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

Allescheria boydii, a true fungus frequently isolated from soil, is best known as a causative agent of maduromycosis of the foot. In our report we describe two patients under treatment for acute leukemia who died from rapidly progressive A. boydii infections. One patient had signs of central nervous system infection and was found at autopsy to have had a large brain abscess. The second patient had a cavitary necrotizing pneumonia with thoracic inlet obstruction (Pancoast's syndrome) and failed to show improvement despite treatment with amphotericin B. The clinical spectrum of allescheriasis is reviewed with particular emphasis on its role as a pathogen in the compromised host. Since A. boydii may resemble other fungi morphologically in tissue sections and may produce infections clinically similar to other mycoses, culture of the organism is required for definitive diagnosis. Based on recently reported in vitro susceptibility studies, miconazole may have a future role in the therapy of A. boydii infections which are resistant to presently available antifungal agents.
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PMID:Allescheria boydii infections in the immunosuppressed host. 27 Sep 6

Nocardia transvalensis, a rare Nocardia species, has previously been recognized as a cause of actinomycotic mycetoma. In a retrospective review of N. transvalensis isolates referred to the Centers for Disease Control (Atlanta) during the period January 1981 through January 1990, we identified 15 patient isolates. Four N. transvalensis isolates originated from one Australian reference laboratory; one patient's isolate that was identified by the Australian laboratory but that was not received at the Centers for Disease Control was also included in our study. A review of the cases of these 16 patients found that N. transvalensis caused infection in 10 patients and colonization in two patients. Six (75%) of eight patients with primary pulmonary or disseminated N. transvalensis infections had an underlying immunologic disorder or were receiving immunosuppressive therapy; three patients with disseminated infection died. All nine infected patients for whom specific antimicrobial therapy was prescribed received trimethoprim-sulfamethoxazole. Results of in vitro antimicrobial susceptibility tests of 11 N. transvalensis isolates revealed increased antimicrobial resistance to amikacin and other drugs when compared with that of other Nocardia species. Severely immunocompromised patients are predisposed to N. transvalensis pneumonia or disseminated infection, and the lung may be the portal of entry.
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PMID:Infections due to Nocardia transvalensis: clinical spectrum and antimicrobial therapy. 152 Jul 93

Human infections due to fungi belonging to the genus Acremonium occur uncommonly, but unlike infections due to other filamentous fungi, usually affect immunocompetent individuals. Mycetoma, which usually develops following trauma, is the most common infection caused by Acremonium spp. Other sites of infection include the eye (generally following abrogation of ocular defenses), colonizing disease of the lung and gastrointestinal tract, as well as locally invasive infections such as osteomyelitis, sinusitis, arthritis, and peritonitis. Pneumonia and disseminated infections including meningitis, endocarditis, and cerebritis rarely have been reported. Optimal treatment of acremonium infections is not well defined both because infections due to these organisms are rare, and because many reports antedate effective antifungal therapy. In addition, susceptibility testing of filamentous fungi is poorly standardized, and in vitro sensitivity may not correlate with clinical response. Based on anecdotal reports, treatment of most invasive acremonium infections requires a combination of surgical intervention, when possible, and a regimen of amphotericin B. Some azoles also display inhibitory activity. Until more details are available regarding susceptibility of these organisms to antifungal agents, amphotericin B is recommended as initial therapy with the addition of either ketoconazole or fluconazole in infections of a life-threatening nature.
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PMID:Infection due to the fungus Acremonium (cephalosporium). 195 81

Curvularia lunata is a saprobic dematiaceous mould that resides primarily in soil (Ellis, 1966). Reports of human disease caused by this organism are rare but include: endocarditis, brain abscess, skin infections, onychomycosis, keratitis, pneumonia, disseminated disease, mycetoma, allergic bronchopulmonary disease, and one case of sinusitis. Since 1983, we have encountered five cases of paranasal sinusitis due to C. lunata. None of the patients suffered from known immunologic disorders or underlying debilitating diseases. These five cases are presented and the literature of human phaeohyphomycosis caused by Curvularia spp. is reviewed.
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PMID:Human Curvularia infections. Report of five cases and review of the literature. 380 44

We report a new case of primary pulmonary mucormycosis. The radiographic evidence and anatomopathological facts demonstrate an intra-cavitary mycetoma of Fowler associated with a chronic pneumonia in the left basal segment. The patient was not immunosuppressed but had undergone a left upper lobectomy 25 years before. This appears to be the first case in which a serological study has confirmed the diagnosis.
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PMID:[Pulmonary mucormycosis. Apropos of a case with serologic confirmation]. 650 61

Cavitary pulmonary disease due to coccidioidomycosis is common; however, development of both the underlying cavity and the fungus ball due to Coccidioides immitis is rare and has been reported on only five occasions. We report a case of coccidioidal mycetoma formation as a late sequelae of primary pulmonary coccidioidal pneumonia. Therapy with 2 gm of amphotericin B was unsuccessful and, because of recurrent hemoptysis, the patient required lobar resection. Endosporulating spherules, as well as septate mycelia with arthrospore formation, were found on histologic examination. The medical and surgical management, as well as the potential of such lesions to produce human to human transmission, is discussed.
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PMID:Pulmonary coccidioidal mycetoma. 673 75

The fungus Aspergillus can cause any of three clinical presentations--invasive aspergillosis, mycetoma, or allergic bronchopulmonary aspergillosis--or a disease process in which one of these entities overlaps with another process such as mucoid impaction, eosinophilic pneumonia, bronchocentric granulomatosis, "farmer's lung," or asthma. More than one form of the disease may be present at the same time; in addition, limited invasion may occur even in "noninvasive" forms of the disease, and the clinical and pathological aspects of allergic aspergillosis are often indistinguishable from those of unrelated allergic conditions. Thus it is no longer possible to compartmentalize the various types of pulmonary aspergillosis into exclusive forms of the disease; rather, the radiologist should be aware that various factors can modify the mode of growth of the fungus as well as the patient's response.
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PMID:The pulmonary aspergilloses: three distinct entities or a spectrum of disease. 725 37

A patient with diabetes mellitus presented with an obstructing mycetoma in the right bronchus intermedius due to Phycomycetes. Review of the literature revealed eight prior case reports of patients with prominent endobronchial disease attributable to phycomycosis. Indolent, obstructing lesions in large bronchi were noted in diabetics. The clinical illness differed from the fulminant fungal pneumonia noted in leukemics but was also lethal because of localized complications such as erosion into the pulmonary artery. The differential diagnosis included mucoid impaction, bronchocentric granulomatosis, and mycotic bronchitis. Surgical resection appears to be the appropriate therapy for well localized bronchial lesions.
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PMID:Phycomycosis: a cause of bronchial obstruction. 739 93

A 79 years old patient developed a large pulmonary aspergilloma in the cavities of his right upper lobe after postinfarctional pneumonia with local abscess formation. The clinical follow-up was characterized by recurrent hemoptysis resulting in marked anemia as well as by a continuous growth of the mycetoma. Suddenly a purulent gangrene of the whole upper lobe occurred infected by actinomyces israelii and staphylococcus but not aspergillus as it could be demonstrated in specimens from repeated transthoracic needle aspirations. After percutaneously inserted chest-tube drainage during 30 days the upper lobe cavity cleared up and the previously impressive aspergilloma had disappeared completely, however, the serum precipitins from aspergillus fumigatus still remained positive. After a course of several months without further pulmonary complications the patient finally died from a ruptured aortic aneurysm. It is suggested, that the spontaneous lysis of the aspergilloma was due to a deprivation of it' nutritive basis by the infected pulmonary tissue. A similar mechanism may also account for a sometimes successful treatment of pulmonary aspergilloma after injection of an amphotericin containing paste as a novel therapeutic strategy which is recommended in the case of patient's inoperable conditions.
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PMID:[Spontaneous lysis of pulmonary aspergillosis: "Aspergillus destroyed by Actinomyces"]. 1107 23

Streptomyces are saprophytic soil organisms rarely known to cause invasive infections other than mycetoma. We report 6 cases of invasive Streptomyces infections and review 13 previously reported cases. Our series included 2 cases of lung abscess or pneumonitis, 3 cases of central venous catheter-related bloodstream infection, and I case of possible hypersensitivity pneumonitis. Most previous cases also included lung infections and bloodstream infections. Preexisting conditions, such as cancer, AIDS or HIV infection, presence of a central venous catheter, and prosthetic heart valve, were present in all cases since 1985. Diverse Streptomyces species were involved, consistent with the highly opportunistic nature of the infections. Clinical management depended on the clinical situation of individual cases without consensus. Available susceptibility data showed that Streptomyces organisms were consistently susceptible to amikacin; frequently susceptible to imipenem, clarithromycin or erythromycin, minocycline, and trimethoprim-sulfamethoxazole; and infrequently susceptible to ciprofloxacin and ampicillin. The diagnosis of Streptomyces infection required microbiologic and pathologic correlation to rule out contamination.
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PMID:Invasive Streptomyces infections: six cases and literature review. 1736 39


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