Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Visceral leishmaniasis is an important public health problem in Libya, but its exact prevalence is not known. Prompted by the paucity of information in the literature relevant to Libyan children, we reviewed the records of 21 children treated at El-Fatah Children's Hospital, Benghazi between March 1982 and May 1990. Visceral leishmaniasis was diagnosed on the basis of the history, physical findings and confirmatory laboratory tests including examination of bone marrow. The duration of illness before seeking medical advice ranged from 3 months to 1.5 years. The commonest presenting features were fever, abdominal distension, anorexia with weight loss, hepatosplenomegaly and pallor. The consistent laboratory findings were anaemia with reticulocytosis and normal serum iron, neutropenia, thrombocytopenia, high ESR and hyperglobulinaemia. The bone marrow was positive for L. donovani in 86% of cases and the indirect haemagglutination test was positive in all patients. Bronchopneumonia was the most common complication and responded rapidly to antibiotics. All patients were treated with sodium stibogluconate 10 mg/kg/day. There were no major side-effects or complications of drug therapy. The relative paucity of cases and their late presentation may reflect a lack of awareness of the occurrence of visceral leishmaniasis by doctors in the community.
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PMID:Visceral leishmaniasis in Libya--review of 21 cases. 138 90

The clinical activity of piperacillin was evaluated in 34 children (mean age: 8 years) presenting with severe infection (septicaemia, meningitis, bronchopneumonia, pyelonephritis). A bacteriological diagnosis was established in 24 cases. The mean duration of treatment was 11 days, and the mean dose 220 mg/kg/day administered in three injections. In 25 cases piperacillin was combined with another antibiotic, usually an aminoglycoside (20 cases). Clinical cure or improvement was obtained in 29 children (85%). Treatment was well tolerated, with only 2 cases of moderate blood eosinophilia. In view of these results the authors suggest that piperacillin could be used in children in two circumstances: severe infections caused by Gram-negative cocci or bacilli in children with cystic fibrosis or neutropenia, and against infections contracted in intensive care units, or in children with febrile leucopenia, combined with an aminoglycoside in the absence of, or pending bacteriological results.
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PMID:[Indications for piperacillin in pediatrics]. 294 80

Flomoxef (FMOX, 6315-S), a newly synthesized antibiotic which belongs to the oxacephem group, was clinically evaluated for its efficacy and safety in 17 patients with ages ranging from 1 month to 9 year-8-month who had bacterial infections. The results obtained were summarized as follows. 1. A pharmacokinetic study following 20 mg/kg FMOX administration by intravenous bolus injection showed that the half-life of FMOX (beta phase) was 39.8 minutes and the urinary excretion of FMOX in the first 6 hours was 76.5%. 2. FMOX was administered to 3 patients with pneumonia, 8 patients with bronchopneumonia, 2 patients with tonsillitis, 2 patients with pyelonephritis, one patient each with cervical lymphadenitis, and pustulosis associated with severe varicella at daily dosage levels of 61.9 approximately 87.2 mg/kg, divided into 3 or 4 administrations by intravenous bolus injection or by 30 minutes drip infusion. The clinical results of these 17 patients were as follows; excellent: 14 patients, good: 2 patients, poor: 1 patient. The efficacy rate was 94.1%. 3. No clinical adverse reaction was observed in any of the 17 patients. Neutropenia, eosinophilia, a slight elevation of GPT and slight elevations of GOT & GPT were observed in 1, 1, 1, and 2 patients, respectively. No abnormality in coagulation system was observed in any of 10 evaluable patients. 4. MICs of FMOX against 13 strains isolated from patients were as follows. MIC against 2 out of 3 strains of Streptococcus pneumoniae was 0.20 micrograms/ml and that of the remaining 1 strain was 0.39 micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical studies of flomoxef in the field of pediatrics]. 343 Jul 17

A retrospective study of 18 immunodepressed patients with acute invasive pulmonary aspergillosis enabled the radiologic picture of this increasingly frequent opportunist affection to be described, and different manifestations of the disease as a function of underlying conditions to be determined. Two groups could be distinguished: the first of patients with malignant blood diseases (n = 10) when the "aplasia" factor was dominant; the second of patients without blood diseases (n = 8) when the immunodepression was usually induced by a recent increase in corticoid therapy. Neutropenia was not a finding in any of these patients. The most frequent radiologic finding was single or multiple round excavating foci, these corresponding to zones of bronchopneumonia containing aspergillus filaments with central tissue necrosis forming the "target" lesion. The aplasia was distinguished by the multiplicity of lesions and their excavation following aplasia in the shape of a crescent due to sequestrum formation. Prognosis was related to severity of subjacent lesions. In the 2nd group, lesions could be single and nodular; prognosis was improved by the possibility of reducing immunodepression factors.
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PMID:[Radiologic aspects of acute invasive pulmonary aspergillosis in 18 immunodepressed patients]. 377 70

Acute lung injury was induced in 24 calves by intratracheal inoculation with Pasteurella haemolytica. Calves in groups 1 and 2 were neutrophil depleted, using hydroxyurea given IV. Group 1 calves (n = 7) were inoculated intratracheally with saline solution, and group 2 calves (n = 7) were inoculated with P haemolytica. Group 3 calves (n = 7) had normal numbers of neutrophils and were inoculated with P haemolytica. Group 4 calves (n = 3) were treated acutely with hydroxyurea IV, had normal numbers of neutrophils, and were inoculated with P haemolytica. After inoculation, calves with normal numbers of neutrophils (groups 3 and 4) became hypoxemic 2 hours after inoculation, and hypoxemia persisted until necropsy (6 hours after inoculation). These calves also developed tachypnea, bradycardia, neutropenia, and lymphopenia. Lung lesions consisted of necrosis of the alveolar walls, intra-alveolar hemorrhage, and a severe exudative and necrotizing bronchopneumonia, with accumulation of proteinaceous fluid in alveoli and lymphatics. In neutrophil-depleted calves (groups 1 and 2), blood gas values, heart and respiratory rates, and numbers of circulating leukocytes did not change after inoculation with saline solution or with P haemolytica. At necropsy, the lungs of neutrophil-depleted calves were grossly normal. Therefore, neutrophils were required for the acute lung injury induced by P haemolytica. The protective effect of neutrophil depletion was a specific effect of hydroxyurea because calves with high circulating concentrations of hydroxyurea and calves with normal numbers of neutrophils (group 4) developed lung injury.
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PMID:Importance of neutrophils in the pathogenesis of acute pneumonic pasteurellosis in calves. 407 35

Cattle with Pasteurella bronchopneumonia usually have a fever, abnormal respiratory sounds in the cranioventral lung fields, consolidation, pleuritis and abscesses. Lungworms primarily affect 4- to 6-month-old calves, which become febrile and dyspneic, with moist rales. Diagnosis is by fecal examination using the Baermann technic. Proliferative pneumonia usually affects stabled adults, which develop severe dyspnea and tachypnea. Diagnosis is by the history, clinical signs and lung biopsy. Acute bovine pulmonary emphysema is caused by ingestion of large amounts of L-tryptophan in lush pasture. Affected cattle have severe, acute dyspnea, an expiratory grunt and froth around the muzzle. Diagnosis is by the history and clinical signs. Bronchiolitis obliterans narrows the airways of older animals to cause dyspnea. A positive response to corticosteroids aids diagnosis. Anaphylaxis occurs in cattle of all types and ages and is precipitated by various antigens in a type-I hypersensitivity reaction. Use of atropine aids diagnosis. Allergic or hypersensitivity pneumonia is caused by an allergy to insecticides, dead ascarid larvae or the mold, Micropolyspora faeni. Diagnosis is by a history of insect fogger use, finding M faeni in the forage, and typical histologic lesions in lung samples. Cattle with caudal vena caval thrombosis have dyspnea, a fever, froth around the muzzle, an expiratory groan and hypergammaglobulinemia. Malignant catarrhal fever is diagnosed by a history of previous exposure to sheep and finding swollen lymph nodes, fever, neutropenia and arteritis.
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PMID:Diagnosis of causes of respiratory diseases in cattle. 623 84

We conducted a prospective nonrandomized study of outpatient therapy with ceftriaxone as a single agent in 50 episodes of fever and neutropenia in children treated with various myelosuppressive regimens for different malignancies. All patients underwent clinical and radiological evaluation and blood/urine cultures taken before starting therapy. Patients with dehydration, hypotension, rigor and clinical exit-site infection of indwelling right-sided catheters were excluded. Forty-one patients completed an antibiotic course of 7 days: in 12 patients fever returned to normal on day 2, in 10 patients on day 3, and in 8 patients on day 4. The duration of neutropenia following the initial febrile episode was 3-10 days. In some patients fever returned to normal after 2 days, but neutropenia persisted up to 10 days. Two patients were bacteremic--Escherichia coli in one, and Acinetobacter/Staphylococcus coagulase negative in another; all isolates were sensitive to ceftriaxone. In nine episodes, antimicrobial therapy was modified because of persistent fever > 39 degrees C in five patients, bacteremia in two, enterocolitis in one, breakthrough fever in two, and bronchopneumonia in one. The low incidence of bacterial isolation is probably attributed to the selection of patients with low risk features. Patients and parents complied with and favored outpatient therapy to hospitalization.
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PMID:Ambulatory treatment with ceftriaxone in febrile neutropenic children. 804 51

We reviewed the experience over 20 years with primary Candida pneumonia among fatal cancer cases at our hospital. Unequivocal evidence of primary Candida pneumonia has been reported in only 55 cases. We report here 31 such cases. Unlike patients with disseminated candidiasis, and contrary to previous studies concentrating on cancer patients, only 9 of our 31 patients had severe neutropenia. In this report, the lack of organ involvement other than the lungs at complete autopsy examination, the exclusion of patients with candidemia, the very high percentage of intrabronchial and intra-alveolar fungal involvement without vascular invasion, and the concomitant presence of candidal esophagitis in some patients suggest that the mechanism of entry of the infectious particles may have been aspiration of oropharyngeal contents. The major clinical manifestations of primary Candida pneumonia are fever and tachypnea. Radiologically, nonspecific patchy infiltrates can be seen. Histopathologically, there is prevalence of bronchopneumonia, hemorrhage, and necrosis. The only accepted criterion for the definitive diagnosis of Candida pneumonia is histologic demonstration of the fungus in lung tissue. In contrast to previous reports, we demonstrated that primary Candida pneumonia can be life-threatening in patients with cancer since it directly contributed to the death of 84% of the patients in the present series. Very little data are available on the therapy and outcome of patients with Candida pneumonia. However, primary Candida pneumonia in the compromised host should be treated as a life-threatening infection with systemic antifungal therapy.
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PMID:Primary Candida pneumonia. Experience at a large cancer center and review of the literature. 850 66

A Pasteurella haemolytica A1 broth was injected intratracheally in eight calves and measurements of pulmonary function values (PFV) were made once before and hourly post inoculation (p.i.). Changes in PFVs, included increased respiratory rate and minute ventilation (up to 158% of baseline 2 h p.i.) and decreased tidal volume and lung dynamic compliance (up to 33% of baseline 3 h p.i.). Total pulmonary resistance was not affected. At and after 3 h p.i. there was a progressive impairement of gas exchange, as judged from arterial O2 tension which decreased up to 65% of baseline. In contrast, arterial CO2 tension was not affected. Pulmonary hypertension was observed during the 3 last h of the study and was attributable to an increased pulmonary vascular resistance. Severe neutropenia was observed at 3 h p.i. and post-mortem histological findings were consistent with an acute fibrinohemorragic bronchopneumonia. In conclusion, P. haemolytica airway challenge unequiovocally resulted in acute pneumonia, providing a reproducible pathophysiological model for investigations regarding new therapeutic strategies.
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PMID:Pulmonary ventilation, mechanics, gas exchange and haemodynamics in calves following intratracheal inoculation of Pasteurella haemolytica. 859 99

Invasive aspergillosis is an emerging cause of death in hematologic patients. Several patterns of lung involvement are described: acute tracheobronchitis, bronchopneumonia, pleural aspergillosis and angioinvasive aspergillosis. The latter pattern is the most common one; it is characterized by different signs, some of which, supported by clinical data, are quite suggestive for fungal etiology. Particularly, nodules and/or wedge-shaped lesions with a ground-glass halo are a useful early feature, best detected by HRCT. Early therapy with amphotericin B may improve survival chances. Therefore, in neutropenia patients we decided, when possible, to perform high-resolution computed tomography (HRCT) as soon as fever appears. This was feasible in 8 of 32 patients with invasive aspergillosis examined with HRCT. Immediate treatment with amphotericin B in one such patient showing a nodule with the halo sign allowed the lesion to completely disappear. The authors describe the frequency of different radiologic signs in 32 patients, as observed in 54 HRCT exams; the results are compared with those obtained with conventional CT and chest X-ray. Compared to chest X-ray, CT detects more lesions and is more sensitive to small pneumothorax and minimal pleural effusion or thickening. HRCT is more suitable to detect initial cavitation and thin ground-glass haloes.
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PMID:[Invasive aspergillosis in the hematologic patient: the usefulness of computed tomographic and high-resolution computed tomographic studies]. 864 47


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