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)

During a one year period acute pericarditis was diagnosed in 16 consecutive patients without acute infarction or malignancy. In two of these patients with both pericarditis and pneumonia Legionella infection was present. One case was caused by Legionella longbeachae and the other by both Legionella longbeachae and Legionella jordanis. When pericarditis is associated with pneumonia Legionella infection should be sought so that effective treatment with erythromycin may be started early.
 ...
PMID:Combined pericarditis and pneumonia caused by Legionella infection. 342 2

A 4-year experience with Legionella pneumophila (LD) diagnosed in 36 patients with cancer was reviewed. Cancer patients represented 24% of the total population of patients acquiring LD during that time. Hematologic neoplasms (42%) and lung cancer (22%) accounted for the majority of afflicted patients. Nosocomial infections occurred in 42% of the patients evaluated. Several risk factors were assessed, and only neutropenia, and previous steroid therapy played a causal role (p less than .05) when assessed in a retrospective case control fashion. Overall mortality in oncology patients with LD (53%) was high and underscores the need rapidly to diagnose and treat this entity. This mortality decreased after 1977 when an effective antibiotic was utilized. Mixed infections also played a major role in outcome and occurred in 31% of the 36 patients studied. The mortality in these cancer patients was 73%, and this emphasizes the need to exclude and treat concomitant bacterial or fungal infections.
 ...
PMID:Legionnaires' disease in patients with cancer. 371 41

The ability of erythromycin A base to penetrate and accumulate in tissue culture cells of human origin was investigated. The antibiotic was highly concentrated by early passage cells of normal bronchus, kidney, liver, lung, and skin and by cancer cells derived from breast, liver, and lung. Intracellular levels 4 to 12 times that of the extracellular milieu were obtained in both early-passage and transformed cells. The total quantity of erythromycin accumulated depended on the extracellular concentration of antibiotic, but the cellular/extracellular ratios were, for the most part, independent of the initial extracellular drug concentration. In all cell types tested, the accumulated antibiotic rapidly egressed when cells were incubated in antibiotic-free medium. Bioactivity assays demonstrated that the expelled drug was unmetabolized, fully active antibiotic. The concentration of erythromycin by a variety of human cell types probably accounts, in part, for the effectiveness of the antibiotic against intracellular parasites such as Legionella and Chlamydia spp.
 ...
PMID:Uptake, accumulation, and egress of erythromycin by tissue culture cells of human origin. 399 46

The records of 59 immunocompromised patients with fever and pulmonary infiltrates who underwent open lung biopsy, were reviewed. A specific diagnosis was made by lung biopsy in 49 (83%) patients, and in 32 instances (54%) the diagnosis was a treatable infection. Only two (3.4%) false-negative biopsies occurred. Transplant recipients were more likely to have a specific, treatable pneumonia (74%) than patients with a reticuloendothelial malignancy (42%, P less than 0.05). This was due to a greater frequency of bacterial pneumonias, primarily due to Legionella, in transplant recipients (P less than 0.01). However, obtaining a specific diagnosis by lung biopsy did not appear to improve outcome. Seventeen of 32 (53%) patients with treatable infections survived, compared to 8 of 16 (50%) with specific, but untreatable, diagnosis and 6 of 11 (55%) with nondiagnostic biopsies. Advanced age and a low platelet count were predictive of death in both transplant recipients and patients with leukemia and lymphoma (P less than 0.05); a high serum creatinine was an additional predictor in renal transplant recipients.
Cancer 1983 Sep 15
PMID:Diagnosis of pneumonitis in immunocompromised patients by open lung biopsy. 634 79

To add information about sporadic Legionnaires' disease, 87 cases of L. pneumophila pneumonia were reviewed. Twenty cases were nosocomial infections and 67 cases were community-acquired. Most cases (64%) occurred between July and October. The mean age of patients was 51.4 years and males outnumbered females 2.5:1.0. Thirty-one percent of patients were receiving corticosteroid, immunosuppressive, or antineoplastic chemotherapy when illness began. Immunosuppression at onset of illness was more common in nosocomial infections (90%) than in community-acquired infections (14%). Seventy percent of patients had underlying diseases. Malignancies, renal failure, and transplantation were the most common conditions underlying nosocomial infections. Chronic lung disease and malignancies were the most common diseases underlying community-acquired infections. The case-fatality rate in nosocomial infection (70%) was greater than that in community-acquired disease (22%). Clinical, laboratory, and radiologic features of the cases were examined. Illness ranged from mild to severe. Extrapulmonary findings of encephalopathy and renal failure were more common in fatal than in non-fatal cases. Indirect immunofluorescent and microagglutination antibody responses plateaued by the fourth week of illness. Twenty-nine patients died. The case-fatality rate of patients receiving erythromycin (6%) was less than that of patients receiving penicillin (36%), ampicillin (28%), cephalosporin (32%), or aminoglycosides (41%). Despite erythromycin therapy, the case fatality rate for nosocomial L. pneumophilia pneumonia was unacceptably high (25%).
 ...
PMID:Sporadic Legionnaires' disease: clinical observations on 87 nosocomial and community-acquired cases. 646 87

In a clinical demonstration, case reports on 3 patients are presented: 1. In a 27-year-old male who developed severe multicentric atypical pneumonia, CNS, liver and renal involvement and signs of rhabdomyolyses suggested infection with Legionella pneumophila. Diagnosis was confirmed by the presence of Dieterle-stain positive organisms and positive culture of lung biopsy tissue. Antibiotic treatment, especially erythromycin, and prolonged mechanical respiration produced complete recovery. 2. The presence of chylomycrons Rin ascitic and pleural fluid in a patient with epimembranous glomerulonephritis and nephrotic syndrome was the first sign of malignant non-Hodgkin lymphoma. Chemotherapy with cyclophosphamid, oncovin and prednisone induced remission of tumor and nephrotic syndrome, which promptly recurred parallel to later reactivation of the malignancy. Paraneoplastically induced nephrotic syndrome, especially due to lymphoma, may precede the malignancy by months. 3. In a 52-year-old male with terminal renal failure due to primary oxalosis a cadaver renal transplant functioned for only 14 months because of oxalate deposits in the transplant. Hemodialysis before and after transplantation modified the clinical course. In place of uremia, the clinical picture was dominated by oxalate-induced gangrenous arteriopathy, arthritis, and heart disease.
 ...
PMID:[Clinical demonstrations. Legionnaires' disease. Tumor-associated nephrotic syndrome. Primary oxalosis]. 703 33

A new and as yet unidentified bacterium was isolated from the lung tissue of a cancer patient with bilateral pneumonia. Clinically, the pneumonia was consistent with legionellosis; the organism cultured from the lung grew only on the charcoal-yeast extract agar routinely used for Legionella isolation. Subsequent testing, however, showed the organism to be quite distinct from the known Legionella species in its biochemical, antigenic, and growth characteristics.
 ...
PMID:Pneumonia caused by a previously undescribed bacterium. 713 Mar 63

As of April 30, 1980, 83 nosocomial cases of sporadic legionellosis had been reported to the Centers for Disease Control (CDC). In all 83 cases the patients had pneumonia; the median age of the patients was 56.5 years. All but one patient were hospitalized at the time of onset. Of 71 patients for whom the outcome is known, 22 (31 percent) died of causes directly attributed to their infection. Eleven patients had end-stage renal disease, 28 were receiving systemic immunosuppressive medications, 17 had cancer, 12 had chronic bronchitis or emphysema, 29 were smokers, and four had diabetes mellitus. Risks of acquiring nosocomial sporadic legionellosis for patients with these conditions relative to the general United States population = 340, 26, 11, 3.7, 1.9 and 1.3, respectively. These risk factors are similar to those identified for sporadic community-acquired legionellosis and for epidemic nosocomial legionellosis. Methods for preventing nosocomial legionellosis are not known, but comparing Legionella to other water-associated organisms which have been spread from medical devices to cause pneumonia may be fruitful.
 ...
PMID:Sporadic and epidemic nosocomial legionellosis in the United States. Epidemiologic features. 721 4

The authors report on their institution's experience with 53 lung biopsies, including 26 open, 22 transbronchial, and five trephine air drill biopsies, performed in immunocompromised patients with roentgenographic pulmonary infiltrates. Open biopsy was far more likely to provide a specific etiologic diagnosis (81%, P less than 0.001) than transbronchial biopsy (32%), or trephine biopsy (20%). Infection (17 biopsies), neoplastic disease, (7) or drug-related pneumonitis (2) were identified most frequently. Patients with myeloproliferative disease, granulocytopenia, or those who had not received prior immunosuppressive therapy were most likely to have a nondiagnostic biopsy (P less than 0.05 for each factor). The overall complication rate of biopsy procedures was 15% and was comparable with all three methods. Survival in this series was not significantly lower if a specific etiologic diagnosis could not be established, but correlated with the respiratory rate (less than 20 per minute), pO2 (greater than 60 torr), and the roentgenographic pattern (other than bilateral diffuse disease) at the time of biopsy (P less than 0.05 for each factor). There were 18 cases (34%) in which a clearcut etiologic diagnosis would not be established at the time of biopsy; based on serologic tests performed ex post facto, 2 of 12 of these cases (17%) were Legionnaire's disease. Lung biopsies were helpful in the management of the majority of the cases, although nondiagnostic biopsies continue to be a problem. The authors propose an approach to the management of compromised patients with pulmonary infiltrates.
Cancer 1981 Sep 01
PMID:Lung biopsy in immunocompromised patients: one institution's experience and an approach to management of pulmonary disease in the compromised host. 727 48

As of 30 September 1979, 1005 confirmed cases of sporadic legionellosis caused by Legionella pneumophila serogroups 1 to 4 in U.S. residents had been reported to the Centers for Disease Control; 19% were fatal. All but 2% of the 1005 cases were associated with pneumonia documented by chest radiograph. About 75% of the cases occurred in June through October. The risk of acquiring sporadic legionellosis was increased among males and persons 50 years or older; persons with renal disease necessitating dialysis or transplantation, with chronic bronchitis or emphysema, with diabetes mellitus, and with cancer (10 selected sites or types); persons who smoke; and persons being treated with immunosuppressive drugs. Increasing age and chronic bronchitis or emphysema were associated with increased risk of death. The sensitivity of culturing L. pneumophila from specimens positive by direct immunofluorescence was estimated to be 45%. The distribution of serogroups 1, 2, 3, and 4 of L. pneumophila in 57 fresh, not previously examined direct fluorescent antibody-positive specimens was 84%, 11%, 4%, and 2%, respectively; all 26 strains isolated from these specimens were of one of these four serogroups.
 ...
PMID:Sporadic legionellosis in the United States: the first thousand cases. 746 7


<< Previous 1 2 3 4 5 Next >>