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Query: UMLS:C0026936 (Mycoplasma)
 14,761 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three young children with Down syndrome developed fever, cough, wheezing, irritability, and tachypnea. They had bilateral infiltrates on their chest radiographs and developed respiratory distress, which required their hospitalization. Laboratory studies suggested that the children had mycoplasma pneumonia. These children may have experienced severe mycoplasma infections early in life because of their Down syndrome-associated immune abnormalities. When young children with Down syndrome develop pneumonia, physicians should consider Mycoplasma pneumoniae as the possible etiologic agent.
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PMID:Severe mycoplasma pneumonia in young children with Down syndrome. 153 77

Four hundred and fifty-three adults in 25 British hospitals entered a prospective study of community-acquired pneumonia. A microbiological diagnosis was established in 67 per cent; Streptococcus pneumoniae (34 per cent). Mycoplasma pneumoniae (18 per cent) and Influenza A virus (7 per cent) were the commonest microorganisms. Our observations support the view that most of those in the microbiologically negative group (33 per cent) had S. pneumoniae infection. In addition to cultures of blood and sputum the most useful initial tests were for sputum pneumococcal antigen and serum mycoplasma specific IgM. Twenty-six patients (5.7 per cent) died, seven within 48 h of admission. Multivariate analyses showed age, absence of chest pain, absence of vomiting, previous treatment with digoxin, tachypnoea, diastolic hypotension, confusion, leucopenia, leucocytosis, and raised blood urea levels were significantly correlated with death. Patients had a 21-fold increased risk of death if they had two of the following: admission respiratory rate greater than or equal to 30/min, admission diastolic BP less than or equal to 60 mmHg, urea greater than 7 mmol/l during admission. Mortality was not related to aetiology except that all three patients with combined Influenza A virus and Staphylococcus aureus infection died. Nine patients had legionella pneumonia; none died. No patients who died from pneumococcal pneumonia, mycoplasma pneumonia or staphylococcal pneumonia had received an appropriate antibiotic before admission. Such deaths are possibly preventable. Assisted ventilation was used in 22 patients of whom 14 survived. Hospital stay in survivors averaged 10.8 days; after six weeks 79 per cent were fit for normal activities, and 55 per cent showed resolution of radiographic signs of pneumonia. We recommend that antibiotics should be given as early as possible and chosen always to cover S. pneumoniae, and in addition M. pneumoniae during outbreaks, and S. aureus during influenza epidemics.
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PMID:Community-acquired pneumonia in adults in British hospitals in 1982-1983: a survey of aetiology, mortality, prognostic factors and outcome. The British Thoracic Society and the Public Health Laboratory Service. 311 95

An acute pneumonia developed in 28 calves which had been housed together from one to two weeks of age. The clinical signs included pyrexia, tachypnoea, respiratory distress and coughing. Some of the calves died. The pneumonia was characterised by an alveolitis with multinucleated syncytia, alveolar epithelial hyperplasia and bronchiolitis. Interstitial emphysema was also present. Fifteen of 19 calves examined serologically had rising neutralising antibody titres to respiratory syncytial virus; in nine calves the rise was fourfold or greater. Respiratory syncytial virus was not isolated from the calves. There was no evidence of parainfluenza type 3 virus involvement. The adult cows being sucked by the calves remained clinically normal throughout the incident. Six calves examined six weeks after the outbreak started had a chronic cuffing pneumonia characterised by lymphocytic bronchiolitis; some of the calves also had bronchiolitis obliterans. Mycoplasma dispar was found in two of them.
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PMID:Acute fatal pneumonia in calves due to respiratory syncytial virus. 725 27

We prospectively studied 110 adult patients coming to Black Lion Hospital between August 1987 and July 1989 with community acquired pneumonia (CAP) for various etiologic agents and clinical and radiographic presentation. Streptococcus pneumoniae was the most common offending pathogen in 72% and 67.5% from sputum and lung aspirate (LA) Gram stain respectively, and in 41% by pneumococcal serotyping of sputum. Blood and LA culture grew Streptococcus pneumoniae in 4 (6%), Staphylococcus aureus in 4 (6%), Enterobacteriaceae in (3%), Pseudomonas, Klebsiella and Streptococcus viridans in one case each. Non-bacterial pathogens included Mycoplasma pneumoniae in 3 (3%), Influenza A in 4 (4%), Influenza B in 3 (3%) and psittacosis/LGV in 4 (4%). Fever, cough, chest pain, tachypnea and coarse crepitations/bronchial breathing were the most common presenting signs and symptoms. Thirty per cent had associated diarrhoea and vomiting initially and 9% had altered state of consciousness at admission. Six patients came in a state of shock. Thirty-nine per cent had underlying illnesses. Ninety-three per cent had either segmental or lobar consolidation. Parapneumonic effusion occurred in 14%. The mortality was 11%. Tachypnea, the presence of underlying illness, altered state of consciousness, extreme leucocytosis and the presence of bilateral and multilobar lung involvement were found to be signs of poor prognosis. Our finding is similar to those from other African countries, except that we are reporting psittacosis/LGV for the first time in Africa.
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PMID:Community acquired pneumonia in adults in Addis Abeba: etiologic agents, clinical and radiographic presentation. 803 77

The etiologic agents causing acute lower respiratory tract infection (LRTI) in hospitalized children were compared for 1995 and 1988. Between May 1994 to April 1995, 397 children were admitted to Tan Tock Seng Hospital for acute LRTI compared to 240 children in 1988. The following criteria for LRTI were used: (i) age less than 12 years with a community-acquired LRTI; (ii) presence of cough or fever of less than 2 weeks' duration; and (iii) presence of tachypnea, chest retractions or pulmonary infiltrates on chest X-ray. Sputum cultures were considered suitable for culture if there were less than 25 epithelial cells per low power field. Moraxella catarrhalis was considered only if heavy growth of more than 3+ was seen. Etiological agents were found in about 70% of patients in both studies. Viruses constituted 41.3% of the etiologic agents in 1995 but constituted only 28% in 1988; 36% had a bacterial etiology in 1995 compared to 15% in 1988. The most common bacteria in 1995 was M. catarrhalis (34.7%) followed by non-type B Haemophilus influenzae (33%). In contrast, in 1988, Mycoplasma (33%) was the predominant organism followed by H. influenzae (17%) and M. catarrhalis (11.4%). The increased incidence of M. catarrhalis could be due to antibiotic selection. A mixed viral-bacterial etiology was found in 12.3% of the 1995 cohort. The majority of the bacteria were positive by sputum cultures; only 4 (3.3%) had positive blood cultures. No penicillin resistance was detected in 1988; however, in 1995, penicillin resistance was found in 17% of the Streptococcus pneumoniae, 38.5% of H. influenzae and 83% of M. catarrhalis. It was also found that 30% of the S. pneumoniae were also resistant to erythromycin, and 23% were resistant to sulfamethoxaxole-trimethoprim; 5% of the H. influenzae had multiple resistance to erythromycin, sulfamethoxazole-trimethoprim and chloramphenicol. Among those patients with antibiotic resistance, 30% had received prior antibiotics of which 18% had had two or more antibiotics, frequently erythromycin or amoxycillin/ampicillin. Judicious use of antibiotics is required to check the rising trend of antibiotic resistance.
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PMID:The changing trend in the pattern of infective etiologies in childhood acute lower respiratory tract infection. 924 92

The clinical, ultrasonographic and radiographic findings in three cows and one bull with pleuropneumonia are described. All the animals had fever, indigestion, tachypnoea and abnormal lung sounds. Percussion of the thoracic wall elicited signs of pain and tests for foreign bodies were positive. Ultrasonographic examination revealed an accumulation of anechogenic to hypoechogenic fluid in the pleural space in the ventral thorax of all the animals. In one animal, echogenic bands of fibrin were observed between the thoracic wall and pulmonary surface. In another, parts of the right lung were not inflated because of severe bronchopneumonia. Radiographic examination revealed a pleural effusion, apparent as a horizontal fluid line, in three animals. In addition, the increased radiopacity in parts of the dorsal lung fields and increased bronchial and peribronchial markings suggested bronchopneumonia. In three animals, the radiographs revealed linear foreign bodies in the reticulum, suggesting that the pleuropneumonia was caused by the penetration of the foreign body into the thoracic cavity. A diagnosis of pleuropneumonia was made in all the animals on the basis of the clinical, ultrasonographic and radiographic findings and the analysis of the pleural fluid. The diagnosis was confirmed at slaughter in three of them; the fourth animal was treated and was clinically healthy when it was discharged.
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PMID:Ultrasonographic findings in cattle with pleuropneumonia. 924 17

Thirty-two thoracoscopies were performed in 28 horses. Sixteen horses were affected with pleuropneumonia whereas 12 were affected with various other thoracic conditions. The indications for thoracoscopy was diagnostic in 19 cases, therapeutic in 11 cases and both diagnostic and therapeutic in 2 cases. Twenty-six thoracoscopies were done standing whereas 6 were performed under general anaesthesia. The specific procedures performed during thoracoscopy were exploratory only (7), biopsy of the lung and lymph nodes (10), drain placement into pleural effusions (2) and abscesses (5), exploration prior to thoracotomy (2), transection of pleural adhesions and decortication (1) and window pericardectomy (2). Diaphragmatic hernia repair (2) and partial pneumonectomy (1) were initiated thoracoscopically but conversion to thoracotomy was necessary for completion. Standing thoracoscopy was well tolerated in most horses. Transient exacerbation of pulmonary compromise evidenced by tachypnoea was readily alleviated by reinflation of the lung. Standing thoracoscopy provided good visualisation of the dorsal and lateral structures of the thorax. The ventral thoracic structures and the cranial ventral diaphragmatic surfaces of the lungs were best visualised in dorsal or lateral recumbency under general anaesthesia. Thoracoscopy is a safe and useful diagnostic and therapeutic tool in horses with thoracic diseases.
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PMID:Thoracoscopy in the horse: diagnostic and therapeutic indications in 28 cases. 984 64

A survey designed to obtain information on the indications, contraindications, complications, and methodology of percutaneous lung biopsy in the horse was sent to large animal diplomates of the American College of Veterinary Internal Medicine. Sixty-five of 190 diplomates returned the survey (response rate: 34%) and 59 of these 65 respondents (91%) indicated that they worked with horses. Forty-four diplomates had performed a percutaneous lung biopsy in 1 or more horses (i.e. 75% of those diplomates working with horses and 68% of total respondents). Clinical and radiologic diagnoses that prompted diplomates to perform percutaneous lung biopsy in the horse included a pulmonary miliary pattern (93%), suspicion of pulmonary infiltrative disease (91%), suspicion of pulmonary neoplasia (91%), suspicion of chronic obstructive pulmonary disease (COPD) (20%), and suspicion of exercise-induced pulmonary hemorrhage (EIPH) (7%). Only one of the respondents reported the use of percutaneous lung biopsy in the diagnostic workup if pneumonia was suspected, but 11% of respondents reported that suspicion of pulmonary abscessation would prompt them to perform a percutaneous lung biopsy. In contrast, a variable percentage of respondents felt there were contraindications to performance of this technique, which included neonatal septicemia (68%), pulmonary abscessation (65%), pleuropneumonia (55%) and pneumonia (42%), EIPH (41%), and COPD (26%). No respondent indicated that suspicion of neoplasia was a contraindication to percutaneous biopsy. Most common complications observed by respondents were epistaxis (68% of respondents), putative pulmonary hemorrhage (52%), tachypnea (39%), and respiratory distress (32%). Ten of 44 respondents (23%) had not seen any complications with percutaneous lung biopsy. Forty-two of 44 respondents (96%) warned owners about possible complications before performing percutaneous lung biopsy. All respondents to this question reported that they would perform percutaneous lung biopsies in horses in the future, but 4 of 41 would use the procedure only as a last resort.
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PMID:Survey of the large animal diplomates of the American College of Veterinary Internal Medicine regarding percutaneous lung biopsy in the horse. 985 39

Much of what we know about childhood community-acquired pneumonia in developed countries comes from studies in Europe, where approximately 2.5 million cases of childhood pneumonia occur yearly. Streptococcus pneumoniae, Mycoplasma pneumoniae, and respiratory syncytial virus are the most common causative agents. Blood culture is seldom positive and mortality is very low in developed countries. Tachypnea and crackles on auscultation are the major findings suggesting pneumonia, but their sensitivity and specificity are not high enough, and, if possible, a radiograph of the chest should be obtained to confirm the diagnosis. Recommendations for antibiotic treatment vary. Based on the etiologic studies we suggest macrolides as the first choice in outpatients and depending on the clinical picture and severity of the illness penicillin G, macrolide, or cefuroxime plus macrolide in hospitalized patients. The recovery of children with pneumonia is usually rapid and in uncomplicated cases routine follow-up radiographs and check-ups are unnecessary.
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PMID:Childhood community-acquired pneumonia. 1039 10

In children, pneumonia must be differentiated from bronchiolitis and asthma. Pneumonia is the only one of these three conditions for which antibiotics are indicated. Clinical signs are more useful than radiological or laboratory investigations for differentiating pneumonia from bronchiolitis and asthma. A child has pneumonia if s/he has tachypnoea or indrawing and is not wheezing. The child's age and the severity of the illness episode predict the aetiology of the pneumonia. The majority of children with community-acquired pneumonia can be managed in primary care. The antibiotic of choice for children < or = 5 years of age is oral amoxycillin and for older children and adolescents is oral erythromycin. Antibiotics will not prevent pneumonia in a child with an upper respiratory tract infection. Up to 80% of adults with pneumonia can be managed as outpatients. Indicators of morbidity and mortality from pneumonia are well described. Clinical features and radiology do not reliably predict the causative agent in adults with pneumonia, thus initial treatment is empirical. Streptococcus pneumoniae is the most common cause of pneumonia in all studies. The initial antibiotic treatment should be active against this organism. Penicillin oramoxycillin or erythromycin are all suitable. Erythromycin has the advantage of being active against Mycoplasma pneumoniae and Legionella species. Follow-up of patients is important to decide whether they are responding to the empirical treatment.
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PMID:Outpatient treatment of pneumonia. 1077 27


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