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)

In a retrospective study of adults with severe community-acquired pneumonia (SCAP) admitted to the intensive care unit, 60 patients were identified from 25 hospitals within the 12-month study period. Thirty-two percent were aged less than 44 years and 65% less than 65. One-third were previously fit. Two or more of the following three features, respiratory rate greater than or equal to 30 min-1, diastolic blood pressure less than or equal to 60 mmHg and blood urea greater than 7 mmol l-1, were present in 72%. A pathogen was identified in 58% and five pathogens, Streptococcus pneumoniae, Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae and Staphylococcus aureus accounted for 86% of these. Gram-negative enterobacteria were identified only once. Forty-eight percent reached the intensive care unit within 24 h of hospital admission, with respiratory failure or progressive exhaustion being the main reason for transfer. However, eight patients were only transferred following a cardio-respiratory arrest on the general ward. Eighty-eight percent received assisted ventilation which was given for a median of 8 days. A median of 4 (range 1-11) different antibiotics were given to each patient, with erythromycin and the penicillins prescribed most frequently. Aminoglycosides were given to 43% of patients, although Gram-negative enterobacteria were rarely found. Forty-eight percent died during the acute illness and a further 5% died shortly afterwards. Multi-organ failure was common with respiratory failure alone accounting for a minority of deaths. Forty-eight percent of deaths occurred within 1 week of hospital admission, but of 18 patients still receiving assisted ventilation at 14 days, 67% survived.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The aetiology, management and outcome of severe community-acquired pneumonia on the intensive care unit. The British Thoracic Society Research Committee and The Public Health Laboratory Service. 156 23

The diagnosis and treatment of pneumonia in mass gathering situations is a medical challenge, requiring prompt decision making and knowledge of the aetiology. We studied cases of pneumonia admitted to two hospitals during the 1994 pilgrimage (Hajj) season to Makkah. Sixty-four patients were enrolled in the study, of which 47 (75%) were men with a mean age of 63 years (range 21-91). Nearly all were from developing countries. Diagnosis was established in 46 patients (72%) with Mycobacterium tuberculosis being the commonest causative organism (20%), followed by gram-negative bacilli (18.8%). Streptococcus pneumoniae accounted for only 10%, with Legionella pneumophilia, Mycoplasma pneumoniae, and viruses accounting each for 6%. The main finding of this study is that M. tuberculosis is a common cause of pneumonia under these unusual "extreme circumstances". Its presentation was acute and indistinguishable from pyogenic pneumonia. Thirty-one per cent of tuberculous cases had upper lobe involvement, 54% lower lobe, and 15% multi-lobar. This was similar to the radiographic features in non-tuberculous pneumonia cases. All but one patient with tuberculosis recovered following the administration of first-line anti-tuberculous drugs. The total mortality was 17%. The preponderance of M. tuberculosis and Gram-negative bacteria over S. pneumoniae may reflect the prior use of amoxycillin and the effect of exhaustion, malnutrition, and old age.
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PMID:Tuberculosis is the commonest cause of pneumonia requiring hospitalization during Hajj (pilgrimage to Makkah). 966 41