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)

A 49-year-old man suffered massive necrosis of the lung subsequent to a pneumococcal lobar pneumonia. Development of massive hemoptysis required emergency lobectomy. The patient is doing well six months after surgery. Pulmonary gangrene is a rare but grave complication of the lobar pneumonia. Both pneumococcal and Klebsiella pneumonias may progress to massive pulmonary gangrene despite antibiotic treatment. Survival seems to depend on the surgical removal of the necrotic tissue, which removes the danger of sudden massive hemoptysis.
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PMID:Massive pulmonary gangrene. 89 47

In the literature only 13 cases of voluminous necrosis of lung tissue, generally referred to as massive pulmonary gangrene, could be found. This disease constitutes an unusual, very severe complication of lobar pneumonia, mostly due to Klebsiella. This type of pneumonia generally affects old or otherwise debilitated persons, quite often chronic alcoholics. It has a high lethality of 20%. Our own observation in a 48-year-old man is presented. He suffered from recurrent massive hemoptysis in relation with a huge cavity of the right lung, filled with necrotic lung tissue. Following right pneumonectomy empyema developed, also due to Klebsiella; it was successfully treated with thoracic fenestration according to Clagett. Knowledge of this severe infrequent complication of pneumonia is necessary since it requires early operative treatment: Out of the 14 patients four were treated medically only and died, while the remaining ten underwent surgery and were all cured.
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PMID:[Massive lung necrosis in klebsiella pneumonia (so-called massive lung gangrene)]. 699 Apr 84

We identified 31 patients with human immunodeficiency virus (HIV) infection and lung abscess. All patients had advanced HIV disease, and the mean CD4 cell count was 17/mm3 (range, 2-50/mm3). Twenty-two patients (71%) had previous opportunistic infections, and 24 (77%) had previous pulmonary infections. Symptoms at the time of presentation included fever (90% of patients), cough (87%), dyspnea (35%), pleuritic chest pain (26%), and hemoptysis (10%). The microbiological etiology was established for 28 patients, and the pathogens recovered were bacteria (65%), Pneumocystis carinii (6%), fungi (3%), and mixed microorganisms (16%). The pathogens included Pseudomonas aeruginosa (11), Streptococcus pneumoniae (6), P. carinii (5), Klebsiella pneumoniae (5), Staphylococcus aureus (4), Aspergillus species (3), viridans streptococcus (2), Haemophilus influenzae (1), Streptococcus milleri (1), Proteus mirabilis (1), and Cryptococcus neoformans (1). Mycobacterium tuberculosis was not isolated; two patients for whom a microbiological etiology was not established responded to antituberculous therapy. Patients were treated for 2-12 weeks; 25% of the patients received > 4 weeks of therapy. The outcome was poor: 36% of the patients had recurrences, and 19% died. In patients with AIDS, lung abscess is associated with advanced HIV infection, is due to a broad spectrum of pathogens, responds poorly to antibiotics, and has a poor prognosis.
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PMID:Lung abscess in patients with AIDS. 882 70

Klebsiella pneumoniae is an uncommon cause of community-acquired pneumonia except in alcoholics. Klebsiella may mimic pulmonary reactivation tuberculosis because it presents with hemoptysis and cavitating lesions. Klebsiella pneumoniae is a difficult infection to treat because of the organism's thick capsule. Klebsiella is best treated with third- and fourth-generation cephalosporins, quinolones, or carbapenems. Monotherapy is just as effective as a combination treatment in Klebsiella pneumoniae because newer agents are used. In the past, older agents with less anti-Klebsiella activity were needed for effective treatment. The patient we present was initially thought to have pulmonary tuberculosis, and when found to have Klebsiella pneumoniae, the suggested treatment was monotherapy with ceftriaxone. The patient was treated parenterally initially, and then was treated for 3 weeks with oral ofloxacin.
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PMID:Klebsiella pneumoniae pneumonia. 931 70

Necrotizing pneumonia is a rare complication of community-acquired pneumonia associated with destruction of the lung tissue during the infection and rise of necrotic foci in consolidated areas. Staphylococcus aureus, Streptococcus pyogenes, Nocardia, Klebsiella pneumoniae and Streptococcus pneumoniae are the most common causative agents. Risk factors for developing necrotizing pneumonia include smoking, alcoholism, old age, diabetes mellitus, chronic lung diseases or liver disease. Diagnosis of necrotizing pneumonia requires supportive care, use of broad-spectrum antibiotics and monitoring for sepsis and respiratory failure. Hemoptysis, abscess, empyema and gangrene are possible complications and surgical intervention may be required. The authors present a clinical case of pneumococcal necrotizing pneumonia in a patient without important risk factors and favourable progression with medical therapy. In this regard, a brief bibliographic review about this pathology is also made.
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PMID:[Necrotizing pneumonia - a rare complication]. 2288 49

Klebsiella species infrequently cause acute community acquired pneumonia (CAP). The chronic form of the disease caused by K. pneumoniae (Friedlander's bacillus) was occasionally seen in the pre-antibiotic era. K. oxytoca is a singularly uncommon cause of CAP. The chronic form of the disease caused by K. oxytoca has been documented only once before. A 50-year-old immunocompetent male smoker presented with haemoptysis for 12 months. Imaging demonstrated a cavitary lesion in the right upper lobe with emphysematous changes. Sputum stains and cultures for Mycobacterium tuberculosis were negative. However, three sputum samples for aerobic culture as well as bronchial aspirate cultured pure growth of K. oxytoca. A diagnosis of chronic pneumonia due to K. oxytoca was established and with appropriate therapy, the patient was largely asymptomatic. The remarkable clinical and radiological similarity to pulmonary tuberculosis can result in patients with chronic Klebsiella pneumonia erroneously receiving anti-tuberculous therapy.
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PMID:Chronic pneumonia due to Klebsiella oxytoca mimicking pulmonary tuberculosis. 2637

Strongyloidiasis, due to infection with the nematode Strongyloides stercoralis, affects millions of people in the tropics and subtropics. Strongyloides has a unique auto-infective lifecycle such that it can persist in the human host for decades. In immunosuppressed patients, especially those on corticosteroids, potentially fatal disseminated strongyloidiasis can occur, often with concurrent secondary infections. Herein, we present two immunocompromised patients with severe strongyloidiasis who presented with pneumonia, hemoptysis, and sepsis. Both patients were immigrants from developing countries and had received prolonged courses of corticosteroids prior to admission. Patient 1 also presented with a diffuse abdominal rash; a skin biopsy showed multiple intradermal Strongyloides larvae. Patient 1 had concurrent pneumonic nocardiosis and bacteremia with Klebsiella pneumoniae and Enterococcus faecalis. Patient 2 had concurrent Aspergillus and Candida pneumonia and developed an Aerococcus meningitis. Both patients had negative serologic tests for Strongyloides; patient 2 manifested intermittent eosinophilia. In both patients, the diagnosis was afforded by bronchoscopy with lavage. The patients were successfully treated with broad-spectrum antibiotics and ivermectin. Patient 1 also received albendazole. Strongyloidiasis should be considered in the differential diagnosis of hemoptysis in immunocompromised patients with possible prior exposure to S. stercoralis.
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PMID:Hemoptysis in the Immunocompromised Patient: Do Not Forget Strongyloidiasis. 3075 12