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

The new quinolones are rarely indicated for the treatment of community-acquired pneumonia in the normal host. For nosocomial pneumonia they may be used when a Gram-negative aerobic bacillus is the causative organism. Pneumonia in the compromised host may be an indication for a quinolone. In the hypogammaglobulinaemic patient with Haemophilus influenzae pneumonia, the quinolones may be used, especially when the organism is resistant to other drugs. For the neutropenic patient with Gram-negative pneumonia the quinolones may be a good choice. However, more clinical studies are needed. In treatment for exacerbations of chronic bronchitis, failures seem to be associated with pneumococcal infections. For patients with cystic fibrosis, the quinolones offer successful ambulatory treatment for their Pseudomonas and Haemophilus infections. The information regarding dosage schedules is still incomplete.
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PMID:The place of quinolones in the treatment of respiratory tract infections. 267 85

From 1976 to 1985, 27 adult invasive Haemophilus infections were observed at the University Medical Center in Lausanne. Only 5 cases (19%) were caused by Haemophilus influenzae type b, while 12 cases (44%) were due to Haemophilus species other than H. influenzae. Two out of 24 strains tested were ampicillin-resistant. The infections were meningitis in 8, pneumonia in 7, endocarditis in 5, sepsis of unknown origin in 4, epiglottitis in 2, and one gynecological infection. Except for the latter three patients, each case was associated with one or more underlying conditions. Seven patients died (26%), in three of whom death was directly related to the infectious process. This report and a review of the literature show that adult invasive Haemophilus infections are not uncommon and may be serious. Associated underlying diseases and advanced age are generally present. In contrast to infections occurring in children, invasive Haemophilus infections in adults are not restricted to encapsulated Haemophilus influenzae type b strains.
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PMID:[Invasive Haemophilus infections in adults]. 349 62

The susceptibility of smokers to pneumonia caused by Haemophilus influenzae may result from impairment of phagocytic or bactericidal function of pulmonary alveolar macrophages (PAM). We compared ingestion and killing of non-typable H. influenzae and H. influenzae type B by alveolar macrophages from asymptomatic smokers and non-smokers. Three times as many cells were recovered from bronchoalveolar lavage of smokers. Non-typable H. influenzae (NTHI) were phagocytosed and killed readily by PAM from both groups of subjects, while H. influenzae type B were resistant to phagocytosis. No difference in uptake of bacteria was detected between PAM of smokers and non-smokers. PAM from smokers had a slightly greater bactericidal activity than PAM from non-smokers. These results suggest that other host factors, such as impaired tracheobronchial clearance or the presence of conditions that favor bacterial growth rather than damage to alveolar macrophages, are responsible for the susceptibility of smokers to Haemophilus infections.
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PMID:Phagocytosis and killing of Haemophilus influenzae by alveolar macrophages: no difference between smokers and non-smokers. 349 51

An outbreak of fibrinous pleuropneumonia was observed in October 1971 in Saskatchewan on a farm of 900 feeder pigs. Morbidity and mortality were low. Pathologic-anatomic findings included fibrinous pleuritis, pulmonary vascular thrombosis and necrotizing fibrinous pneumonia. Hemophilus parahemolyticus was isolated from the lungs of affected animals. In addition pulmonary lesions were found which suggested an adenovirus infection. It was speculated that the viral infection possibly predisposed the pigs to the Hemophilus infection. The H. parahemolyticus isolate was sensitive to common antibiotics.
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PMID:Porcine Hemophilus parahemolyticus pneumonia in Saskatchewan. I. Natural occurrence and findings. 427 28

The records of 476 infants and children with bacterial meningitis treated between 1979 and 1982 were reviewed. By the sixth hospital day 90% or more of children with pneumococcal or meningococcal infection compared with 72% of children with Haemophilus infection (P less than 0.001) were afebrile. The rates of prolonged fever for 10 days or more, persistent fever for 5 to 9 days and secondary fever were 13, 13 and 16%, respectively. The conditions associated with prolonged fever for 10 days or more were subdural effusion (27%), drug fever (23%) and concomitant arthritis or pneumonia (20%); 15% were of indeterminable cause. The principal conditions associated with persistent fever for 5 to 9 days were other foci of disease (17%), nosocomial infections (16%) and subdural effusion (14%); in 42% the cause was unknown. The conditions associated with secondary fever were nosocomial infections (27%) and subdural effusion (23%); 39% were of indeterminable cause. Neither the duration nor the patterns of fever correlated with neurologic abnormalities at discharge, including hearing deficit.
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PMID:Fever during treatment for bacterial meningitis. 647 34

Review of the bacteriology records of a University Hospital pediatric service for a 30-month period revealed 42 patients with Hemophilus influenzae type b bacteremia and 30 patients with Streptococcus pneumoniae bacteremia, all under age 10. Eighty-eight percent of the Hemophilus bacteremias and 7% of the pneumococcal bacteremias occurred in children less than 2 years of age. Hemophilus bacteremia was seen mot frequently in the first year of life, in contrast to pneumococcal bacteremia which was seen evenly throughout the first and second years of life. In all but one of the Hemophilus infections, a definite source of the bacteremia was apparent; these included CNS infection (58%), cellulitis (14%), and pneumonia (12%). In contrast, no obvious source was apparent in 37% of the pneumococcal bacteremias. When a focus for pneumococcal bacteremia was identified, otitis media and pneumonia were the most frequent diagnoses. Most of the occult pneumococcemias were transient; the results of repeat blood cultures before a treatment decision were helpful in determining the necessity for and duration of antibiotic therapy in those patients with no obvious source of infection.
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PMID:Bacteremia in childhood. 696 25

PROBABILITY-BASED ANTIBIOTIC THERAPY: In children, the risk of an unfavorable course of bacterial infections requires careful selection of the initial antibiotic prescription based on the disease state, bacterial epidemiology and the child's age. ACUTE COMMUNITY ACQUIRED PNEUMONIA: Before the age of 5 years, antibiotics active against Haemophilus influenzae such as amoxicillin or clavulanic acid can be given orally. In children over 5, amoxicillin or a macrolide are effective. SEVERE EAR, NOSE AND THROAT INFECTIONS: For sore throats, clinical and bacterial results of a 4-day antibiotic regimen using a second generation cephalosporin are equivalent (with better compliance) to a 10-day regimen of penicillin V. For acute middle ear infections, a combination of amoxicillin-clavulanic acid is usually prescribed as initial treatment. COMMUNITY ACQUIRED BACTERIAL MENINGITIS: The most recent consensus established the indication for cefotaxime or ceftriaxone. The increasing number of peni-R pneumococci and the major drop in the frequency of Haemophilus infections have led to new therapeutic propositions currently under investigation. ACUTE SKIN INFECTIONS: For impetigo, general antibiotics-oxacillin or a derivative-are required due to the risk of contagion. BONE AND JOINT INFECTIONS: For these urgent situations, in vitro sensitivity and antibiotic penetration into the infected tissue are the determining factors. BACTERIAL DIARRHEA: Antibiotics are not required in case of acute diaarhea with little or no fever. Antibiotics could be discussed for cholera-like diarrhea and are required in case of invasive bacterial diarrhea, shigelosis, cholera, and Clostridium difficile as well as diarrhea with fever and blood loss in infants or salmonella-induced diarrhea with signs of extradigestive complications. URINARY TRACT INFECTIONS: The choice of the antibiotic and the duration of treatment depend on the clinical presentation: lower tract infection, acute pyeloephritis, or prophylaxis. The causal germ must be identified for adapted antibiotic treatment.
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PMID:[Infections in pediatrics]. 908 4

We review and summarize published information on diseases caused by Haemophilus influenzae in India and unpublished data from our center covering more than three decades. Since the mid-1950s H. influenzae has been the most common cause of pyogenic meningitis in children admitted to our hospital, accounting for one-third to one-half of cases. Information from other centers in India has been scanty; the lower frequency of isolation of Haemophilus in studies in some centers may be caused by unsatisfactory media and culture methods. The annual numbers of admissions for pyogenic meningitis in our hospital have been quite similar to the numbers of cases of poliomyelitis. Assuming that the similar numbers of children hospitalized with these two diseases indicate similar incidence rates in the community and taking into account the frequency of Haemophilus isolations in pyogenic meningitis, we estimate that there may be as many as 75 to 100 cases of meningitis caused by this organism per year per 100000 children <5 years of age. Although pneumonia caused by H. influenzae has been recognized in a few studies, information is too scanty to attempt the estimation of incidence. Pus-producing infections caused by Haemophilus are rare. Epiglottitis caused by Haemophilus does not seem to occur in India. In recent years we have found that most invasive Haemophilus infections are caused by H. influenzae type b (Hib); other types or untypable strains are infrequent. An increasing prevalence of resistance to chloramphenicol and ampicillin has been recognized in our center and elsewhere. Thus from a hospital perspective, primary prevention by using Hib vaccine seems to be a rational and beneficial intervention. Community-based studies to measure the disease burden of Hib are urgently needed for a more satisfactory assessment of the need for, and cost benefit of, Hib immunization of all infants.
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PMID:Haemophilus influenzae disease in children in India: a hospital perspective. 978 53

An effective vaccine to prevent invasive infections caused by Haemophilus influenzae type b (Hib) bacteria has been available for more than 20 years. Hib conjugate vaccine is safe, efficacious and easy to use, and its cost-benefit ratio is high both in industrialized as well as in developing countries. In spite of this, WHO estimates that every year approximately 8 million children contract life-threatening Haemophilus infections, especially meningitis or severe pneumonia. If we want to take seriously the Millenium Development Goal of reducing the mortality of under 5-year-old children by two-thirds before the year 2015, an effective means to contribute to this would be more efficient use of Hib vaccines.
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PMID:Foresight in medicine: current challenges with Haemophilus influenzae type b conjugate vaccines. 2020 18

Historically, Haemophilus influenzae (Hi) serotype b (Hib) caused most invasive Haemophilus infections worldwide, mainly in children. In 1989 routine childhood vaccination against Hib was initiated in Iceland. We conducted a population-based study of all patients in the country with Haemophilus spp. isolated from sterile sites (n = 202), from 1983 to 2008. Epidemiology, clinical characteristics of the infections and serotypes of the isolates were compared during the pre-vaccination (1983-1989) and post-vaccination era (1990-2008). Following the vaccination, the overall incidence of Hib decreased from 6.4 to 0.3/100,000 per year (p <0.05) whereas the incidence did not change significantly for infections caused by Haemophilus sensu lato not serotype b, hereafter referred to as non-type b Hi (0.9 vs 1.2, respectively). The most frequent diagnosis prior to 1990 was meningitis caused by Hib, which was subsequently replaced by pneumonia and bacteraemia caused by non-type b Hi. Most commonly, non-type b Hi were non-typeable (NTHi; 40/59), followed by Hi serotype f (14/59) and Hi serotype a (3/59). Pregnancy was associated with a markedly increased susceptibility to invasive Haemophilus infections (RR 25.7; 95% CI 8.0-95.9, p <0.0001) compared with non-pregnant women. The case fatality rate for Hib was 2.4% but 14% for non-type b Hi, highest at the extremes of age. Hib vaccination gives young children excellent protection and decreases incidence in the elderly due to herd effect in the community. Replacement with other species or serotypes has not been noted. Pregnant women are an overlooked risk group.
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PMID:Evolving epidemiology of invasive Haemophilus infections in the post-vaccination era: results from a long-term population-based study. 2207 Jun 37


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