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

Mortality surveys undertaken in rural areas of The Gambia, a small country on the west coast of Africa, indicate that acute lower respiratory tract infections (ALRI) are the most frequent cause of death among children and that approximately 1 in 25 rural Gambian children dies from an ALRI before the age of 5 years. Community surveys suggest that each child experiences an average of one episode of ALRI accompanied by radiographic changes before reaching this age. Etiologic studies have shown that pneumococci, Haemophilus influenzae type b (Hib), and respiratory syncytial virus are the most important causes of ALRI in Gambian children who present to a hospital, and the same three organisms are probably the major causes of severe ALRI in rural communities. Hib probably accounts for 5%-10% of cases of severe ALRI in Gambian children, and because the incidence of severe ALRI is high, an effective Hib conjugate vaccine might save as many childhood deaths by preventing pneumonia as by preventing meningitis.
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PMID:Epidemiology of acute lower respiratory tract infections, especially those due to Haemophilus influenzae type b, in The Gambia, west Africa. 158 69

The clinical profile of 150 hospital based cases (6 months-7 yrs) of measles presenting between May 1986 to May 1987 was analyzed. Nearly a quarter (28%) were less than 1 yr; 60% belonged to 1-3 yrs age group, 8.6% were 3-5 yrs old and 2.6% were in the 5-7 yrs age group. The male:female ratio was 1.2:1. Nearly half (53.3%) were well nourished, 36.6% had Grades I-II PEM and 9.9% had Grades III-IV PEM. About half (47%) showed no complications; 53% had some complications of which 15% had more than one system involvement. Respiratory complications were seen in 50%, nutritional deterioration in 17.3%, gastrointestinal and neurological in 14.6% each and cardiac in 1.3%. The respiratory complications included pneumonia (16%), bronchitis (12.6%), activation of TB (10.66%), otitis (7.3%) and miliary tuberculosis (4%). CNS complications were encephalitis in 8%, meningitis in 3.3%, convulsions -2.6% and limb paresis in 0.6%. Children below 1 yr had a greater incidence of complications and multisystem involvement. Children between 3-5 yrs had respiratory and GI system involvement and children greater than 5 yrs showed respiratory system involvement only. No complications were seen in the well nourished group while early grades of PEM had mild complications. Severe degree of malnutrition had higher incidence and severity of complications. The need for large coverage of measles vaccine in our country especially amongst the malnourished group is obvious.
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PMID:Clinical profile of measles--a prospective study of 150 hospital based children. 160 95

Broad spectrum cephalosporins have been studied extensively in animal models of experimental infections. There is generally good correlation between the results of therapy of experimental infections and clinical trials in humans. However, the results of animal model studies are better predictors of the failure than of the success of a chemotherapeutic regimen. Cefotaxime and the new 'fourth' generation agent, cefpirome, were comparable in the treatment of experimental meningitis caused by Streptococcus pneumoniae. Cefpirome was the most effective cephalosporin as therapy for methicillin-susceptible Staphylococcus aureus experimental endocarditis. The most effective broad spectrum cephalosporins for the treatment of Gram-negative experimental pneumonia were cefpirome, cefotaxime and cefodizime. Cefpirome was equivalent to ceftazidime or cefazolin as treatment for Pseudomonas aeruginosa or methicillin-susceptible S. aureus experimental osteomyelitis. Because of its potent activity in vitro and in animal models of experimental infections caused by methicillin-susceptible S. aureus and Gram-negative bacilli, cefpirome may offer a therapeutic advantage over currently available broad spectrum cephalosporins.
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PMID:Animal models as predictors of outcome of therapy with broad spectrum cephalosporins. 160 55

Haemophilus influenzae type b (Hinb) is the main etiologic agent of severe pediatric illnesses, such as meningitis, epiglottitis and pneumonia. Countries most affected by this pathogen are localized in the American, European and African continents. While this organism was originally isolated 100 years ago, the first field trial using a whole killed vaccine was performed until 1959. Since then, further controlled clinical trials have mainly been conducted in the North American and European continents. Under appropriate safety and efficacy evaluation tests performed by the Federal Drug Administration Agency (FDA), five vaccines were licensed: one single and four conjugated preparations. Worldwide and regional epidemiologic data concerning serious diseases produced by this organism have shown their outstanding impact in the public health of developed countries. Unfortunately, in developing countries similar epidemiological indexes are lacking for lethal and disabling diseases, such as meningitis. In order to decrease high morbidity and mortality rates of this meningeal disease and its neurological sequelae, immunoprophylactic preventive measures have been recommended. Furthermore, some risk factors of this infant illness can also be reduced. New strategies regarding conjugate Hib-vaccines are reviewed. Finally, promising virulence factors or self Hib-structures for the production of vaccines are suggested, such as outer membrane proteins (OMP), lipooligosaccharides, fimbriae or pili.
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PMID:[Vaccines against Haemophilus influenzae B: present, past and future]. 161 46

Cryptococcus neoformans is an important opportunist pathogen in human immunodeficiency virus (HIV) infection. Cryptococcal meningitis (CM) 3rd after primary HIV neuropathy an Toxoplasma gondii among infectious neurological diseases in AIDS patients. Extrapulmonary infection due to C. neoformans has occurred in up to 13% of patients. 86% of the Cryptococcus spp isolates in the US, Canada, and Japan are serotype A. Thousands of infection due to var neoformans have been reported in AIDS patients but only 3 cases of var gattii. Cryptococcal pneumonia meningitis appears in 63-84% of AIDS patients with symptoms of fever, headache, meningism, and photophobia. 17-37% of AIDS patients with Cm die during therapy, and only 18-30% live over 12 months. Treatment in patients without immunodeficiency deficit is with a combination of .3 mg/kg/day of amphotericin B and 150 mg/kg/day of flucytosine for 4 weeks. A dose of .5-.8 mg/kg/day amphotericin was most effective although renal toxicity occurred in 80% of patients. Fluconazole has been used since 1987: cerebrospinal fluid concentrations reached 60-80% in serum. Treatment in 8 of 14 patients receiving 400 mg/day fluconazole failed while it did not in 6 patients treated with .7 mg/kg/day of amphotericin for 7 days and flucytosine 100 mg/kg/day. 200 mg/bid itraconazole was given to 32 patients with cryptococcosis (24 CM cases and 26 AIDS victims) and 65% of CM patients improved clinically with negative cultures. The relapse of 2 of 106 patients taking 200 mg/day fluconazole and 13 of 77 patients taking 1 mg/kg/week amphotericin B occurred in maintenance therapy. CM was suppressed in 10 of 15 patients with 400 mg/kg itrazonazole. Prophylactic use of azole drugs in AIDS does not protect completely from CM although it reduced systemic fungal infections such as cryptococcosis.
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PMID:Cryptococcal infection in AIDS. 161 62

The common infective conditions encountered at King Khalid Teaching Hospital, Riyadh, Saudi Arabia were described. These data were collected mostly during a period of 8 years between 1981 to 1988. These infections included brucellosis, cholecystitis, conjunctivitis, enteric fever, gastroenteritis, infective endocarditis, meningitis, otitis media, pneumonia, septicaemia, sorethroat, treponemal infections, urethritis, urinary tract infections, and vaginitis. A scheme for empiric chemotherapy has been suggested for these infections based on the sensitivity results obtained mostly from the microbiology laboratory at Teaching Hospital, Riyadh. This scheme of empiric therapy is offered as a guide only. It does not cover all possibilities and is not intended as a rigid dogma. Empiric therapy has also been suggested for some other infective conditions where sufficient data were not available from the Teaching Hospital. Empiric therapy should be started after relevant specimens are collected. Culture and sensitivity tests are invaluable in the management of patients with infectious diseases. As soon as sensitivities of the infecting organisms' are known, treatment should be adjusted accordingly. In some cases, Gram-staining is valuable to guide the initial therapy (eg. meningitis, pneumonia, and urethritis). Finally, close liaison between physicians and clinical microbiologists is mandatory for successful therapy.
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PMID:Empiric therapy of common bacterial infections in Saudi Arabia; a review. 161 94

A commercially available agar gel diffusion (AGD) assay was used to investigate the teichoic acid antibody (TAA) response in 183 patients with proven Staphylococcus aureus (SA) infections. Two control groups were also investigated. One consisted of 100 hospitalized patients with a variety of medical and surgical conditions other than SA infection and the other consisted of 116 healthy hospital staff members. The sensitivity of the AGD assay varied markedly depending on the site of infection in the patients with proven SA infections. All patients with SA endocarditis developed positive TAA titres (greater than or equal to 1:4), although more than one third of these were initially negative. In patients with chronic osteomyelitis or septic arthritis, 41% had positive TAA titres, whereas no positive titres were detected in patients with acute osteomyelitis or septic arthritis. Lower rates of positive TAA titres were found in patients with deep abscesses (27%), pneumonia (14%) and post-operative infections (9%), but no positive titres occurred in patients with acute uncomplicated bacteremia, cellulitis or meningitis. In 100 hospitalized control patients, no positive titres were detected, and only 1 of 116 (0.9%) healthy hospital staff controls was positive. Suggested guidelines for the use of the AGD assay are discussed.
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PMID:Detection of teichoic acid antibodies in Staphylococcus aureus infections. 164 Dec 54

During the last few years, among nosocomial pathogens, Acinetobacter spp. have given rise to an increasing number of nosocomial infections. Acinetobacter strains are widely distributed in nature; in hospitals, the human skin is the likely source for most outbreaks of hospital infections. The organism has been frequently found in the inanimate environment, especially in moist situations and it has been isolated from various types of opportunistic infections (septicaemia, endocarditis, meningitis, pneumonia, skin and wound sepsis and urinary tract infection). For epidemiological studies, various typing methods such as biotyping, bacteriocin typing and serology have been developed. More recently electrophoretic patterns of cell-envelope proteins and plasmid analysis have proved useful in differentiating outbreak strains. Antibiogram typing may be useful but the antibiotic resistance of Acinetobacter spp. has changed rapidly within the last few years and thus antibiotyping must be complemented by other typing systems. New methods such as electrophoretic analysis of isoenzymes, definition of plasmidotype profiles or restriction endonuclease digestion of chromosomal DNA are under investigation.
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PMID:Hospital infection with Acinetobacter spp.: an increasing problem. 167 90

A 12-month prospective study of infection was carried out in the special care baby unit (SCBU), Khoula Hospital, Muscat, Sultanate of Oman. During this period, 8720 babies were born in the hospital and 1265 were admitted to the SCBU. Altogether, 490 babies were of less than 36 weeks' gestation. A total of 190 babies (160 born in the hospital, 30 born before admission) satisfied the criteria for infection. The most common clinical presentation was pneumonia. There was one outbreak of iatrogenic infection. Infection was confirmed microbiologically in 76 of 190 symptomatic babies. Staphylococcus aureus was the most common pathogen and was isolated from 48 infected babies (25%). Beta-haemolytic streptococci were isolated from superficial sites only in eight babies. Klebsiella spp were the commonest enteric bacteria isolated, but they were rarely associated with infection. Of 46 babies who had bacteraemia, 9 also had meningitis. Nine of the 46 babies died, including 6 of the 9 who had meningitis. The mortality following Gram-negative infection was higher than that following Gram-positive infection. Fourteen per cent of infected babies born in hospital and 27% of those born before admission died. A high proportion of bacteria isolated were resistant to ampicillin and/or gentamicin. Results suggest that alternative antibiotics would be more appropriate for initial treatment. The study shows that in developing countries, unsophisticated research, using basic facilities, can be of value in identifying the problems of infection and in recognizing possible solutions to them.
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PMID:Survey of infection in babies at the Khoula Hospital, Oman. 169 43

A 2.5-year retrospective study of pyogenic meningitis in hospitalized children in Kelantan was carried out with regard to aetiology, clinical features, investigation, treatment and outcome. There were 58 children with 43 cases (74.1%) occurring below the age of 1 year. Frequent presenting symptoms included fever (98.3%), fits (77.6%), anorexia (39.7%), vomiting (34.5%) and drowsiness (12.1%). On admission, 37 (63.7%) had neck stiffness, 10 (17.2%) had Kernig's sign and 32 (55.2%) had coma. CSF cultures were positive for Haemophilus influenzae in 29 (50%), Streptococcus pneumonia in 13 (22.4%) and Neisseria meningitidis in 3 (5.2%). The antibiotic sensitivity profiles showed that the three main organisms were 100% sensitive to Chloramphenicol, Streptococcus pneumoniae was 100% sensitive to penicillin, Neisseria meningitidis was 100% sensitive to penicillin and ampicillin, and Haemophilus influenzae was 90% sensitive to penicillin and ampicillin. The total hospital mortality was 18.9%. All but two of the eleven deaths occurred in children younger than 1 year. Nineteen of the 35 (54.3%) survivors attended for at least one follow-up after discharge from hospital. Of these 19 children, 47.4% had neurological sequelae.
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PMID:Pyogenic meningitis in hospitalized children in Kelantan, Malaysia. 169 51


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