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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Illness associated adenovirus infection is described in 15 immunocompromised patients. Patients were immunocompromised by severe underlying disease, immunosuppressive or corticosteroid therapy or by age (prematurity). Evidence of adenovirus infection was obtained by either viral isolation or, in two cases, characteristic adenovirus inclusion bodies at postmortem study. All clinical illness was associated with high fever (temperature greater than 39 degrees C). Eighty per cent of the patients had severe systemic complaints including malaise, lethargy, fatigue and night sweats; a similar number of gastrointestinal symptoms. Pulmonary complaints were described in 11 of 15 cases and included cough (67 per cent) and tachypnea (53 per cent). Roentgenologic evidence of pneumonia was demonstrated in 12 of 15 patients (80 per cent). Elevation of serum hepatic enzyme levels (serum glutamic pyruvic transaminase (SGPT)) occurred in eight of 11 patients (73 per cent) and was moderate to severe (serum glutamic pyruvic transaminase greater than 450 IU/liter) in five of 11 (45 per cent). Nine patients died; seven after a rapid downhill course and two after a prolonged illness. Evidence of adenovirus infection microscopically by autopsy in the lung, liver or both is demonstrated in four patients with fulminant systemic illness. Adenovirus infection should be considered in the etiology of severe overwhelming illness in the immunocompromised host.
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PMID:Adenovirus infection in the immunocompromised patient. 624 99

A laboratory-housed breeding colony of white-handed gibbons (Hylobates lar) experienced an epizootic of upper respiratory tract disease characterized by lethargy, anorexia, coughing, and serous rhinorrhea. Signs were more severe in adults than in offspring, and all animals recovered without complications. Base-line, acute, and convalescent sera from the most severely affected gibbons were tested for antibodies against a wide spectrum of infectious agents. For personnel known to have had contact with the gibbons, testing for the same agents was done on base-line sera and sera obtained at the same time as the acute and convalescent sera were obtained from the gibbons. Rising titers against parainfluenza-3 virus were detected in 6 of 7 gibbons tested. An increase in titer was not seen in the sera of personnel.
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PMID:Epizootic of parainfluenza-3 virus infection in gibbons. 631 55

Groups of 8 male crossbreed domestic goats were given 3 dosage levels of aflatoxin B1 [(AFB1) mg/kg of body weight/day] orally: 0.1 for 34 days; 0.2 for 18 days; or 0.4 for 10 days. Clinical condition, feed consumption, and selected blood values were determined. Clinical signs of toxicosis included decreased feed consumption, slight-to-moderate loss of body weight, mucopurulent nasal discharge, dyspnea, coughing, lethargy, icterus, diarrhea (4 goats), and subnormal body temperature 24 to 48 hours before death. Clinicopathologic changes included increases in total RBC count, PCV, hemoglobin concentration, serum bilirubin concentration, and serum activities of aspartate aminotransferase, isocitric dehydrogenase, and ornithine carbamyl transferase. Goats given the 2 smaller dosage levels of AFB1 had slight increases of serum total protein (TP) concentration compared with control goats, but goats given the larger dosage levels of AFB1 initially had a slight decrease in TP. Aflatoxin had little effect on total WBC count. Serum alanine aminotransferase (ALT) activities in goats given the 2 larger dosage levels of AFB1 were similar to those of control goats, but goats given the smallest dosage level of AFB1 had increased serum ALT activities. Aflatoxin did not produce consistent dose-related changes in serum alkaline phosphatase activities. Seemingly, goats are susceptible to aflatoxin. Onset of clinical signs was dose-related. Onset and magnitude of increases in PCV, hemoglobin concentration, serum bilirubin concentration, and activities of serum aspartate aminotransferase, ornithine carbamyl transferase, and isocitric dehydrogenase were dose-related. Changes in TP and activities of serum ALT and alkaline phosphatase were neither dose-related nor were they potentially useful indicators of toxicosis.
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PMID:Caprine aflatoxicosis: experimental disease and clinical pathologic changes. 643 Jan 34

M. pneumoniae is a common cause of pneumonia. The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell count is normal or only slightly elevated, and the Gram stain of the sputum (if any can be obtained) reveals polymorphonuclear leukocytes and few bacteria. The diagnosis is more difficult when the patient presents with symptoms not suggestive of pneumonia including lethargy, dyspnea, and a 1- to 4-week history of shortness of breath without cough or fever in association with diffuse reticulonodular or interstitial pulmonary infiltrates. The disease in the previously healthy host is usually benign and self-limiting. However, the course is shortened by the administration of tetracycline derivatives or erythromycin. M. pneumoniae pneumonia can occur in association with other diseases including sickle cell anemia, sarcoidosis, systemic lupus erythematosus, Hodgkin's disease, and various other immunodeficiency states. In these patients mycoplasma pneumonia can be very serious. Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients.
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PMID:Mycoplasma pneumonia. 676 79

Mycoplasma pneumonia usually follows a benign course and the patient does not require hospitalization. The present report summarizes the feature of eight children admitted for a moderately severe pneumonia during an epidemic of Mycoplasma pneumoniae in Victoria. All children were previously healthy. The usual presenting symptoms included cough, fever, lethargy, and weight loss. All children had moderately severe respiratory distress and physical signs in the chest consistent with extensive parenchymal involvement. Half of this group had radiological evidence of a small pleural effusion. Complement fixation titres for Mycoplasma pneumoniae in paired samples confirmed the diagnosis. Clinical and radiological resolution was complete after one to three months. It is suggested that severe mycoplasma pneumonia may be more common than previously appreciated.
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PMID:Severe mycoplasma pneumonia in previously healthy children. 721 82

To determine whether inexperienced health workers can recognize severe infection in infants less than 3 months of age, a study was conducted of 200 infants with cough, fever or 'not feeling well'. The presence or absence of five symptoms: cough, difficulty in breathing, feeding problem, fever or history of convulsions, and ten signs: appearing ill, respiratory rate > or = 60/min, chest indrawing, grunting, cyanosis, wheeze, lethargy, 'too hot', 'too cold' or abdominal distension, were recorded by a health worker, who made a diagnosis of 'ill' or 'mildly ill'. Each infant was then reviewed by an experienced paediatrician who made a diagnosis of 'ill' (pneumonia, sepsis, meningitis or other severe illness) or 'mildly ill'. Using these diagnoses as the 'gold standard', the sensitivity, specificity, and positive predictive values of each parameter were calculated. In 89% of the 200 infants, the health worker made the correct diagnosis. Forty infants were admitted. In 36 instances (90%) the health worker made the correct decision. The most discriminating symptoms and signs were 'not feeding well', 'appears ill', chest indrawing and grunting. A respiratory rate > or = 60/min was 78% sensitive and 69% specific. Our study suggests that inexperienced health workers can recognize severe illness in infants under 3 months of age.
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PMID:Recognition of illness in very young infants by inexperienced health workers. 750 92

An emerging swine disease principally involving periweaning piglets was examined. The disease was clinically characterized by lethargy, fever, emaciation, coughing, and severe abdominal breathing, hence colloquially named "Heko-heko" disease. The consistent lesions in affected piglets were diffuse interstitial pneumonia with pronounced type II pneumocytic proliferation, meningoencephalitis, and regression of the lymphoid tissues. The causal virus was isolated in primary porcine lung cell (PLC) cultures from various organs of affected piglets and showed serological relatedness to the European porcine reproductive and respiratory syndrome (PRRS) virus. Numerous virus particles, measured about 49 nm in diameter, were detected in the cytoplasm of alveolar epithelial cells and pulmonary macrophages in PLC cultures infected with the isolate. The condition could be experimentally reproduced in conventional piglets by intranasal inoculation with the isolate and the virus was reisolated from the infected animals.
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PMID:An outbreak of porcine reproductive and respiratory syndrome in Japan. 786 92

At the two largest open air markets in Kumasi, Ghana, interviews were conducted with 143 women who had at least one child aged less than five years. Researchers wanted to examine their knowledge, attitude, and practices concerning acute respiratory infection (ARI) in children. The women tended to be married, Christian, from the Ashanti tribe, aged 20-29 years, and to have 2-3 living children. 73.4% had a child or children who had suffered from cough and fever within the last six months. 73.4% named exposure to cold as a direct cause of cough. Many women incorrectly blamed worm infestation for causing cough and fever (21%) and constipation for causing cough (25.9%). None mentioned pathogens as a cause of cough and fever. None said that good ventilation and avoidance of overcrowding prevent cough and fever. The more serious the symptoms, the more likely the mothers were to seek treatment at a health care facility (e.g., cough only, 0.7%; cough and fever, 6.3%; cough, fever, and anorexia, 30%; and cough, fever, and lethargy, 57.3%). Common home care practices for treating a runny nose included ephedrine or other types of nasal drops, herbal medicines, antipyretics, and antibiotics. 39.9% would use antibiotics to treat coughs. Honey and cough syrup were often used to treat cough and fever. Some herbal and home care therapies had potentially harmful effects. For example, 25.9% said that they used castor oil and enemas to prevent ARI. The women had an acceptable knowledge score on severity of symptoms (mode = 15/20; range = 11-18). These findings indicate a need for a health education program targeting mothers of children aged less than five years.
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PMID:Maternal knowledge, attitude and practices regarding childhood acute respiratory infections in Kumasi, Ghana. 788 91

Adenoviral pneumonia, while most common in infancy and young childhood, is rare in school childhood. Here, we report one case, a 13 years old otherwise healthy girl, suffered from fulminating pneumonia caused by adenovirus infection. She had dry cough, pharyngitis, lethargy, myalgia and fever in the beginning. Four days later, the patient became tachypneic, dyspneic and drowsy, and developed hypoxemia and diffuse bilateral infiltrates on chest radiographs. The laboratory data revealed elevated SGOT, CPK and LDH. Adenovirus was isolated from patient's endotracheal suction tube tips. Fortunately, weaning from mechanical ventilation was accomplished on the fifth day of hospitalization, despite of the high fatality rate of adenoviral pneumonia in this age group. The clinical characteristics and therapeutic management of our case are discussed and literatures reviewed.
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PMID:[Fulminating adenovirus pneumonia: report of one case]. 794 37

The authors' primary purpose was to identify home healthcare needs of adults (N = 244) living with HIV disease/AIDS. The study followed a retrospective chart review of a stratified random sample of cases discharged during 1991 from a certified home health agency (CHHA) in New York City. Frequently observed signs and symptoms included dyspnea, weakness, fatigue/lethargy, pain, ataxia, cough, skin lesions, and memory deficit. Additional problems identified included inadequate nutrition, issues related to compliance with prescribed medications, inadequate in-home support systems, inadequate facilities/utilities in the home, financial concerns and lifestyles that included drug/alcohol abuse and tobacco use. The results suggest that the health care needs of people living with HIV disease/AIDS in the home care setting are multifaceted and extend beyond the clinical manifestations of HIV disease.
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PMID:Home healthcare needs of adults living with HIV disease/AIDS in New York City. 803 11


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