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

Eight adult patients from Port Elizabeth with significantly raised indirect fluorescent antibody titres of greater than or equal to 256 against the Legionnaires' disease bacterium are described. One of these patients had in addition elevated antibody levels against Mycoplasma pneumoniae. The clinical manifestations of the patients ranged from an 'influenza-like' illness in 1 patient to pneumonia of varying severity in 6. One patient had a severe illness with fever, couth and encephalopathy, together with the uncharacteristic features of lymphadenopathy and a petechial rash. This patient did not have pneumonia. Attention is drawn to unusual clinical aspects in some of the patients and the need for improved definitive diagnostic procedures is emphasized.
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PMID:Legionnaires' disease in Port Elizabeth. 699 44

The authors report the first two cases of legionnaires' disease from Catalonia. Both patients were chronic bronchitic males, and the cases were sporadic. The onset of the disease was characterized by a febrile illness with muscle and joint pains, respiratory symptoms (cough and mucous sputum production), and mental changes. There were no digestive complaints. Pulmonary consolidation occurred in both patients in the left upper lobe. Blood chemistries disclosed the existence of an absolute lymphopenia, altered liver function tests, and elevated CPK levels. Bacterial cultures of blood and sputum, respiratory virus screening (influenza A and B, parainfluenza 1, 2 and 3, and adenoviruses), and tests for Mycoplasma pneumoniae, Coxiella burnetti and Chlamydia psittaci were all negative. Antibody titers against Legionella pneumophila by indirect immunofluorescence were 1/1024 (positive) for serotype 1 and 1/1024 (positive) for serotype II in one patient, and 1/1024 (positive) for serotype I and 1/128 (negative) for serotype II in the other patient. The authors review the epidemiological, clinical, biochemical and diagnostic aspects of legionnaires' disease, which knowledge will undoubtedly allow to detect an increasing number of cases.
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PMID:[Legionnaires' disease. First observations in Catalonia (author's transl)]. 725 29

The incidence of bacterial, viral, mycoplasma, and rickettsial infections has been assessed prospectively in 210 adult patients with pneumonia who presented to a district hospital over a six-year period. One hundred and thirteen infective agents were detected in 103 patients. The agent most frequently detected was Mycoplasma pneumoniae which accounted for 30 infections. A bacterial pathogen was found in 43 patients. Streptococcus pneumoniae was the most common of these (24 patients); Staphylococcus aureus (eight), Haemophilus influenzae (four), Klebsiella spp (three), and Legionella pneumophila (three) were all less common. Chlamydial or rickettsial infections (Psittacosis or Q fever) were detected in nine patients. Viral infections were found in 31 patients (22 influenza A, four influenza B, two parainfluenza, and three respiratory syncytial virus). There were 10 patients in whom more than one pathogen was identified. In 107 patients no pathogens could be identified. Seventy-five per cent of these patients had either received antibiotics before entering hospital, or were unable to produce any sputum for culture. The incidence of bacterial pneumonia has probably therefore been underestimated. Nevertheless this survey does emphasise the importance of M pneumoniae as a pathogen in patients with pneumonia presenting to hospital.
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PMID:Causes of pneumonia presenting to a district general hospital. 731 31

We present a case of Legionnaires' disease complicated by cold agglutinin disease. Therapy with erythromycin gluceptate was associated with resolution of both the pneumonia and the hemolysis. Complement-fixing antibody levels to Mycoplasma pneumoniae, influenza A, and adenoviruses were measured repeatedly throughout the clinical illness and were persistently nondiagnostic. The cold agglutinin present in the patient's serum was characterized as an IgM that demonstrated anti-I specificity. Thus, Legionella pneumophila should be considered a potential causative agent in patients with pneumonia and cold agglutinin disease.
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PMID:Cold agglutinin disease in a patient with Legionnaires' disease. 743 51

Respiratory infections precipitate wheezing in many asthmatic patients and may be involved in the aetiopathogenesis of asthma. Several studies have demonstrated that viral infections may provoke asthma. Bacterial infections seem to play a minor role. However, Chlamydia pneumoniae has been recently reported as a possible cause of asthma. The aim of the present study was to evaluate the role of C. pneumoniae infection in acute exacerbations of asthma in adults. Seventy four adult out-patients with a diagnosis of acute exacerbation of asthma were studied. Acute and convalescent (> or = 3 weeks) serological determination of antibodies to cytomegalovirus, respiratory syncytial virus, adenovirus, influenza A and B, parainfluenza 1 and 3, Mycoplasma pneumoniae and Legionella pneumophila were performed by means of immunofluorescence tests. C. pneumoniae specific antibodies were detected by two microimmunofluorescence tests using a specific antigen (TW-183) and a kit with three chlamydial antigens. Pharyngeal swab specimens were also obtained for C. pneumoniae identification. Samples for bacterial culture were obtained in patients with productive cough (15 out of 74 patients). Fifteen patients (20%) presented seroconversion to at least one of the studied pathogens. Seven were found to be infected by virus, six by C. pneumoniae alone, and one by M. pneumoniae. One more patient showed seroconversion to C. pneumoniae and cytomegalovirus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acute exacerbations of asthma in adults: role of Chlamydia pneumoniae infection. 771 98

Diabetes mellitus is often identified as an independent risk factor for developing lower respiratory tract infections. Pulmonary infections, such as those caused by Mycobacterum tuberculosis, mucor, Staphylococcus aureus, and gram-negative bacteria may occur with an increased frequency whereas infections due to Streptococcus pneumoniae, Legionella, and influenza may be associated with increased morbidity and mortality. The predisposition to lower respiratory tract infections may represent alterations in pulmonary host defenses at several levels. The purpose of this article is to review the spectrum of pulmonary infections encountered in the diabetic patient, focusing on predisposing defects in pulmonary host defense, highlighting characteristic clinical features, and discussing diagnostic approaches, therapeutic interventions, and prophylaxis in this patient population.
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PMID:Pulmonary complications of diabetes mellitus. Pneumonia. 776 21

Over a two year period, we prospectively studied 110 adult patients with Community Acquired Pneumonia (CAP) who presented to the Black Lion Hospital, Addis Ababa, Ethiopia. Pneumococcal infection was diagnosed in 41% by the detection of pneumococcal antigen in sputum and other biologic fluids; in 72% by Gram stain of Lung Aspirate (LA) and in 67.5% by Gram stain of sputum. Blood and Lung Aspirate culture grew Streptococcus Pneumoniae in 4 cases (6%), Staphylococcus Aureus in 4 (6%), Enterobacteriacae in 3(5%), Pseudomonas, Klebsiella Pneumoniae and Strep. Viridans in one case each. Other non-bacterial causes included Mycoplasma Pneumoniae in 4 (4%) Influenza A in 4 (4%), Influenza B in 3 (3%) and Psittacosis/LGV in a 4 (4%). There was no case of Legionnaires disease. 39% had taken treatment before coming to hospital. The mortality was 11%. The study showed that antibiotic treatment during the preceding 36 hours did not affect the outcome of the Gram stain.
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PMID:The etiology of community acquired pneumonia in adults in Addis Ababa. 784 Nov 1

Lower respiratory disease is a major source of morbidity in military recruits, with hospitalization rates for pneumonia more than 30 times that of the non-recruit population. The etiologic agent remains unknown in over 75% of cases. This study prospectively examined the etiology of pneumonia among recruits at Naval Training Center, San Diego, California. Recruits presenting with cough, fever, or shortness of breath and pulmonary infiltrates on chest X-ray were eligible for enrollment. A standardized scoring form and focused physical exam were completed on each subject. Sputum specimens were obtained for Gram's stain and culture, DNA probing for Legionella and Mycoplasma species, and direct fluorescent antibody staining for Legionella. Acute and convalescent serologies were performed for adenovirus, influenza A and B, Mycoplasma pneumoniae, Chlamydia group, and respiratory syncytial virus. Of 110 eligible patients, 100 consented to enrollment and 75 patients completed the study. Etiologic diagnoses were obtained in 40 of the patients (53%). M. pneumoniae, Haemophilus influenzae, and viruses accounted for the majority of infections. Mixed infections were seen in six patients. Forty-seven percent of patients had no diagnosis established. Pneumonia in this series of military recruits was frequently caused by M. pneumoniae and H. influenzae. Fifty percent of cases were undiagnosed with routinely available laboratory methods. Further studies are warranted to more clearly define the etiologic agents of recruit pneumonia and the utility of prophylactic measures.
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PMID:Pneumonia in military recruits. 787 Mar 17

In a retrospective analysis of lower respiratory tract infections in an ex-injection-drug users community, we found an outbreak (April to July 1991) of Chlamydia pneumoniae infection. The epidemic occurred in a group of 26 community members (23 men and 3 women, mean age, 28.9--3 years) living and working together, who underwent acute and convalescent serologic tests for Mycoplasma pneumoniae, Legionella pneumophila, cytomegalovirus, adenovirus, Coxiella burnetii, and Chlamydia pneumoniae. All subjects were submitted to chest radiograph, while sputum and blood cultures were performed in symptomatic patients. Antibodies to C pneumoniae were determined by a microimmunofluorescence test. Among all subjects studied (13 HIV-1 positive and 13 HIV-1 negative), 11 (8 HIV-positive and 3 HIV-negative) developed pneumonia, 2 (1 HIV-positive and 1 HIV-negative) developed pharyngitis, and 2 (1 HIV- positive and 1 HIV-negative) developed flu-like syndromes sustained by C pneumoniae; in 4 subjects (2 HIV-positive and 2 HIV-negative) suffering from flu-like syndrome, no causal agents were found. Seven subjects (one HIV-positive and six HIV- negative) remained asymptomatic without any evidence of infection. The prevalence of antibodies to C pneumoniae in HIV-1-positive subjects observed in a sample of community members was significantly higher than in HIV-1-negative subjects. C pneumoniae seems to be involved in respiratory tract infections in HIV-1-infected subjects. Our data suggest that C pneumoniae should be included in the diagnostic approach of respiratory infections in HIV-infected subjects.
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PMID:Outbreak of Chlamydia pneumoniae infection in former injection-drug users. 813 45

During autumn 1992, we observed two unrelated family outbreaks of Chlamydia pneumoniae infection. Family A consisted of grandmother (aged 77 yrs), father (aged 41 yrs), mother (aged 38 yrs), daughter (aged 10 yrs), and two sons (aged 6 yrs and 3 months, respectively). The grandmother and daughter suffered from pneumonia, father from pharyngitis and bronchitis and the older son from mild bronchitis. No symptoms were recorded in the mother and younger son. Symptomatic subjects showed a fourfold increase in immunoglobulin G (IgG) titre for Chlamydia pneumoniae, determined by a microimmunofluorescence test with specific antigen (TW-183). Other serological studies against Mycoplasma pneumonia, Legionella pneumophila, influenza virus type A and B, adenovirus and respiratory syncytial virus (RSV) were negative. Sputum culture gave a positive result for Haemophilus influenzae, colony forming units (cfu) = 10(4).ml-1 in the grandmother. No serum positivity was recorded in the mother and younger son, who remained asymptomatic. All symptomatic patients were successfully treated with macrolides. Family B consisted of mother (aged 63 yrs) and daughter (aged 36 yrs). Both suffered from Chlamydia pneumoniae pneumonia. Diagnosis was made by means of serological microimmunofluorescence test, and direct identification using an indirect immunofluorescence test on pharyngeal swab. Sputum culture and other serological tests remained negative. Both patients were successfully treated with macrolides. These observations emphasize the relevance of Chlamydia pneumoniae in family cluster respiratory infections.
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PMID:Two family outbreaks of Chlamydia pneumoniae infection. 814 7


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