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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mycoplasmal pneumonia, tularemic pneumonia, Q fever pneumonia, psittacosis, and Legionnaires' disease are the most frequently encountered treatable atypical pneumonias. Mycoplasmal pneumonia, the most common, is often accompanied by nonexudative pharyngitis, conjunctivitis, or otitis. The nonproductive cough is characteristic. Tularemic pneumonia is characterized by substernal chest pain, bloody pleural effusion, and bilateral hilar adenopathy. Although the clinical presentation is mild, roentgenographic findings are impressive. Q fever pneumonia resembles psittacosis but is less serious; it may be accompanied by subacute bacterial endocarditis, hepatitis, or both. Psittacosis is characterized by prominent headache, bloody sputum, and relative bradycardia. Tetracycline is the drug of choice for either. In Legionnaires' disease, pneumonia is accompanied by prominent extrapulmonary symptoms. The most important diagnostic clues include diarrhea and mental confusion. Relative bradycardia and laboratory abnormalities are also helpful. Erythromycin is the drug of choice unless doubt exists as to the diagnosis.
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PMID:The atypical pneumonias: a diagnostic and therapeutic approach. 47 55

We evaluated 50 consecutive patients with acute ischemic stroke to assess the prevalence of systemic infection preceding the neurological event. We analyzed the immunohematologic characteristics of patients with and without signs and/or symptoms of a preceding infectious process. Patients were examined less than or equal to 7 days after cerebral infarction and evaluated for fibrinogen, anticardiolipin antibodies, fibrin D-dimer (a fragment of cross-linked fibrin), plasminogen activator inhibitor-1, and protein S. Of the 50 patients, 17 had symptoms of infection beginning less than or equal to 1 month before the stroke (11 had upper respiratory tract infections, three urinary tract infections, two subacute bacterial endocarditis, and one pneumonia). Compared with patients without infection, patients with infection had significant increases in fibrin D-dimer concentration (5.3 +/- 1.1 versus 4.7 +/- 0.9 log-transformed ng/ml, p less than 0.05) and cardiolipin immunoreactivity, IgG isotype (1.8 +/- 1.3 versus 1.1 +/- 0.9 log-transformed phospholipid units, p less than 0.04), and, when studied less than or equal to 2 days after the stroke, increased fibrinogen levels (459 +/- 126 versus 360 +/- 94 mg/dl, p less than 0.05). In conclusion, infection-associated cerebral infarction is common and is associated with substantial immunohematologic abnormalities.
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PMID:Immunohematologic characteristics of infection-associated cerebral infarction. 148 66

The case of a 9-month-old baby girl who failed to develop normally due to nutritional neglect and secondary immunodeficiency characterized by marked thymic involution is reported. The child died of systemic Pseudomonas aeruginosa (P. aeruginosa) infection manifested in pneumonia, lung abscesses, bacterial endocarditis and ecthyma gangrenosum. At autopsy the child was 64 cm in height (normal for a 4- to 5-month-old child) and 5.1 kg in weight (normal for a 2- to 3-month-old child). Multiple gangrenous ecthymas, consisting of deep ulcers, induration and inflammation, were observed in the skin over the entire body. The lungs showed hemorrhagic pneumonia, multiple lung abscesses, and necrotizing arteritis in the abscesses and surrounding areas. The thymus weighed 2.3 g and showed marked involution. Histological examination showed so-called nutritional thymectomy characterized by severe cortical atrophy and clustering, cystic dilation and amorphous changes of the Hassall's corpuscles. In the heart, dark brown verrucae were present at the attachment sites of the tendinous cords of the papillary muscle in the anterior and posterior cusps of the mitral valve, suggesting infectious endocarditis. Bacteriological examination demonstrated P. aeruginosa in the ecthymas, lung abscesses and blood. As primary immunodeficiency was considered unlikely, immunodeficiency secondary to thymic involution following malnutrition seemed to have led to a fatal systemic infection with P. aeruginosa, whose virulence is generally weak. This suggests a close association of the development of such infection and immunodeficiency with child neglect.
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PMID:Child neglect followed by marked thymic involution and fatal systemic pseudomonas infection. 191 16

Cotton fever is a benign, self-limited syndrome that may mimic sepsis in intravenous drug addicts. We present an illustrative case and a review of the literature. Serious illness such as pneumonia and infectious endocarditis must always be considered in febrile addicts. However, trivial illness accounts for 16% to 26% of such fevers. Recent evidence suggests that emergency physicians are able to diagnose trivial illness with 93% specificity in febrile adult drug addicts. Short-term observation units may be an alternative to hospital admission for febrile drug users with a presumptive diagnosis of trivial illness and in those in whom the diagnosis of cotton fever is entertained.
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PMID:"Cotton fever": a benign febrile syndrome in intravenous drug abusers. 236 14

A combination drug of sulbactam/ampicillin (SBT/ABPC) was intravenously administrated to 18 patients with ages 3 months to 10 years 10 months with various acute infections including 14 cases of pneumonia, 1 case each of tonsillitis, subacute bacterial endocarditis, empyema and suspected sepsis. Clinical responses were excellent in 14 cases and good in 4 cases. Bacteriological responses of 8 isolated strains were: 7 strains were eradicated and 1 strain was decreased. No side effect was observed in any case. Eosinophilia was observed in 2 cases, thrombocytosis in 2 cases, elevation of GOT in 1 case and elevations of GOT and GPT in 1 case. From the above results, it seemed that SBT/ABPC was a useful drug for the treatment of bacterial infections in the pediatric field.
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PMID:[Clinical study on sulbactam/ampicillin in the pediatric field]. 274 52

Patients usually provisionally diagnosed as having typhoid fever or pneumonia are regularly admitted to the Rietfontein Fever Hospital suffering from psittacosis. The main symptoms are intense headache, chills and fever and an irritating non-productive cough. Later most patients develop signs of pneumonitis most clearly seen on radiographic examination. An important clue to the diagnosis is a history of contact with birds, most often budgerigars and more recently cockatiels. The diagnosis may be confirmed by the isolation of Chlamydia psittaci, the causative organism, but more usually reliance is placed on the results of serological tests revealing the development of chlamydial antibodies. None of the patients in this series developed serious complications, but if not treated psittacosis sufferers may develop severe pneumonitis, hepatitis and gastro-enteritis; the mortality rate is up to 20%. A rare but fatal complication is chlamydial endocarditis, presenting with the signs and symptoms of subacute bacterial endocarditis, but giving repeated negative blood cultures. The illness responds specifically to treatment with tetracycline antibiotics within 48 hours. Chlamydial infections are widespread among avian species. In the RSA most cases of psittacosis have resulted from contact with budgerigars and cockatiels, but outbreaks have been associated with imported batches of birds including South American parrots and Australian finches, emphasizing the need for vigilance at seaports.
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PMID:Psittacosis in the RSA. 370 61

For one year all narcotic addicts admitted to the Detroit Medical Center with infectious endocarditis (74 cases) were compared with a control group of bacteremic addicts who had other infections (106 cases). Endocarditis was caused by Staphylococcus aureus (60.8% of cases), streptococci (16.2%), Pseudomonas aeruginosa (13.5%), mixed bacteria (8.1%), and Corynebacterium JK (1.4%). S. aureus endocarditis most frequently involved the tricuspid valve; streptococci infected left-sided valves significantly more often than other organisms (P = .001). Biventricular and multiple-valve infections were commonest in patients with pseudomonas endocarditis (P = .05). Two-dimensional echocardiography, when combined with an abnormal chest roentgenogram, was highly predictive of endocarditis. Bacteremia in the absence of endocarditis was associated with primary skin and soft tissue infection, mycotic aneurysm at the site of narcotic injection, septic arthritis, septic thrombophlebitis, pneumonia, osteomyelitis, mediastinal abscess, and unclassified infection. Polymicrobial bacteremia in the nonendocarditis group was associated with markedly increased morbidity. Mild hyponatremia occurred in 41% of all patients and was also associated with significantly increased morbidity. Analysis of the two groups disclosed similarities and differences with implications for the pathophysiology and treatment of addicts with bacteremic infection.
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PMID:Bacteremia in narcotic addicts at the Detroit Medical Center. II. Infectious endocarditis: a prospective comparative study. 375 55

Streptococcus pneumoniae is an infrequent cause of infectious endocarditis in adults. In the past 2 years, however, we have encountered several cases at our institution, and additional cases have been reported in the literature. This infection typically follows pneumonia in the setting of chronic alcoholism and may additionally be complicated by meningitis. Less commonly, pneumococcal endocarditis occurs in other hosts or follows primary infection at other extrapulmonary sites. In such cases, the diagnosis may be initially missed, with a resultant delay in institution of appropriate therapy. Moreover, there are controversies regarding the optimal therapy for infections of this nature in the era of penicillin resistance. Since a comprehensive review of this topic has not been published since 1990, we reviewed cases of pneumococcal endocarditis in the penicillin era, with particular attention to disease recognition, the role of echocardiography, and the dilemmas surrounding medical and surgical therapeutic interventions.
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PMID:Review of pneumococcal endocarditis in adults in the penicillin era. 982 9

Clinical course of infectious endocarditis (IE) was analysed for 43 intravenous drug abusers. 42 of them had primary IE, one patient--secondary. Acute course and high activity of the disease were registered in 86% of the patients. IE was provoked by Staphylococcus aureus (50%), Staphylococcus epidermidis 920%), Staphylococcus haemolyticus (11%), E. coli (8%), Pseudomonas aeruginosa (2%), Candida albicans (2%), mixed microflora (7%). Vegetations were detected on the tricuspid, mitral and aortic valves (52, 23 and 19%, respectively), on more than one valve (6%). Pneumonia, pleuricy, hydrothorax, enlargement of the liver, spleen, nephritis and anemia were found in 76, 44, 9, 100, 75, 70 and 88% of the patients, respectively. Cardiac failure aggravated the disease in half of the patients, lethality was 18%. Thus, IE in intravenous drug abusers is characterized by a primary form, acute active course, prevalent damage to the tricuspid valve, polyorganic involvement, high lethality. IE cure in such patients is feasible only in adequate antibacterial therapy, timely surgical correction and giving up drug abuse.
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PMID:[Infectious endocarditis in intravenous drug abusers]. 1101 26

A 69-year-old woman presented with pneumonia and subacute bacterial endocarditis. Nine days after intravenous vancomycin and ciprofloxacin were commenced, the patient developed a bullous mucocutaneous eruption. Clinical presentation and histopathology were consistent with drug-induced linear IgA bullous disease (LABD). The patient's lesions resolved with cessation of antibiotics. A review of the features of drug-induced LABD and the drugs that have been implicated are presented.
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PMID:Drug-induced linear IgA bullous disease following antibiotics. 1148 15


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