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

Fibreoptic bronchoscopy with bronchoalveolar lavage (BAL), transbronchial lung biopsy (TBB) and brushing was performed, in 134 episodes of pulmonary disease in 118 compromised patients. Sixty eight of the patients were infected with immunodeficiency virus type 1 (HIV-1), 18 were renal and pancreas transplant recipients, 7 were liver and 15 were bone marrow transplant recipients, and 10 patients were undergoing immunosuppressive and/or cytotoxic drug therapy. Pneumocystis carinii (PC) was the predominant pathogen in HIV-1 infected patients. It was considered to be the aetiological cause of pneumonia in 54/82 (66%) episodes of lung complications noted in these patients. Cytomegalovirus (CMV) was the most common micro-organism in transplant recipients. CMV pneumonia was diagnosed in 22/42 episodes of pulmonary disease in these patients. CMV was detected by bronchoscopy procedures at a relatively high frequency of 36/82 (44%) episodes in HIV-1 infected patients. However, after analysis of clinical information, cultures from leucocytes and autopsy findings, CMV seemed to be involved in the pathogenicity of pneumonia in only two out of the 36 patients. Bacterial aetiology, including mycobacterial agents, was unusual, but was the major cause of pulmonary infections in 6/10 episodes in patients undergoing extensive immunosuppressive and/or cytotoxic drug therapy. Bronchoscopy was helpful in establishing correct aetiology in 98/134 (73%) episodes of pulmonary disease. Growth of Candida albicans and bacteria should always be viewed sceptically because of the possibility of contamination from colonization in the upper respiratory tract.
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PMID:Aetiology of pulmonary diseases in immunocompromised patients. 185 Nov 3

The importance of macrophage infection for the development of acquired immune deficiency syndrome (AIDS) was investigated. Molecularly cloned simian immunodeficiency virus (SIV)mac239 replicates very poorly in cultured macrophages yet it causes AIDS in rhesus monkeys. Three of five rhesus monkeys that died with AIDS following SIVmac239 infection showed no disease manifestations directly associated with macrophage infection, such as encephalitis and granulomatous interstitial pneumonia. Simian immunodeficiency virus recovered from the peripheral blood of these three animals at or near the time of death replicated very poorly if at all in cultured macrophages, and tissues taken at autopsy showed little or no infection of macrophages by immunohistochemical staining. However two of the five rhesus monkeys that died with AIDS following SIVmac239 infection displayed a characteristic SIV-related meningoencephalitis and/or granulomatous pneumonia, lesions associated with macrophage infection. Simian immunodeficiency virus recovered from the peripheral blood of these two animals near the time of death replicated extremely well in cultured macrophages, indicating the emergency of macrophage-tropic variants in vivo. Furthermore tissues taken at autopsy from these two showed many infected macrophages by immunohistochemical staining. These results indicate that AIDS and death can occur without obvious involvement of macrophage infection. However the presence of macrophage-tropic viral strains appears to influence the disease course and disease manifestations.
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PMID:Macrophage-tropic variants of SIV are associated with specific AIDS-related lesions but are not essential for the development of AIDS. 185 37

The 863 patients, aged 10 years and younger, treated at the Children's Chest Clinic of Bellevue Hospital during three decades (1953 through 1981) clearly indicated the success of antituberculosis therapy. There were no deaths from tuberculosis. Early treatment is associated with a reduction in the serious forms of disease, eg, meningitis, miliary disease, and bone infections, and with preventing death. Medication was well tolerated: only 1.1% of the patients had adverse reactions, all of which were reversible. Consistent compliance with medication of only 62% of patients is a challenge to the medical profession. Only 22.5% of mycobacterial cultures were positive. Long-term follow-up of patients was rewarding: seven pregnancies with healthy mothers and babies, and no reactivation of tuberculosis by later infections, even those such as measles or pneumonia. The severity of disease was related largely to patient's age (3 years and younger) and intimacy of contact, the highest rate being when the mother was the contact. The long-term experiences emphasizes the value of early identification, therapeutic compliance, and comprehensive contact, tracing in the future elimination of tuberculosis. Prophylactic therapy and close observation should be considered for contacts, especially those exposed to human immunodeficiency virus infections and addicted to drugs.
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PMID:Tuberculosis in children 10 years of age and younger: three decades of experience during the chemotherapeutic era. 186 20

A 26-year-old woman with common variable immunodeficiency syndrome (CVID) associated with frequent episodes of pneumonia underwent an open lung biopsy showing bronchiolitis obliterans organizing pneumonia (BOOP). Following corticosteroid therapy, there were no further episodes of pneumonia. In addition, there was roentgenographic and gas exchange improvement. This is the first case of BOOP in association with CVID. An immunologic basis of BOOP is postulated.
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PMID:Bronchiolitis obliterans organizing pneumonia in common variable immunodeficiency syndrome. 186 36

The stages of human immunodeficiency viruses (HIV) life cycle are described as guide to therapeutic intervention. Practical therapeutic recommendations are given. They should be directed to viruses as the causal agent and to the features of opportunistic infections as well as of associated malignant tumors. Recently 3 progresses could be reached: (1) the application of azidothymidine in the latency phase, when the number of CD4 positive cells decreases below 500/mm3, whereby the progression of the disease can be delayed and side-effects can be reduced; (2) the prophylaxis of pneumocystis carinii pneumonia by inhalation of pentamidin; and (3) the introduction of fluconazole acting against yeast fungus infection, whereby development of resistant yeast strains is still missing and side-effects are smaller than with other antimycotics. In addition, the application of HIV-vaccine in already HIV-infected persons seems to be effective. By combining several drugs their toxicity is to be reduced. Interdisciplinary research and good cooperation among clinicians are conditions for an effective therapy. Last but not least psychosocial aspects and a good psychological guidance and counseling of the affected persons should be considered.
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PMID:[Therapy of HIV infection (AIDS)]. 189 84

Bacillus cereus is rarely a pulmonary pathogen but may cause pneumonia in immunocompromised patients. A patient with bronchiectasis and no recognisable immunodeficiency had this organism isolated during two infective exacerbations, once from respiratory secretions and once by blood culture. Ciprofloxacin treatment was effective on both occasions.
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PMID:Successful treatment of Bacillus cereus infection with ciprofloxacin. 190 95

A retrospective review was conducted of 22 human immunodeficiency virus type 1 (HIV-1)-infected children under 13 years of age presenting to an inner city pediatric emergency department to determine their clinical manifestations of disease and utilization of emergency department services. When compared with a population of 78 normal children, the infected children were more likely to present with cough, difficulty in breathing, and lethargy. Pneumonia, diarrhea, and dehydration were more common diagnoses in the infected children, who were more likely to be admitted, had more invasive procedures, and required more professional staff to provide care. There was no significant difference in the frequency of visits (visits/month of age) when comparing the two groups. As expected, the infected children presented with problems associated with pediatric HIV-1 infection. Our results suggest that HIV-1-infected children require an increased level of care in the emergency department and subsequent admission to the hospital. These children did not visit the emergency department more frequently than the controls. This may be the result of an active outpatient HIV clinic in our hospital, which is available to both scheduled and unscheduled patients.
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PMID:Utilization and clinical manifestations of human immunodeficiency virus type 1-infected children presenting to a pediatric emergency department. 190 79

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

A 56-year-old man was admitted with hemiparesis and shortness of breath. He was positive to human immunodeficiency virus (HIV) antibody and was diagnosed as acquired immunodeficiency syndrome (AIDS) with Kaposi's sarcoma and pneumocystis carinii pneumonia. He developed chronic photosensitivity and vitiligo preceding the onset of the AIDS-related complex (ARC). Association of the two skin lesions with HIV infection is very rare. Although the role of HIV infection in these skin lesions is not significant, the immunological responses in the early course of HIV infection may have contributed to the development of both of these skin lesions.
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PMID:Vitiligo and chronic photosensitivity in human immunodeficiency virus infection. 192 Sep 68

A 21 year old homosexual man presented with an acute pneumonitis during symptomatic seroconversion for human immunodeficiency virus (HIV-I) infection. The symptoms resolved spontaneously without any therapeutic interventions needed. Acute pneumonitis should be added to the ever-increasing spectrum of clinical manifestations in primary HIV-I infection.
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PMID:Primary HIV-I infection associated with pneumonitis. 192 33


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