Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seven cases of Pneumocystis carinii pneumonia with granulomatous reaction in patients infected with the human immunodeficiency virus are described. The patients were all adult men between the ages of 32 and 45 years, with different high-risk factors. Clinically, all the patients presented with a history of non-productive cough and shortness of breath. Two of the patients had a past history of pulmonary pneumocystosis. Radiologically, six patients had diffuse pulmonary infiltrates and one nodular pulmonary infiltrate. Transbronchial lung biopsies were obtained in four patients and open lung biopsies in three. All presented a predominant granulomatous reaction composed of epithelioid and multinucleated giant cells. Several other special stains to detect the presence of other microorganisms to account for the granulomatous reaction were negative.
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PMID:Granulomatous Pneumocystis carinii in AIDS patients. 823 7

A 24-year-old man was admitted with a 7-month history of non-productive cough, and recent onset of fever and progressive dyspnea. A chest X-ray film and computed tomography (CT) scan showed bilateral infiltrates that indicated pneumocystis pneumonia (PCP). A transbronchial lung biopsy specimen demonstrated Pneumocystis jirovecii infection on Grocott staining, and was positive for acid-fast bacilli without necrotizing granuloma, which indicated coinfection with both Pneumocystis jirovecii and Mycobacterium tuberculosis. A test for human immunodeficiency virus (HIV) infection was positive, and his CD4 + T-lymphocyte count was 92 cells per cubic millimeter. Chest CT findings and pathological findings.were atypical for active tuberculosis (TB). It is important that clinicians should be aware that HIV-infected patients may have concurrent pulmonary TB and PCP, because the diagnosis is difficult.
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PMID:[Coinfection with Pneumocystis jirovecii and Mycobacterium tuberculosis in a patient with AIDS: a first report in Japan]. 2148 52

A 55-year-old man who had a living kidney transplant 3 months previously was admitted complaining of 4 days of non-productive cough and fever. Because of his low oxygen saturation (SpO2 83% on room air), ground-glass opacities in both lung fields, and marked elevation of beta-D-glucan, a diagnosis of Pneumocystis jirovecii pneumonia (PCP) was considered. The diagnosis of PCP was confirmed by bronchoalveolar lavage. Subsequently, his oxygenation level decreased even after the administration of trimethoprim-sulfamethoxazole, therefore we concurrently administered 60 mg of prednisolone. His clinical symptoms and radiographic findings gradually improved. However, his respiratory condition and radiographic findings exacerbated again after the tapering of prednisolone. His condition improved after the prednisolone dose was returned to 30 mg per day. This case suggested that, in the treatment of PCP in patients without human immunodeficiency virus (HIV) infection, reduction of steroids may cause exacerbation of PCP, similar to immune reconstitution inflammatory syndrome which occurs in HIV patients.
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PMID:[A case of Pneumocystis jirovecii pneumonia after kidney transplantation with re-exacerbation following therapy]. 2168 45

A chronic 'productive' or 'wet' cough is a common presenting complaint for patients attending the adult respiratory clinic. Most reviews and guidelines suggest that the causes of a productive cough are the same as those of a non-productive cough and as such the same diagnostic pathway should be followed. We suggest a different diagnostic approach for patients with a productive cough, focussing on the conditions that are the most likely causes of this problem. This review is intended to briefly summarise the epidemiology, clinical features, pathophysiology and treatment of a number of conditions which are often associated with chronic productive cough to aid decision making when encountering a patient with this often distressing symptom. The conditions discussed include bronchiectasis, chronic bronchitis, asthma, eosinophilic bronchitis and immunodeficiency. We also propose an adult version of the paediatric diagnosis of protracted bacterial bronchitis (PBB) in patients with idiopathic chronic productive cough who appear to respond well to low dose macrolide therapy.
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PMID:Causes of chronic productive cough: An approach to management. 2618 84