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

We have investigated 12 transplant recipients (nine bone marrow transplants, three renal) with 15 episodes of pneumonitis caused by cytomegalovirus (CMV) and ten patients (eight bone marrow transplant recipients, two renal transplant recipients) with 12 episodes of interstitial pneumonitis in whom no CMV was detected, to determine whether levels of CMV-specific IgG in the lung are diagnostic of infection. We have also assessed whether a vigorous specific local antibody response is important for survival. CMV-specific IgG and herpes simplex (HSV)-specific IgG were measured in bronchoalveolar lavage (BAL) fluid and serum using albumin to correct for simple diffusion from serum into the lung. We have found evidence for local production or facilitated transport of CMV-specific IgG in ten patients with CMV pneumonitis but also in six patients with pneumonitis where no CMV was detected. Similar results were found for HSV-specific IgG although only one patient had a demonstrable HSV infection. There was a tendency for those patients producing large amounts of immunoglobulin in the lung to survive compared with those who died, but there were wide variations between patients in each group. The local humoral immune response in transplant patients with pneumonitis was not specific to the infecting agent and is most probably the result of polyclonal B cell activation or facilitated transport of IgG from serum to lung secretions. Measurement of CMV-specific IgG response in the lung should not, therefore, be used for diagnostic or prognostic purposes.
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PMID:Is the measurement of virus-specific antibody in the lungs of transplant recipients with cytomegalovirus pneumonitis of diagnostic or prognostic value? 284 78

Acyclovir (Zovirax) and zidovudine (Retrovir) dominate antiviral therapy. They interfere with the multiplication of herpes viruses (acyclovir) and HIV (zidovudine) by incorporation into nascent DNA chains and interruption of the further linking of nucleotides. All types of infection caused by herpes simplex virus are potentially treatable by acyclovir, but treatment has to start to be effective. It is especially important to treat immunosuppressed patients because their infections are more prolonged and severe. A typical attack of herpes zoster in an immunocompetent patient is shortened by about 2 days if high doses of acyclovir are given within 3 days of the start of the skin lesions, but unfortunately the incidence of post-herpetic neuralgia is not diminished. Zidovudine lowers early mortality in patients with AIDS and pneumocystis carinii pneumonia. However, much of the effectiveness of zidovudine is lost later; the average prolongation of life in treated patients is estimated to be about 1 year. Some two thirds of patients with AIDS can be treated with zidovudine; in the others the drug is ineffective (Kaposi's sarcoma) or contraindicated. Frequent blood counts are necessary to monitor myelotoxicity.
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PMID:[Antiviral drugs--1988]. 285 Nov 67

Severe herpesvirus infections in 18 immunocompromised patients (25 episodes) were treated with i.v. acyclovir. Six patients had 13 episodes of mucocutaneous herpes simplex infections, eight children had varicella, three patients had generalized zoster, and one patient had cytomegalovirus pneumonia. No patient died from infections. In 18 episodes treatment with acyclovir produced a beneficial effect, in 5 episodes acyclovir was probably beneficial, and in 2 patients the effect could not be evaluated. No serious side effects could be definitely attributed to acyclovir administration. These data support the previous experience that i.v. acyclovir may be useful in the treatment of herpesvirus infections in immunocompromised patients.
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PMID:Intravenous acyclovir for herpesvirus in immunocompromised patients. 298 63

Three cases of cholesterol interstitial pneumonia in patients 3, 9 and 10 years of age respectively are reported. All three were born in Island of Reunion. Two were sisters. All had failure to thrive, dyspnea on rest and clubbing. Respiratory symptoms had appeared early in infancy. Open pulmonary biopsy was diagnostic. Prognosis was poor the boy dying at 4 years of age and severe respiratory insufficiency at 9 or 10 years in the two girls. Current etiological investigations were non contributory. However a profile of chronic infection with Epstein Barr virus (EBV) was found in each case while serological profiles ruled out infection with a virus of the herpes group virus (cytomegalovirus, herpes simplex). The possible role of EBV as an etiological agent of cholesterol pneumonia is discussed and genetic or environmental factors as well.
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PMID:[Cholesterol pneumopathy in children. Apropos of 3 cases. Possible role of chronic Epstein-Barr virus infection]. 300 Mar 13

We studied 51 consecutive pediatric patients for the frequency and morbidity of viral infections after liver transplantation. The incidence of primary (67%) and reactivation (48%) Epstein-Barr virus (EBV) infections and reactivation (88%) cytomegalovirus (CMV) infection was comparable to that seen in adult transplant recipients. However, fewer pediatric than adult transplant recipients experienced primary CMV infection (P less than .01). Five (38%) of 13 CMV infections were symptomatic and included hepatitis, pneumonitis, enteritis, and mononucleosis. Two of 14 patients with primary EBV infection subsequently developed, at two months and two years after initial infection, an EBV-associated lymphoproliferative syndrome, and one of 10 patients with reactivated EBV infection developed a possible EBV-associated febrile encephalopathy. Other viruses causing infection in these children included herpes simplex virus, varicella-zoster virus, adenovirus, parainfluenza virus, respiratory syncytial virus, and rotavirus.
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PMID:Epstein-Barr virus, cytomegalovirus, and other viral infections in children after liver transplantation. 303 64

Herpes viruses and Candida albicans are among the most common opportunistic pathogens infecting patients with neoplastic disease, especially those patients receiving cancer chemotherapy. Herpes virus infections have increased as treatment of oncological disease has become more aggressive and immunosuppression disorders have become more prevalent. Herpes simplex virus on the lips and mouth of a patient receiving chemotherapy can progress to multiple lesions in the mouth, larynx, and in rare instances can lead to pneumonitis and widely disseminated infection. The management and dental findings of a 13-year-old patient with acute lymphocytic leukemia are described.
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PMID:Oral complications in a patient with acute lymphocytic leukemia: a report of case. 327 38

Four new cases of neonatal herpes pneumonia and five cases from the literature were assessed. Clinical presentations, laboratory abnormalities, and radiographic features were analyzed in an effort to establish helpful criteria for early institution of antiviral therapy. Any neonate who develops respiratory distress between the third and 14th days of life and has a chest radiograph that reveals prominent hilar with a central interstitial infiltrate is at high risk for herpes pneumonia. Antiviral therapy pending antigen detection and culture results should be strongly considered in any such patient when the etiology of pneumonitis is unknown and any of the following is found: (1) thrombocytopenia; (2) evidence of disseminated intravascular coagulation; (3) elevated values in liver function tests; (4) a positive result in a rapid screening test for herpes simplex virus; (5) lymphocytic pleocytosis of the cerebrospinal fluid; (6) development of vesicular skin lesions; or (7) further deterioration in clinical status during treatment with antibiotics.
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PMID:Neonatal herpes simplex pneumonitis. 328 69

Plasma concentrations of beta 2 microglobulin (B2M), the light chain of the class I major histocompatibility complex, were measured serially in 26 patients undergoing allogeneic bone marrow transplantation (BMT). The concentrations fell after conditioning treatment, and recovered when the marrow was transplanted. Bacterial infection did not influence B2M concentration, but nine of 22 episodes of acute graft versus host disease were associated with raised concentrations. Increased plasma B2M concentrations were also a feature of eight episodes of chronic graft versus host disease, and these fell after treatment. Reactivation of herpes simplex, varicella zoster, or cytomegalovirus infections were also accompanied by raised B2M concentrations. Three patients with cytomegalovirus pneumonitis had high concentrations of plasma B2M, the rise starting between five and 22 days before onset of symptoms. Although it is non-specific, serial measurement of plasma B2M in patients undergoing BMT may be clinically useful in monitoring chronic graft versus host disease.
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PMID:Changes in plasma beta 2 microglobulin concentrations after allogeneic bone marrow transplantation. 330 8

Varicella zoster (VZV) and herpes simplex (HSV) viruses commonly cause self-limited infection of the skin and mucous membranes. However, certain groups of subjects, including neonates, cancer patients, organ and bone marrow transplant recipients and those with congenital or acquired deficiencies of cell mediated immunity, are at increased risk for dissemination of either virus to the lungs and/or other viscera. The highest risk for VZV pneumonitis is in bone marrow transplant recipients, 44%, and in children with acute leukemia, 32%. The mortality from this complication of VZV infection in the preantiviral era was at least 25%. Except for neonates, dissemination and mortality rates for HSV infections are less than for VZV infections in the high risk groups. Cell-mediated immunity has a major role in both recovery from primary infection and modulation of latent infection, but antiherpes antibodies also have an important role in moderating the extent and severity of infection. Both viruses cause a patchy nodular pneumonia with scattered necrotic and hemorrhagic foci. Physical examination is often misleading and rapid progression of pneumonia can occur within hours. Intravenous acyclovir, administered early in the course of HSV and VZV infection at dosages of 250 mg/m2 and 500 mg/m2 every eight hours, respectively, has nearly eliminated the risk of severe symptomatic pneumonitis. Treatment of established pneumonitis with acyclovir at these doses has also reduced the mortality of herpesvirus pneumonias.
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PMID:Varicella zoster and herpes simplex virus pneumonias. 332 Dec 72

In a group of 74 hospitalized patients with the diagnosis of acute infectious pneumonia, the etiological contribution of viral and bacterial agents is analyzed in cases of clarified etiology and an assessment is made of the relationship between the explained etiology and the overall epidemiological situation. Etiology was clarified in 36 patients (48.6%). Viral and bacterial etiology was confirmed in 13.3% and 39.8% of the entire group respectively. In three cases, mixed viral and bacterial infection was reported. Most prominent among the viral agents were herpes simplex, parainfluenza, respiratory syncytial and influenza type B viruses. As far as the bacterial agents were concerned, the species most frequently isolated were Staphylococcus aureus, Streptococcus pneumoniae and a variety of Enterobacteriaceae. The relationship between the overall epidemiological situation and pneumonia etiology is discussed as well as the relevance of the diagnostic methods employed.
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PMID:On the epidemiology and etiology of pneumonia in adults. 339 28


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