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

The experience with 45 patients with lung abscess over a three-year period at the University College Hospital (UCH), Ibadan, is presented. This study confirms the rarity of this disease among Nigerian children and its prevalence in young adults in the third and fourth decades of life. The most common presenting symptoms were purulent cough, chest pain, fever, and life-threatening hemoptysis which was the sole indication for emergency operation in 14 out of 16 patients who were treated surgically. The predominance of these abscesses in the right lung, especially in the superior segment of the lower lobe, supports the fact that aspiration of infected material, following depressed level of consciousness, esophageal obstruction, foreign bodies, and oral sepsis form the major causative factors in patients with lung abscess. The frequent association of sickle cell disease, bronchiectasis, hypertension, and pulmonary aspergilloma contribute significantly to the morbidity and mortality attendant to this disease in our environment. Twenty-nine patients were treated medically with five deaths and 16 patients were treated surgically with six deaths. The high operative mortality (37.5 percent) in this series was due to the extreme emergency conditions under which these patients were operated.
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PMID:Lung abscess: a review of three-years' experience at the University College Hospital, Ibadan. 42 74

We report a case of idiopathic crescentic glomerulonephritis with pulmonary hemorrhage associated with anti-myeloperoxidase antibodies (anti-MPO ab). A 74 year-old female was admitted to our hospital because of rapidly progressive glomerulonephritic syndrome and dyspnea with bloody sputum. On admission anti-MPO ab, one of anti-neutrophil cytoplasmic antibodies, were detected but anti-GBM antibodies and immune complexes were not detected. Renal biopsy showed crescentic glomerulonephritis and lung biopsy showed massive alveolar hemorrhage. Both tissue had pauci-immune deposit by immunofluorescence microscopy. Hemodialysis and steroid administration were started. Pulmonary hemorrhage was improved remarkably, but renal failure progressed rapidly to end stage kidney, then hemodialysis was continued. Although subsequent 3 years uneventful maintenance hemodialysis had been performed, she admitted to our hospital again because of progressive dyspnea with hemoptysis after upper respiratory tract infection. On admission anti-MPO ab were detected again and steroid administration was started. Pulmonary hemorrhage was improved with decreased anti-MPO ab titer. While tapering the dosis of steroid, anti-MPO ab again increased and pulmonary hemorrhage recurred. Although pulse methylprednisolone therapy and plasma exchange were performed, respiratory failure progressed rapidly and she died of sepsis. Postmortem examination showed no evidence of systemic vasculitis. In this case, titer of anti-MPO ab was associated with not only idiopathic crescentic glomerulonephritis but also with pulmonary hemorrhage. We tried to detect enzymatically active MPO in serum. Titer of serum MPO was also associated with disease activity and anti-MPO ab. It is suggested that both anti-MPO ab and serum MPO are closely related to the pathogenesis of idiopathic crescentic glomerulonephritis and pulmonary hemorrhage.
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PMID:[A case of anti-myeloperoxidase antibodies-associated idiopathic crescentic glomerulonephritis with pulmonary hemorrhage]. 166 75

Solid organ transplant recipients can experience serious disease and death from infection due to the parasitic roundworm Strongyloides stercoralis. This parasite lives in soil contaminated with human feces. Domestic dogs and cats may be another reservoir. Larvae can penetrate the skin, are carried hematogenously to the lungs, migrate up the bronchial tree, and then can be passed to the upper small intestine. Autoinfection occurs in the setting of immunosuppression when invasive larvae penetrate the gut wall and cause disseminated infection. Polymicrobial sepsis is sometimes seen due to enteric organisms adhering to the parasite. Transplant recipients are at highest risk during the first 3 months posttransplant. Many organ systems may be affected. Pulmonary symptoms include cough, wheezing, sputum production, dyspnea, hemoptysis, tachypneas, and pleuritic pain. Hyperinfection, an augmentation of the normal skin-lung-intestine life cycle, occurs in roughly two-thirds of infected transplant recipients, with dissemination in the remainder. Diagnosis is made primarily by examination of the stool or intestinal secretions for ova and parasites. Occasionally, parasites are noted in the sputum. New serologic tests show promise. The parasite may remain in the host for over 25 years before immunosuppression causes either dissemination or hyperinfection. Thiabendazole given for 3 to 7 days is the treatment of choice for organ transplant recipients. Repeat courses may be needed to eradicate infection.
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PMID:Strongyloides infections in transplant recipients. 234 6

A case of aortic aneurysms caused by fungus, following a sepsis of prostatic origin which produced the death of the patient after a massive hemoptysis, is presented. The postmortem study showed an aortic-pulmonary fistula as the cause of massive hemoptysis. We comment on the clinical features and the etiology of the different types of mycotic aneurysms. The advances in diagnosis techniques, the suspicion and the medical-surgical therapy are the factors which improved the prognosis of this serious disease.
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PMID:[Massive hemoptysis secondary to mycotic aortic aneurysm]. 249 94

The various forms of bronchoplastic and angioplastic procedures are the best means of avoiding pneumonectomy. Essential indications are limited respiratory reserve and central site of a malignancy. In a retrospective study 248 broncho- and angioplastic operations carried out in the years 1973 to 1983 were analyzed. Reference date for the analysis of survival was January 1986. In consequence the minimum period of follow-up was two years. For all patients (n = 248) the 5-year-survival was 22% with a 30-day-lethality of 13%. The 5-year-survival of all bronchial sleeve resections operated radically (stage I and II of the TNM-classification) (n = 44) was 42% with a 30-day-lethality of 7%. The 5-year-survival of all bronchoplastic operations of stage I and II (n = 88) was 38% with a 30-day-lethality of 14%. Improved suture material and surgical techniques caused a reduction of operative lethality from 23% to 8% during the described period. In the first thirty postoperative days the following complications caused death: Hemoptysis (n = 5), insufficiency of the anastomosis (n = 3), right heart failure (n = 5), pulmonary embolism (n = 4) and sepsis (n = 1).
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PMID:[Bronchoplastic and angioplastic operations in bronchial carcinoma]. 282 31

Nonmalignant causes of Pancoast's syndrome are extremely rare. The authors report the case of a 32-year-old man, receiving treatment for acute lymphoblastic leukemia, who had a clinical picture resembling that of Pancoast's syndrome. Invasive mucormycosis was diagnosed as the cause of the syndrome at emergency thoracotomy undertaken to control massive hemoptysis. In spite of adequate treatment, the patient died 5 weeks postoperatively of overwhelming sepsis. A review of the literature disclosed only two other similar cases. The authors conclude that the development of Pancoast's syndrome in the immunosuppressed patient should raise suspicion of an invasive fungal infection. A precise early diagnosis may allow successful, specific antifungal therapy to be instituted.
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PMID:Acute Pancoast's syndrome caused by fungal infection. 305 66

A 79-year-old man was hospitalized because of staphylococcal sepsis, and subsequently died from massive hemoptysis. Autopsy revealed a lung abscess which had eroded into the aorta. Severe atherosclerosis of the aorta may have been an important contributing factor.
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PMID:Fatal hemoptysis due to lung abscess and pulmoaortic fistula. 339 31

During an 18-year period, 501 cases of thoracic complications of amebic abscess of the liver were studied; 175 had inflammatory reactions of thoracic structures (165 with pleural effusions and pneumonitis, ten with pericarditis) and 326 ruptured through the diaphragm (175 into the airways, 106 into the pleural cavity, 5 into the pericardium, 39 into the airways and pleura, and 1 into the pleura and pericardium). The thoracic complication was preceded by a picture suggesting an acute inflammatory process or a chronic wasting disease. Depending on type, the complication itself was signaled by increase or change in character of right upper abdominal or lower thoracic pain, dyspnea, or overt respiratory insufficiency, hemoptysis, and expectoration of necrotic material, sepsis, tamponade, and shock. Chest roentgenograms showed small to massive pleural effusions, basal pneumonitis, and cardiomegaly; serology, liver scans, and induced pneumoperitoneum were diagnostic. Treatment included metronidazole and emetine, drainage of pleural or pericardial contents or promotion of bronchial drainage, and meticulous care of associated respiratory, circulatory, and systemic derangements. Mortality for cases with rupture was 11.4 percent, due mainly to sepsis, shock, respiratory insufficiency, and tamponade. The rest of the patients were discharged in cured or improved condition.
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PMID:Thoracic complications of amebic abscess of the liver: report of 501 cases. 722 56

In the past 2 years, eight patients have had repair of coarctation of the aorta or interrupted aortic arch along with an intracardiac procedure performed through a simple midsternotomy. Five underwent total repair and three had palliation for the intracardiac lesion. Four patients did well (including one who required a resection for recoarctation), two died intraoperatively, and two died postoperatively (11 and 21 days), one of them from clostridial sepsis and the other from cerebral anoxia that followed a cardiac arrest precipitated by a massive hemoptysis. We found that with this approach the aortic obstruction could be readily relieved and the intracardiac procedure carried out. Since the majority of these patients have compromised hemodynamic status, the ease of instituting immediate bypass, avoidance of a separate incision, and feasibility of total repair are major advantages.
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PMID:Transmediastinal repair of complex coarctation and interrupted aortic arch. 724 40

Mucormycosis is an opportunistic fungal infection that commonly begins by invading the respiratory tract. The purpose of the present study was to define the clinical presentation of pulmonary mucormycosis and to evaluate current treatment regimens. Thirty patients treated at our institution and 225 cases reported in the literature were reviewed. For the combined groups, the mean age at presentation was 41 +/- 21 years and associated medical conditions included leukemia or lymphoma (37%), diabetes mellitus (32%), chronic renal failure (18%), history of organ transplantation (7.6%), or a known solid tumor (5.6%). The in-hospital mortality was 65% for patients with isolated pulmonary mucormycosis, 96% for those with disseminated disease, and 80% overall. The mortality in patients treated surgically was 11%, significantly lower than the 68% mortality in those treated medically (p = 0.0004). The most common causes of death were fungal sepsis (42%), respiratory insufficiency (27%), and hemoptysis (13%). Pulmonary mucormycosis has a high mortality; however, antifungal agents appear to improve survival. In addition, surgical resection may provide additional benefit to patients with pulmonary mucormycosis confined to one lung.
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PMID:Pulmonary mucormycosis: results of medical and surgical therapy. 816 12


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