Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A gram-negative, weakly acid-fast bacillus has been isolated in embryonated eggs and in guineapigs from lung tissue of two renal-transplant recipients with acute purulent pneumonia. Culture of infected lung tissue and subculture of the egg isolate on artificial media, including media for legionnaires' disease bacterium (Legionella pneumophila), failed to produce growth. Ultrastructural analysis showed that the organism is a prokaryote with a cell-wall structure typical of a gram-negative bacillus but different from that of L. pneumophila. In both patients serum antibody to both isolates developed in high titre. In its microbiological, tinctorial, and ultrastructural characteristics this bacterium differs sufficiently from L. pneumophila and other pulmonary pathogens to indicate that it may be a new agent of bacterial pneumonia.
 ...
PMID:New bacterial agent of pneumonia isolated from renal-transplant recipients. 8 63

Eight immunosuppressed patients had pneumonia due to Pittsburgh Pneumonia Agent (PPA), a gram-negative, weakly acid-fast bacterium cultivatable only in embryonated eggs and guinea pigs and distinct from Legionella pneumophila. The diagnosis was established by isolation of the agent from lung or visualization of the organism in lung tissue. The clinical presentations, radiographic abnormalities and pathology were not specific. The most consistent feature associated with the disease was the recent institution of daily high-dose corticosteriod therapy in all patients. Five of the eight patients died despite broad-spectrum antibiotic and antituberculous therapy. Anti-microbial activity against PPA was demonstrated for sulfamethoxazole combined with trimethoprim, for rifampin and for erythromycin with an egg-protection assay. Serologic studies with an indirect fluorescent-antibody technic suggested that seroconversion or high titers may be a sensitive test for PPA disease. PPA appears to be a newly recognized cause of life-threatening bacterial pneumonia in immunosupressed patients.
 ...
PMID:Opportunistic lung infection due to "Pittsburgh Pneumonia Agent". 38 16

The pulmonary histopathologic features in a sporadic case of Legionnaires' disease are shown. The changes include acute bronchitis with focal ulceration and diffuse acute interstitial pneumonitis. These changes are not those seen with typical bacterial pneumonia but are similar to changes seen when viruses, rickettsiae, chlamydiae, or Mycoplasma pneumoniae organisms are the infecting agents.
 ...
PMID:Legionnaires' disease. Clinical and pulmonary histopathologic features of a sporadic case. 67 58

The Working Party for Legionellosis headed by the Japanese Ministry of Health and Welfare processed to standardize the diagnostic procedures for Legionella pneumonia, as the first step to clarify the actual occurrence of patients with this respiratory disease. All the clinical data were collected and analysed on the 28 culture-confirmed patients in Japan during the past 11 years, from 1980 through 1990. The 28 patients were distributed throughout Japan, from Hokkaido to Kyushu. Out of 28 patients, 18 were community-acquired and 10 were nosocomially infected. In 8 of 18 community-acquired patients, any significant underlying disease was not observed. Though it was dominant in the age group in their 60s & 70s, victims were distributed in adults over 20 years of age and even in a new born baby. Only 5 out of 28 patients recovered successfully. From the autopsy findings, in 5 out of the remaining 23 expired patients, Legionella pneumonia seemed to be successfully treated, but other disease or other bacterial pneumonia put an end to the patients. The results of clinical laboratory tests and the efficacy of antibiotics to Legionella pneumonia were essentially the same as those reported in the literature.
 ...
PMID:[Culture-positive Legionella pneumonia in Japan, 1980-1990. Working Party for Legionellosis, Japanese Ministry of Health and Welfare]. 129 51

In a prospective study the efficacy of fiberoptic bronchoscopy was evaluated in the diagnosis of infections with opportunistic pathogens, Kaposi's sarcoma and nonspecific interstitial pneumonitis in 171 episodes of pneumonitis in 151 HIV-infected patients. Samples were collected by suction through the inner aspiration channel of the bronchoscope (n = 164), telescoping plugged catheter (n = 117) and transbronchial lung biopsy (n = 82). A high incidence of infections with pyogenic bacteria (12%), Legionella spp. (5 %) and Mycobacterium tuberculosis were diagnosed (9%). Bronchoalveolar lavage demonstrated a high diagnostic rate in bacterial pneumonia (significance level greater than 10(5) cfu/ml) and a low degree (10%) of contamination (less than 1% squamous epithelial cells). Bronchoalveolar lavage was more effective than the telescoping plugged catheter in yielding a significant number of colonies in patients with bacterial pneumonia previously treated with antibiotics. Nondiagnosed pneumonitis was more frequent in intravenous drug abusers than in homosexual men (p less than 0.001).
 ...
PMID:Fiberoptic bronchoscopic diagnosis of pulmonary disease in 151 HIV-infected patients with pneumonitis. 165 32

Bronchoalveolar washout was performed in 130 patients with pneumonia during a period of 28 months. Microbiological investigation involved common bacteria, Legionella, fungi, viruses (Cytomegalovirus, herpes, RSV), Mycobacterium, and Pneumocystis carinii. Infection HIV was present in 75% of patients. The remaining patients had malignant diseases or severe pneumonia. The overall sensitivity of the technique was 65.4% and the positive predictive value was 92%. The technique was less sensitive in cases of bacterial pneumonia (sensitivity = 34.4%). This was attributed to the fact that 82.8% of these cases received antibiotic therapy. Pneumocystis carinii and Mycobacterium tuberculosis were the most common agents (44.8% and 34.5%, respectively). In seven instances the clinical picture was related to cytomegalovirus, although this diagnosis can not be easily done.
 ...
PMID:[Evaluation of bronchoalveolar lavage in the microbiological diagnosis of pneumonia in patients at risk]. 186 7

A rapid diagnostic team was formed to facilitate the diagnosis of pulmonary infections in solid organ transplant recipients. Seventy-seven renal and three liver transplant recipients developed 86 episodes of pneumonitis between 6 and 2,410 days posttransplant (median, 117 days). A diagnosis was established in all but seven patients. More than one diagnosis was established in 25. Cytomegalovirus (CMV) occurred in 51 episodes, bacterial pneumonia in 16 episodes, Pneumocystis carinii (PCP) in 11 episodes, fungal or Nocardia in 10 episodes, and Legionellosis in six episodes. Over half of the episodes of pneumonitis occurred in the period 1 to 4 months posttransplant. Bacterial pneumonia occurred significantly later than pneumonitis caused by PCP, Legionella, or CMV. Death occurred in 24 transplant recipients (31%) including 19 of 49 patients (39%) with CMV. Diffuse disease was the most common abnormality noted on initial chest roentgenogram (79 of 111, 71%). Interstitial infiltrates were the most common type of radiographic lesion observed, accounting for 62 of 111 (56%). Fiberoptic bronchoscopy was performed in 69 transplant recipients. Thirty-six of the 65 diagnoses made were established early, within 24 hours after bronchoscopy. Of the remaining diagnoses established later than 24 hours, all but one case of CMV was included. Bronchial alveolar lavage alone established 31 of the diagnoses. Bronchial brushings alone established only six cases, including five episodes of bacterial pneumonia and one case of CMV. We conclude that a team approach relying on fiberoptic bronchoscopy is useful in establishing the diagnosis of pulmonary infections in solid organ transplant recipients.
 ...
PMID:The rapid diagnosis of pulmonary infections in solid organ transplant recipients. 216 Jul 17

Approximately 4% of recipients of solid organ transplants in the United States develop bacterial pneumonia in the posttransplant period, often in the first 3 months following transplantation. The incidence of bacterial pneumonia is highest in recipients of heartlung (22%) and liver transplants (17%), intermediate in recipients of heart transplants (5%), and lowest in renal transplant patients (1 to 2%). The crude mortality of bacterial pneumonia in solid organ transplantation has exceeded 40% in most series. Beyond those risk factors identified for nosocomial pneumonia, the occurrence of primary cytomegalovirus (CMV) infection, graft rejection, maintenance antirejection therapy with prednisone, azathioprine, and antilymphocyte globulin, antirejection therapy with high-dose corticosteroids or OKT3 and splenectomy have been associated with a significantly increased risk of bacterial pneumonia in these patients. In the first 3 months posttransplant, gram-negative bacilli, Staphylococcus aureus and Legionella predominate and mortality is very high, in excess of 60%. Thereafter, bacterial pneumonias are caused primarily by Streptococcus pneumoniae and Hemophilus influenzae, with considerably lower mortality. Bacterial pneumonia must be suspected in any transplant patient presenting with fever and cough, especially associated with dyspnea or infiltrates on chest radiograph. If large numbers of bacteria and polymorphonuclear leukocytes are not visualized in respiratory secretions the work-up should proceed directly to fiberoptic bronchoscopy with bronchoalveolar lavage and/or protected brush specimen to establish the microbiologic diagnosis as accurately as possible. For presumptive gram-negative bacillary pneumonia, the initial regimen must be effective against Pseudomonas aeruginosa. Prevention of bacterial pneumonia in transplant patients must begin with immunization against S pneumoniae and Influenza A, and include precautions taken to prevent nosocomial pneumonia. It further may include measures to prevent CMV infection and the use of trimethoprim/sulfamethoxazole prophylaxis during the first year posttransplantation. Ultimately, novel technologies such as selective antimicrobial decontamination and/or protective isolation during the early postoperative period may prove effective.
 ...
PMID:Bacterial pneumonia in solid organ transplantation. 218 17

Micro-organism counts of bronchoalveolar lavage (BAL) and microbrush swabs were obtained from 40 immunocompetent (group A) and 23 immunosuppressed (group B) patients with nosocomial pneumonia, and a control group consisting of 40 patients with noninfectious pulmonary infiltrates. The sensitivity of BAL was high: 77.5% for group A and 85% for group B, while microbrush swabs gave many false-negative results. Microorganism counts were at or above 10(5) cfu/ml in 32 of 44 examinations (bacterial or mycotic pneumonia), but in only one case of the control group. Lower counts were obtained with localized infection and microorganisms difficult to culture (Aspergilla and Legionella). Granulocytosis in the lavage fluid was demonstrated in 38 of 41 patients with bacterial pneumonia and thus proved useful in the differential diagnosis. In 16 of 40 immunocompetent and 13 of 23 immunosuppressed patients with pneumonia the results were therapeutically of importance. Thus, invasive diagnosis is indicated especially in complicated or treatment-resistant nosocomial infections.
 ...
PMID:[Bronchoscopic diagnosis of pneumonia with quantitative microbial count determination]. 220 28

We studied the efficacy and safety of bronchoscopy with bronchoalveolar lavage (BAL) in mechanically ventilated patients. Seventy-seven patients, 60 of whom underwent BAL, were analyzed. Of the patients undergoing BAL, 30 had clinical pneumonia, 24 had a diagnosis other than pneumonia by clinical criteria or autopsy, and six could not be classified but clinically improved without changing their antibiotic therapy. Of the 30 pneumonia patients, 18 had bacterial cultures felt to be diagnostic of bacterial pneumonia: two cases of Legionella pneumophila, and 16 cases with one or more organisms recovered at greater than 10(4) cfu/ml of BAL fluid. No patient without the clinical diagnosis of pneumonia had a positive bacterial culture greater than 10(4) cfu/ml of BAL fluid (chi-square = 18.2, p less than .001). Of the patients classified with pneumonia, Pneumocystis carinii was found in six and cytologic evidence of viral infection in three patients. Of the 30 patients undergoing BAL with pneumonia, 27 had one or more pathogens identified in the lavage specimen. Although no patient died as a result of lavage, significant hypoxemia was encountered in some patients undergoing lavage. In 35 patients with the same FIO2 before and after bronchoscopy, the median change in PO2 was -8.0 torr (range -63.0 to +29.0). We found that bacterial cultures of BAL fluid appeared useful in defining the presence and etiology of pneumonia.
 ...
PMID:Use of bronchoalveolar lavage to diagnose bacterial pneumonia in mechanically ventilated patients. 229 9


1 2 3 4 5 6 7 8 Next >>