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

Intravenous ciprofloxacin and ceftazidime were compared for efficacy in the treatment of nosocomial pneumonia and urinary tract infection (UTI). Patients with nosocomial pneumonia were randomized to receive ciprofloxacin (as the lactate salt) 300 mg i.v. every 12 hours or ceftazidime (with sodium carbonate) 2 g i.v. every eight hours. Patients with UTI were randomized to receive ciprofloxacin 200 mg i.v. every 12 hours or ceftazidime 1 g i.v. every eight hours. Sputum and urine specimens were collected before, during, and after therapy. For patients with pneumonia, the organisms most frequently isolated before treatment began were Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, and Proteus mirabilis. Of the 17 pneumonia patients who completed ciprofloxacin treatment, 15 (88%) had resolution of signs and symptoms or improvement. Of the 15 ceftazidime-treated pneumonia patients, 13 (87%) had resolution or improvement. Staphylococcus aureus, Streptococcus species, Acinetobacter species, and K. pneumoniae infections persisted for the ciprofloxacin treatment failures. Infections by Enterobacter cloacae and Acinetobacter species persisted for the ceftazidime treatment failures. For UTI patients, E. coli was the organism most frequently isolated before treatment. All 14 UTI patients who completed treatment showed resolution or improvement. In the ciprofloxacin group two patients were superinfected by Enterococcus species, and in the ceftazidime group there were two superinfections by Enterococcus species and one by Enterobacter cloacae. Intravenous ciprofloxacin was as effective as ceftazidime in the treatment of nosocomial pneumonia and urinary tract infection. Caution should be exercised when treating serious infections by streptococci or staphylococci.
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PMID:Intravenous ciprofloxacin versus ceftazidime for treatment of nosocomial pneumonia and urinary tract infection. 199 86

The advances in the antibiotic therapy of acute bacterial infections can be shown by the decreasing frequency of complications and fatalities in children. The annual death-rate from pneumonia in children aged one month to 15 years has fallen in Schleswig-Holstein from 1.8 (1954-1958) to 0.6 per 10,000 (1969-1973). At the same time the total death-rate in the same age group has fallen from 14.5 to 9.3 per 10,000 children. The percentage of pneumonia in the total death-rate was 5.3% in 1971-1973: 1.6% in the first month of life and after the sixteenth year 2.3%. Pneumonia was in fourth place (after accident, malformation and neoplasm) as a cause of death in children more than one month old. Of 245 children operated on for congenital heart disease in 1983-1984, bacterial and fungal infections occurred in 3.6% compared to 17.8% of 469 in 1968-1972. Staphylococcal infections decreased from 3.4% to 0.8% and those caused by gram-negative bacteria from 6.9% to 0. Perioperative prophylaxis was performed with cefotaxime plus piperacillin in 1983-1984 versus oxacillin plus ampicillin in 1968-1972. Between 1984 and 1989, 944 children (premature babies and term babies) were treated in the intensive care unit of the University Children's Hospital of Kiel. The incidence of sepsis was 5% (congenital sepsis 4%, sepsis acquired after birth 1%). Early diagnosis and treatment of severe bacterial infections with cefotaxime plus piperacillin reduced the mortality rate of sepsis to 2%. Sepsis never developed under treatment with cefotaxime plus piperacillin.(ABSTRACT TRUNCATED AT 250 WORDS)
Infection 1991
PMID:[Progress of antibiotic therapy in pediatrics]. 200 18

Of 91 children and adults with lower respiratory tract infection, 17 (18.7%) had evidence of infection with Chlamydia pneumoniae. Infection was more common in older adolescents and adults than in children. Only 3 of 8 culture-positive patients with paired sera had serologic evidence of acute infection. Two patients were culture positive over a 12-month period. Two other culture-positive patients had evidence of coinfection with other bacterial respiratory tract pathogens, which in these cases appeared to be responsible for the acute episode of pneumonia. Patterns of infection ranged from acute pneumonia to apparent chronic asymptomatic carriage, and there was no characteristic clinical presentation. Studies using cultures in other populations, including asymptomatic individuals, are needed for a better understanding of the epidemiology and clinical relevance of this organism.
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PMID:Infection with Chlamydia pneumoniae in Brooklyn. 201 Jun 29

We report a case of pneumonia, caused by Bordetella bronchiseptica, in a previously healthy, immunocompetent 37-year-old male patient who had suffered chest injury in a car accident. The patient was admitted to the Intensive Care Unit where endotracheal intubation was performed. Seventy-two hours later he presented with fever associated with pulmonary affection which was diagnosed as right lobar pneumonia. Abundant colonies of B. bronchiseptica were isolated from the pharyngeal exudate and respiratory secretions, suggesting prior oropharyngeal colonization by B. bronchiseptica, as a result of repeated contact with his dog, with subsequent infection of the lower respiratory tract assisted by the process of intubation. We review different human infections produced by B.bronchiseptica as well as the antibiotic susceptibility studies performed.
Infection
PMID:Pneumonia caused by Bordetella bronchiseptica in a patient with a thoracic trauma. 201 9

Rhodococcus equi is an aerobic, intracellular, gram-positive rod-coccus that is partially acid fast. The organism is primarily a pathogen in animals and has only rarely been seen in immunocompromised humans. Its most common manifestation is a slowly progressive pneumonia that may cavitate. Infections are thought to be acquired via respiratory exposure to animals or soil. R. equi infections are difficult to treat, usually requiring prolonged administration of parenteral antibiotics and often necessitating surgical drainage. A case of cavitary pneumonia and recurrent bacteremia with R. equi in a patient with AIDS is reported, and the current literature on R. equi infections in humans is reviewed.
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PMID:Rhodococcus equi infection in the patient with AIDS: literature review and report of an unusual case. 201 40

Over the last 10 years Rhodococcus equi has been identified as an important, albeit very rare, opportunistic pathogen. As the number of patients immunocompromised from HIV infection grows, this microorganism will likely become of increasing clinical importance. Infection with R. equi is usually insidious, causing progressive pulmonary disease that is typically pleural based at the time of microbiological diagnosis. As in the case we present, the clinical and microbiological diagnoses may be significantly delayed, either by the common pitfalls encountered in the laboratory identification of R. equi, or by the failure to recognize the pathogenic potential of the isolate. R. equi infection should be suspected in immunocompromised patients with pneumonia, when a pure or predominant growth of aerobic, non-sporeforming gram-positive bacilli is found on cultures of bronchoalveolar lavage fluid and other pulmonary pathogens have been excluded.
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PMID:Rhodococcus equi--an easily missed opportunistic pathogen. 202 22

Although transmission of Chlamydia trachomatis to infants during vaginal birth can result in conjunctivitis and pneumonitis, there is uncertainty about other adverse effects of chlamydial infection during pregnancy. There is some evidence that it may contribute to adverse complications such as premature rupture of membranes, preterm labor and birth, low birth weight, and still birth. Infection with C. trachomatis is also implicated in postabortal, postcesarean section, and postpartum maternal infections. Treatment of chlamydial infection during pregnancy has proved beneficial in the prevention of neonatal morbidity and is now recommended by the Centers for Disease Control.
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PMID:Chlamydia trachomatis infection during pregnancy. 203 32

Nosocomial pneumonia continues to be a leading cause of fatal nosocomial infection in the United States. Although there are differences in pathogens by age, the importance of nosocomial pneumonia is apparent in the adult population as well as in the pediatric patient groups. The ability to diagnose these infections utilizing clinical suspicion and microbiologic/rapid diagnostic tests will allow the clinician to effectively treat nosocomial pneumonia in the critically ill patient. Unfortunately, these treatment modalities and preventive measures have not kept pace with our understanding of the pathogenesis of this infection. The pediatric patient population presents several unique and specific infection control, diagnostic and treatment problems for the practicing clinician. The appropriate infection control and isolation policies for specific viral and multiple antibiotic resistant bacterial isolates remains a cornerstone in the prevention of nosocomial pneumonia. The judicious use of empiric antibacterial chemotherapy remains important in the treatment of patients with nosocomial pneumonia. However, in the pediatric patient population the recognition that viral and fungal etiologies are important causes of nosocomial pneumonia challenge the clinician to apply the appropriate diagnostic and effective treatment regimens in pediatric nosocomial pneumonias. The epidemiologic data for the clinician's own institution in regards to etiologic causes of nosocomial pneumonia, drug susceptibility patterns as well as the seasonal and patient distribution of these infections are critical. Nosocomial pneumonia will continue to remain a significant cause of morbidity, mortality, and hospital cost in the United States in the upcoming decades. The advent of new rapid diagnostic testing and improved treatment modalities for effective therapy and prevention will be aided by the advent of immunologic therapy for these disease states.(ABSTRACT TRUNCATED AT 250 WORDS)
Infection
PMID:Nosocomial pneumonia in children. 205 Apr 23

Pneumocystis carinii has been recognized as a cause of pneumonia in immunocompromised patients for over 40 years. Until the 1980s, Pneumocystis pneumonia (pneumocystosis) was most often seen in patients undergoing chemotherapy for malignancy or transplantation. Infection could be prevented by trimethoprim-sulfamethoxazole prophylaxis; thus, it was an uncommon clinical problem. With the onset of the AIDS epidemic, Pneumocystis pneumonia has become a major problem in the United States because it develops in approximately 80% of patients with AIDS and because almost two-thirds of patients have adverse reactions to anti-Pneumocystis drugs. Thus, physicians and laboratories in any community may be called upon to diagnose and provide care for patients with Pneumocystis pneumonia. The classification of the organism is currently controversial, but it is either a protozoan or a fungus. P. carinii appears to be acquired during childhood by inhalation and does not cause clinical disease in healthy persons but remains latent. If the person becomes immunosuppressed, the latent infection may become activated and lead to clinical disease. Damage of type I pneumocytes by Pneumocystis organisms leads to the foamy alveolar exudate which is characteristic of the disease. Diagnosis is established by morphologic demonstration of Pneumocystis organisms in material from the lungs. Current efforts to find better anti-Pneumocystis drugs should provide more effective therapy and prophylaxis.
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PMID:Pneumocystis carinii, an opportunist in immunocompromised patients. 207 Mar 42

We report on 20 cases of Legionnaires' Disease (LD) in heart transplant recipients during a two-year study. The overall frequency in this setting amounts thus to 17% (20/115). In contrast, the frequency of legionellosis in postoperative cardiac patients without immunosuppression was only 4.7% (4/84). Legionellosis was diagnosed by culture and/or antibody detection in ten (20) as well as by the detection of urinary antigens in all 20 patients. Only nine (20) patients developed pneumonia, whereas five patients presented with nodular infiltrates. The remaining six patients had moderate fever with no signs of lung infection. In contrast to the majority of patients with other underlying diseases, antigen shedding lasted for long periods in most transplant patients. In high risk patients the application of conventional diagnostic methods together with regular urinary antigen testings (i.e. twice a week) may be advantageous for the early diagnosis of Legionella infection.
Infection
PMID:Legionellosis in heart transplant recipients. 207 9


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