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

Infection due to Fusarium species is an increasing cause of serious potentially fatal disease in patients with cancer. We described 9 patients with infection caused by Fusarium species during a 4-year period at the M. D. Anderson Hospital. The spectrum of infections included disseminated disease in 4 patients, skin or soft-tissue infections in 3, pneumonia in 1, and fungemia in 1. All 4 patients with disseminated infection had culture- and biopsy-proven skin lesions caused by Fusarium species and the blood cultures yielded the organism in 3 of these 4 patients. Maxillary sinusitis was the presenting manifestation of Fusarium infection in 2 of these 4 patients, suggesting that paranasal sinuses are potential portals of entry for the infection. Eight patients had a hematological malignancy and 7 were neutropenic at the onset of their infection. Patients with deep-seated infections remained neutropenic and died from infection despite treatment with amphotericin B. All 5 isolates tested in vitro showed resistance to ketoconazole and miconazole, whereas 3 were susceptible to amphotericin B. Fusarium species could play a role in producing myelosuppression and fungal cultures are required to differentiate it from the more commonly encountered Aspergillus species. Fusarium species are emerging as a serious, potentially fatal, pathogen in patients with cancer.
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PMID:The emerging role of Fusarium infections in patients with cancer. 335 14

Clinical characteristics and course of disease of 19 pneumococcal, 11 adenoviral, 15 mycoplasmal and 10 mixed pneumonias, diagnosed in 55 military conscripts, were compared. Controls consisted of 104 conscripts with upper respiratory infections (URI). The triad: productive cough, blood stained sputum, and chest pain aggravated by breathing (pneumococcal score) distinguished pneumococcal and mixed pneumonias but not adenoviral and mycoplasmal pneumonias from URI. Higher C-reactive protein (CRP) and white blood cell (WBC) count distinguished the pneumococcal pneumonias, but not the other pneumonias, from URI. The pneumococcal scores and simple laboratory tests on admission were compared. The score effectively separated pneumococcal from adenoviral and mycoplasmal pneumonias, and patients with mixed infections from mycoplasmal infections. Higher CRP values and WBC counts distinguished pneumococcal pneumonia from other pneumonias. Auscultation revealed crackles in 27% of adenoviral and in 60-70% of mycoplasmal, pneumococcal and mixed pneumonias. Maxillary sinusitis was more common in pneumococcal (56%) than in mycoplasmal (7%) or mixed pneumonia (10%) or URI (14%). Pneumococcal pneumonias differed in most respects from the other groups. It is difficult to distinguish between adenoviral, mycoplasmal and mixed pneumonia and also URI.
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PMID:Clinical diagnosis of pneumococcal, adenoviral, mycoplasmal and mixed pneumonias in young men. 339 72

Nosocomial sinusitis is a complication of endotracheal intubation and mechanical ventilation in critically ill patients. Its incidence is often underestimated because of a lack of clinical signs. It is suspected in patients with nasal discharge or unexplained fever. Its diagnosis is based on radiological examination, by radiograph or computed tomography scan, and microbiological cultures of maxillary sinus aspirate. Maxillary sinusitis is often associated with involvement of the sphenoid, ethmoid, and/or frontal sinuses. Its incidence varies greatly according to diagnostic criteria and the population studied. Infectious sinusitis is less frequent than noninfectious sinusitis, occurring in 20 to 30% of patients intubated for at least seven days. Its incidence is higher in nasotracheally than in orotracheally intubated patients. Other risk factors include nasogastric tubes and head trauma. The main causative agents are gram-negative bacilli, primarily Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae, but Staphylococcus aureus and yeasts are also common. Patients with nosocomial sinusitis are more likely to develop pneumonia than those without sinusitis. The sinus provides a bacterial reservoir from which organisms may seed the tracheobronchial tree. The association of sinusitis and pneumonia is mainly due to Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. The treatment of sinusitis is based on the removal of all nasal tubes, topical decongestants, and maxillary sinus drainage and lavage. The role of intravenous antibiotics is controversial.
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PMID:Sinusitis in mechanically ventilated patients and its role in the pathogenesis of nosocomial pneumonia. 887 69