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)

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.
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PMID:The rapid diagnosis of pulmonary infections in solid organ transplant recipients. 216 Jul 17

Patients with HIV frequently present at some time in their illness with community-acquired pneumonia (CAP). Early in the prognosis of HIV when CD4 counts are somewhat decreased, HIV patients with CAP are infected with the same pulmonary pathogen as normal hosts plus Legionella, Salmonella or Chlamydia pneumoniae. Later in HIV, when the CD4 counts are markedly reduced, Pneumocystis carinii (PCP), CMV and acid-fast organisms (TB or MAI) are important pulmonary pathogens. This article presents a clinical approach to empiric antibiotics based on chest x-ray appearance and CD4 count. This permits a rational therapeutic approach to avoid excessive coverage commonly employed by clinicians because of the multiplicity of potential pulmonary pathogens in HIV patients with CAP.
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PMID:Community-acquired pneumonia in patients with HIV. 1498 50