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

Annualy in the USA, the estimated occurence of pneumococcal disease exceeds 500 000 cases of pneumonia (50 000 deaths), 1 200 000 cases of otitis media and 5 000 cases of meningitis. The pneumococcus remains the single most important pathogen which can cause pneumonia. When bacteremia accompanied pneumococcal pneumonia (one-fifth of these), the case fatality rate is approximately of 25% and exceeds 50% in individuals over 50 years of age. Most of the deaths (60%) occur within the first five days of illnesses, despite prompt antibiotic treatment of these patients. Emergence of pneumococcal strains with diminished sensitivity for penicillin, or resistant to tetracycline and other antibiotics is also a factor which lend increasing support to the concept that high risk patients should be protected from pneumococcal infection by immunoprophylaxis. A change of capsular types associated with bacteriemic disease has occured, in the USA, during the past three decades. The types 1 and 3 are less common than in the pre-antibiotic era, and the types 4, 8, 12, and 14 have become more prevalent. Infections with type 2, an epidemic type, have occured infrequently in the past 20 years. In the USA, at the present time, nearly four-fifths of bacteremic cases are associated with only 14 of the 84 pneumococcal capsular type ; in descending frequency : 8, 4, 1, 14, 3, 51, 12, 6, 56, 9, 19, 23, 5 and 20 (American system of nomenclature). The predominant capsular types of otitis media are : 1, 3, 6, 7, 14, 18 and 23. The polyvalent pneumococcal polysaccharide vaccine newly developed in the USA, is safe, antigenic and effective. Its widespread use can be expected to reduce the number of deaths attribuable to pneumococcal bacteremia.
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PMID:Clinical aspects and importance of pneumococcal infections. 39 20

Using counter-immunoelectrophoresis (CIE), the authors have looked for pneumococcal antigens in biological fluids in 141 pneumococcal infections cases (70 meningitis, 25 empyema, 40 pneumonia, 5 peritonitis, 1 pericarditis). The best results (superior to bacteriological results) were obtained with CSF and pleural fluid. Testing sputum by CIE seems to have a real interest in pneumonia. CIE associated with bacteriology, gives more than 20% increase in aetiological diagnosis in pneumococcal infections and permits to set accurate aetiological diagnosis in less than two hours.
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PMID:[Contribution of the counter-immunoelectrophoresis for the diagnosis of pneumococcal infections (author's transl)]. 39 23

Between 1971 and 1974, group Y meningococcal disease developed in 88 Air Force recruits; 68 had primary bacterial pneumonia. None of the patients with primary pneumonia had the stigmata of meningococcemia or meningitis. Patients with pneumonia responded well to small doses of parenteral penicillin. Ten patients had meningococcemia, and six had meningitis. Pneumonia, therefore, predominated over meningococcemia and meningitis 4:1. Skin lesions were rare in patients with meningococcemia but frequent in those with meningitis; otherwise, these clinical syndromes were similar to group B and C meningococcal disease. There was only one death, a patient with known preexisting leukopenia.
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PMID:Group Y meningococcal disease in United States Air Force recruits. 40 77

We report three mildly ill infants who had meningococcal bacteremia and in whom meningitis or fulminant septicemia never developed. The infants were observed during a three-month period. Two of these infants had pneumonia, as evidenced by infiltrates on chest roentgenogram. The serogroups of the organisms isolated were B, Y, and 135. In none of the infants could specific bactericidal antibody be demonstrated in acute or convalescent serum.
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PMID:Meningococcal bacteremia: clinical and serologic studies of infants with mild illness. 40 80

Although a common cause of infection in animals, group C streptococci are rarely noted to be pathogenic in man. A total of 150,000 blood cultures obtained at the Mayo Clinic from 1968 to 1977 revealed group C streptococci in only eight patients. Acute bacterial endocarditis, meningitis, pheumonia, cellulitis and bacteremia due to group C streptococci are described in a host who had undergone immunosuppression (immunosuppressed host), and the relatively few cases previously reported are reviewed. Although severe, these infections may respond favorably to penicillin therapy. Endocarditis caused by group D streptococci is acute and destructive, and associated with early cardiac decompensation. The manifestations of cellulitis and pneumonia are similar to those when group A streptococci are causative organisms. Meningitis due to group C streptococci is acute and severe, and responds slowly to antimicrobial therapy. Colonization also occurs.
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PMID:Infections due to group C streptococci in man. 43 51

From July, 1974 to February, 1978, we managed 12 infants with listeriosis. This infection presented in two distinct forms: an early-onset type (nine patients), often representing a congenital infection following maternal illness, and a late-onset type in which the patient presented with meningitis (three patients). Of our nine infants with early-onset disease, three died, three developed permanent sequelae, and only three were normal at follow-up. Appropriate early management in the perinatal period may improve the outlook in this condition. Affected infants were often premature and had pneumonia, rash, and hepatosplenomegaly at birth. Prenatal clues to the diagnosis included maternal fever, abdominal pains, and leukocytosis with meconium staining of the preterm amniotic fluid. Examination of gastric aspirate at birth showed gram-positive coccobacilli. Antibiotic therapy should be started prenatally and continue for three weeks after birth to prevent recurrences of the late-onset type. This late-onset disease presented as meningitis after the second week of life and responded well to antibiotics. Our three patients recovered without sequelae.
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PMID:Perinatal listeriosis--a review of twelve patients. 43 5

Seven cases of adult Haemophilus parainfluenzae infections diagnosed by positive blood cultures are compared with cases previously reported in the English literature. Three patients had pneumonia, while the others had epiglottitis with meningitis, pharyngitis, arthritis, and endocarditis, respectively. Nonendocarditic manifestations of adult H parainfluenzae infection were reported in four other cases. In addition to the diseases of our patients, H parainfluenzae also has been isolated from cerebral abscesses. Patients did well with antibiotic therapy and there were no deaths. Patients did well with antibiotic therapy and there were no deaths. Report of antibiotic sensitivity testing of 50 strains disclosed 6% of isolates resistant to ampicillin sodium, with all sensitive to chloramphenicol. If the antibiotic sensitivity of the organism is unknown, then chloramphenicol therapy should be instituted until adequate susceptibility studies have been performed. If the organism is sensitive to ampicillin, then this is the drug of choice.
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PMID:Adult bacteremic Haemophilus parainfluenzae infections. Seven reports of cases and a review of the literature. 47 36

Cefoxitin, a parenteral cephamycin beta-lactam antibiotic, was evaluated for safety and efficacy in children with bacterial infections other than meningitis. Twentysix patients between 3 months and 7 years of age were treated with 80 to 160 mg/kg per day. The most common diagnoses were cellulitis (13 patients), pneumonia (5 patients), and bone and joint infection (4 patients). Nine patients were bacteremic. The most frequently recovered pathogens were Staphylococcus aureus (six patients), Haemophilus influenzae (four patients), and Streptococcus pneumoniae (three patients). All organisms were susceptible to cefoxitin. All 26 children were considered improved or cured. No severe adverse reactions were encountered. Phlebitis (4%), eosinophilia (12%), and elevated liver function tests (4%) were associated with therapy. Cefoxitin appears to be a safe, effective, and well-tolerated antibiotic when used in children with susceptible bacterial infections other than meningitis.
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PMID:Clinical and bacteriological evaluation of cefoxitin therapy in children. 48 29

Laboratory and clinical studies of cefamandole (CMD), a new semisynthetic cephalosporin, were investigated and following results were obtained. 1) Absorption and excretion study following 25 mg/kg intravenous administration was carried out in pediatric patients. In 6 cases, mean serum levels of 116.7 +/- 24.0 micrograms/ml, 62.1 +/- micrograms/ml, 12.2 +/- 2.7 micrograms/ml, 2.9 +/- 1.1 micrograms/ml, 0.6 +/- 0.6 micrograms/ml and 0.1 +/- 0.2 micrograms/ml obtained after 15, 30 minutes, 1, 2, 4 and 6 hours administration. In 4 cases, mean urinary recovery of 68.2 +/- 17.2% (0 approximately 8 hours) was obtained. The mean half life of serum level was 0.36 +/- 0.08 hours. 2) The transfer of cefamandole was poor in infants with meningitis. 3) Cefamandole was given to 22 children with acute pyelitis (1 case), acute pneumonia (19 cases), and meningitis (2 cases). The dosage was 80.0 approximately 284.2 mg/kg/day, and it was divided into 4 approximately 6 times and given intravenous or intravenous drip. The duration of administration was from 3 to 17 days. The overall efficacy rate in 22 cases was 95.2%, i.e., excellent in 5, good in 15, poor in 1, and unknown in 1. In bacteriological examination, there were eradication of the organisms in 9 (52.9%), decrease in 4, unchange in 4 out of 17 strains. 4) Any noticeable adverse reaction was not observed.
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PMID:[Laboratory and clinical studies of cefamandole in children (author's transl)]. 50 21

Fungal infections are increasing in frequency, especially among patients with haematological malignancies. The fungi which cause most of the infections in cancer patients are Candida spp. and Aspergillus spp. These fungi seldom infect individuals with normal host defence mechanisms. Many factors predispose patients to fungal infection, including neutropenia, lymphopenia, gastro-intestinal ulceration, intravenous catheters and adrenal corticosteroid therapy. Candida spp. cause 5 major types of infection: dermatitis, thrush, gastro-intestinal, primary organ and disseminated infection. Aspergillus spp. and Phycomycetes cause pulmonary, disseminated or rhino-cerebral infection. Cryptococcus neoformans usually causes meningitis but may cause pneumonia or disseminated infection. The diagnosis of fungal infection is often made only at postmortem examination, because it is difficult to isolate the aetiological agent from sites of infection. Amphotericin B remains the mainstay of antifungal therapy, but is seldom effective in the patient with compromised host defences. Successful management of these infections in the future will depend upon improvement in diagnostic capabilities as well as the introduction of more effective and less toxic antifungal agents.
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PMID:Fungal infections in the cancer patient. 60 7


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