the community and event of healthcare workers about the benefit of early diagnosis of tuberculosis.
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PMID:[Clinical, biological and radiological spectrum of newly diagnosed pulmonary tuberculosis]. 1828 47


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