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)

Because of its clinical polymorphism and the difficulties to made a bacteriological and/or serological diagnosis, leptospirosis is an affection always non-detected. Nevertheless it is daily met affection in French Polynesia. Based on a homogenous series of 120 observations gathered from 1984 to 1990, all of them bacteriologically and/or serologically confirmed, we studied the different clinical and evolutive features of that disease. Fever is present in 91.6 p.c., cephalgia in 79.16 p.c. and myalgia in 70.83 p.c. Admission was necessary once out of four times. The four syndromes we observed in Tahiti are: infections syndrome, meningeal syndrome (30 p.c.) associated to an hyperproteinic grade in the C.S.F. (40 p.c.) and a lymphocytic reaction (60 p.c.). Liver syndrome, with hepatalgia (58.33 p.c.) and pain at the mass motion of liver (65 p.c.), that is an important sign in the local context; jaundice (28.33 p.c.) on the presence of which we must not based a diagnosis of leptospirosis: Biological renal syndrome displayed by transitory renal insufficiency with proteinuria, hematuria and leucocyturia. Neurological complications are mainly of encephalitic manifestations (5.8 p.c.). Hemorrhagic syndrome is expressed in digestive hemorrhage (8.33 p.c.) epistaxis (6.66 p.c.) and hemoptysis (6.66 p.c.). Cardiovascular manifestations are expressed in collapsus in 5.83 of the cases. Pulmonary abnormalities are frequent: cough (26.66 p.c.) and non specific X Ray image (19.16 p.c.). All patients are treated by Penicillin G (10 to 20 millions per day) by parenteral route with enteral alternative for an average of 10 days. Recovery was fast (7 to 10 days). In 65.8 p.c., slower in 15 p.c. (15 to 20 days); failure at first stage was observed in 10 p.c. of the cases, and relapse at medium or long term occurred under treatment in 8 cases (6.66 p.c.). Three dead were deplored (mortality 2.5 p.c.).
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PMID:[Leptospirosis in French Polynesia: 120 case reports]. 160 50

Most cases of blastomycosis are sporadic and only nine outbreaks representing a total of 112 cases have previously been reported. Less than half of these have been culture proven cases. Outbreaks have previously occurred in North Carolina, Minnesota, Illinois, Wisconsin and Virginia. We report three culturally confirmed cases of blastomycosis from Elizabethton, Tennessee, who had onset of illness within a one-week span of time. The patients presented with fever, chest pain, weight loss, poor appetite and myalgia. Each initially had a dry cough which became productive of purulent sputum as the illness progressed. Mild hemoptysis occurred during each patient's course. Serologic testing by immunodiffusion and enzyme immunoassay were positive and testing by complement fixation was negative in each case. The diagnosis was made by histopathology on transbronchial biopsy or transthoracic needle aspiration material. Each patient improved on ketoconazole therapy.
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PMID:An outbreak of blastomycosis in eastern Tennessee. 176 58

In association with treatment for pharyngitis, a 47-year-old white man developed a systemic illness with fever, myalgia, episcleritis, hemoptysis, pleurisy, eosinophilia, and renal impairment. Renal biopsy revealed granulomatous interstitial nephritis, which resolved due to no specific treatment other than withdrawing all medication. Both the severe systemic manifestations and spontaneous recovery are unusual in association with drug-induced granulomatous nephritis. The drugs that may have caused the reaction included dihydrocodeine, phenylpropanolamine, erythromycin, and amoxycillin. Although the latter three drugs have been previously implicated in the development of interstitial nephritis, there have been no previous reports of granulomatous interstitial nephritis with any of these drugs.
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PMID:Drug hypersensitivity causing granulomatous interstitial nephritis. 335 73

14 cases of leptospirosis ictero-haemorrhagica observed on Reunion island with predominant or isolated pulmonary symptoms are described. Hospitalisation was motivated in every case by haemoptysis, at times profuse, which occurred in patients with fever and myalgia. The chest radiographs revealed an alveolar and/or a bilateral alveolar pattern of variable severity. In spite of the importance of chest radiography port raying an extensive and serious pneumonia in one case out of every two, the outcome was favourable with a mean time lag of one week. In three cases, an adult respiratory distress syndrome (ARDS) was seen requiring assisted ventilation and one death occurred. The diagnosis of leptospirosis may be considered, even in countries of low endemicity, in a case pneumonia with extensive haemoptysis or an adult respiratory distress syndrome whose cause is not established by the usual tests.
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PMID:[Predominant pulmonary manifestations in leptospirosis icterohemorrhagica]. 393 42

Wegener granulomatosis is characterized by focal necrotizing granulomatosis of the upper respiratory and pulmonary tracts, by a necrotizing vasculitis and focal necrotizing glomerulonephritis. Clinical symptoms typically include intractable sinusitis or persistent nasal obstruction, serous otitis media, hemoptysis and pleurisy. These symptoms can also be accompanied by intermittent fever, weight loss, myalgia and sensory neuropathy. The oral lesions, including palatal ulceration, lingual ulceration, aphthae, nonhealing extraction sockets, gingivitis, have been infrequently described. Wegener's granulomatosis occasionally presents in the early stages as a characteristic hyperplastic gingivitis, named by the authors "strawberry gums", which fails to respond to conventional periodontal therapy. A case is reported, in which this clinically distinctive gingivitis was the presenting lesion with the serous otitis, illustrating that less frequently occurring entities, such as Wegener's granulomatosis, should be considered in the differential diagnosis of localized gingival lesions which fail to respond to conventional therapy.
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PMID:[Wegener's syndrome (or granulomatosis). A clinical case]. 816 31

Leptospirosis may have important complications, such as acute respiratory failure (ARF) associated or not with other organic dysfunction, with a high mortality rate. We report the characteristics and evolution of severe leptospirosis associated with ARF. During 10 years, 35 consecutive adult patients admitted in two general Intensive Care Units with severe leptospirosis and ARF, were followed up. Clinical characteristics, associated organic dysfunction and mortality were analyzed. Survivors were compared with non-survivors. The most frequent clinical manifestations were dyspnea, fever, myalgia, jaundice, hemoptysis and coughing. All patients presented ARF, needing mechanical ventilation, as well as other organic dysfunctions. The mortality rate was 51%. Non-survivors were older and had a higher incidence of organic dysfunction, mainly renal, cardiovascular and neurological failures, as well as a higher level of acidosis. In conclusion, leptospirosis should be considered as a cause of severe ARF and other associated organic dysfunctions.
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PMID:Leptospirosis as a cause of acute respiratory failure: clinical features and outcome in 35 critical care patients. 1214 50

An outbreak of leptospirosis occurred during the rainy season in the city of Mumbai, India. Out of 169 suspected cases, 74 (43.7%) were determined serologically positive by microagglutination test (MAT) carried out with a battery of eight pathogenic serovars, while 78 (46.1%) were shown positive for IgM antibodies to leptospira by enzyme-linked immunosorbent assay. On the basis of MAT, serovar Copenhageni accounted for 66 (89.1%) out of the 74 cases admitted during the period of the outbreak. Myalgia, conjunctival suffusion, cough with hemoptysis, icterus, and oliguria were significantly more common in patients whose samples were determined positive by MAT. The presence of pulmonary signs and symptoms and renal failure were significantly associated with mortality in patients presumed to be suffering from leptospirosis.
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PMID:An urban outbreak of leptospirosis in Mumbai, India. 1260 28

A dengue outbreak occurred in Kaohsiung City starting in July in 2001. We studied the clinical profile of all patients admitted to Kaohsiung Veterans General Hospital during this outbreak from July 2001 to January 2002. A total of 25 cases of clinically suspected dengue fever were treated during this period, and 13 of them were confirmed by laboratory results (13/25; 52%). Eleven of the 25 patients (11/25; 44%) were admitted. The mean age of the patients with laboratory confirmation of infection was 53 years (range, 7 to 85 years). Headache (7/13; 53.8%), bone pain (8/13; 61.5%), myalgia (10/13; 76.9%), abdominal pain (7/13; 53.8%), and skin rash (9/13; 69.2%) were the most common presentations. A high proportion of patients were classified as having dengue hemorrhagic fever (DHF) [6/13; 46.2%] and 2 of these patients had dengue shock syndrome (DSS) based on the World Health Organization criteria. Pretibial petechia (6/13; 46.1%), gastrointestinal bleeding (6/13; 46.1%), and hemoptysis (4/13; 30.8%) were the most common hemorrhagic manifestations. The average hospital stay was 7.1 days. Thrombocytopenia was very common and 84.6% patients had a platelet count less than 100,000/mm3. Monocytosis was found in all patients. Few patients required blood or platelet concentrate transfusion. The 2 patients who developed DSS both survived. All patients recovered completely without any obvious sequela. In conclusion, there was a high percentage of DHF among patients in the dengue outbreak in 2001. Increasing rates of DHF compared to previous reports from Taiwan may be a sign of hyperendemicity (multiple serotypes present) of the dengue virus in Kaohsiung City and its greater likelihood elsewhere in Taiwan. Prevention and control of both dengue fever and DHF have thus become increasingly important.
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PMID:Characteristics of a dengue hemorrhagic fever outbreak in 2001 in Kaohsiung. 1549 6

Severe leptospirosis rarely presents with primary pulmonary manifestations, without any associated jaundice or renal dysfunction. The authors report a nine-year-old boy who presented with complaints of abrupt onset of high fever; with myalgia, headache, and pain in right chest region, productive cough with hemoptysis and vomiting developing over the past 72 hours. Chest radiograph showed consolidation in the right upper lobe with air bronchogram. A history of contact with sewage water and presence of conjunctival suffusion in a child with pneumonia made us suspect leptospirosis. Following prompt initiation of parenteral penicillin therapy the child's complaints resolved over the next five days. Dri-Dot test to detect anti-Leptospira antibodies was positive. The diagnosis of leptospirosis was confirmed by a positive microagglutination test to Leptospira interrogans serovar Australis by a fourfold rise in antibody titer in paired sera collected during convalescence. Leptospirosis presenting with pulmonary hemorrhage has been associated with significant mortality but it can be successfully treated with early clinical suspicion of alveolar hemorrhage and prompt therapy.
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PMID:Leptospiral pneumonia. 1568 65

We retrospectively reviewed 34 consecutive patients with serologically confirmed leptospirosis admitted during years 1992-2002. Nine patients (26.5%) had respiratory symptoms on admission including cough (n = 4), shortness of breath (n = 4), cyanosis (n = 2), and hemoptysis (n = 1). Six patients had pulmonary radiographic findings including (1) diffuse, ill-defined, ground-glass density (n = 3); (2) diffuse alveolar opacities (n = 2); and (3) small nodular density (n = 1). Male/female ratio was 8/1 and mean age was 47 years. Seven patients reported their exposure source including hunting (n = 2), fishing (n = 2), fresh water swimming (n = 2), and canoeing (n = 1). All patients had fever (mean = 40.1 degrees C). Other common symptoms were headache (n = 4), vomiting (n = 3), and myalgia (n = 3). Biological abnormalities included elevated liver enzymes (n = 8), proteinuria (n = 7), lymphopenia (n = 6), hematuria (n = 5), renal failure (n = 4), anemia (n = 4), and elevated neutrophil count (n = 4). PaO(2 )was measured for 3 patients while they were breathing room air (32, 55, and 66 mmHg). Suspected diagnosis on admission included leptospirosis (n = 2), bacterial pneumonia (n = 2), intoxication, influenza, viral hepatitis, biliary tract lithiasis, and rapidly progressive glomerulonephritis (one patient each). The first serologic testing for leptospirosis was positive for 5 patients (55%). Serovar was presumptively identified for 7 patients: Australis (n = 3), Grippotyphosa (n = 2), and Icterohaemorrhagiae (n = 2). Seven patients were treated with penicillin; two patients received no antibiotics. All patients were cured. In conclusion, patients with leptospirosis may present predominantly with nonspecific pulmonary symptoms. In these patients, leptospirosis must be suspected when there is a potential exposure to rats, especially in case of high-grade fever, myalgia, hepatitis, and renal abnormalities.
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PMID:Respiratory manifestations of leptospirosis: a retrospective study. 1621 64


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