Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

The destruction of proliferating lymphoid cells within germinal centers with subsequent replacement by histiocytoid cells has been described in infants and children dying of viral and bacterial infections. The etiology and significance of "epithelioid germinal centers" (EGCs) are unknown. The cells implicated in forming EGCs have included histiocytes and dendritic reticulum cells. We have studied four children at autopsy who died at ages ranging from 10 months to 7 years. Three contracted fatal infections, one with fulminant meningococcemia, one with bacterial sepsis, and one with viral hepatitis. The fourth child contracted viral pneumonitis and died of acetaminophen toxicity. Epithelioid germinal centers were found in numerous lymphoid organs (spleen, lymph nodes, and Peyer's patches) in all four cases. Avidin-biotin complex immunohistochemical analysis performed on formalin-fixed splenic tissue from the first three cases and snap-frozen splenic tissue from the second case revealed an absence of B cells in the follicular centers. The mantle zones surrounding follicles were thin but intact. The histiocytoid cells expanding the germinal centers were positive for S100 and R4/23 (dendritic reticulum cells) and negative for numerous histiocyte markers (alpha 1-antitrypsin, alpha 1-antichymotrypsin, and lysozyme). Increased numbers of killer cells (Leu-7) were present within the affected germinal centers in the three cases in which material was available for immunohistochemical studies. Overwhelming infections in these patients seem to result in anomalous natural killer cell activation resulting in localized nonselective destruction of follicular centers similar to anomalous natural killer cell activity reported to occur in fatal infectious mononucleosis. This may lead to an acquired immunodeficiency that precludes long-term survival in affected patients.
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PMID:Epithelioid germinal centers in overwhelming childhood infections. The aftermath of nonspecific destruction of follicular B cells by natural killer cells. 284 41

A case of septic induced abortion in a 15-year-old girl referred to the hospital as a pediatric patient with the provisional diagnosis of meningococcemia is reported. The patient was admitted in shock, cyanotic, and vasoconstricted. Pertinent comments by the nurses that the patient admitted coitus 12 to 14 weeks previously and followed by amenorrhea, were apparently ignored. The 1st gynecologic consultant was called after the patient experienced severe cramps and passage of part of a placenta. He recommended intravenous oxytocin and curettage, but this advice was not followed because the hospital pharmacy did not stock oxytocin and because the administration would not permit curettage on a child. Dilation and curettage was performed after transfer to a general hospital. The patient died 6 weeks after admission, and the pathologist's final summary noted that extensive pneumonia together with organizing thrombi suggest that the patient may have thrown septic emboli very early in the course of her disease. It is concluded that errors and omissions were disastrous, but even more reprehensible was the failure of residents to credit nurses' notes or follow consultants' recommendations which clearly pointed all along to the correct diagnosis. Finally, when the patient aborted in bed, the urgency of intervention was not recognized and the time which was her last chance for survival was lost.
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PMID:Septic induced abortion. 472 34

Neisseria meningitidis Group Y has been considered to be an uncommon pathogen in children. We reviewed the cases of Group Y meningococcal disease in children managed at our institution from 1974 through 1982. Twenty-four percent (6 of 25 cases) of the meningococcal disease in children between 5 and 20 years of age was caused by N. meningitidis Group Y. This serogroup of meningococcus was not isolated from children younger than 5 years of age. Meningococcemia characterized by purpura fulminans was the most common presentation. Pneumonia, a common presentation of Group Y meningococcal disease in military recruits, was not observed. Group Y meningococcal disease had emerged as a cause of meningococcemia and meningitis in older children and adolescents.
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PMID:Meningococcal group Y disease in children. 644 Jan 25

In the period 1973 through 1978, the New York City Department of Health serogrouped 648 isolates of Neisseria meningitidis and investigated 259 cases if meningococcal meningitis and meningococcemia. Although meningitis and septicemia were mainly due to groups B and C, groups Y and W-135 caused nearly one third of the cases. There was no difference in mortalities when disease caused by the classic groups A, B, and C was compared with disease caused by the new serogroups X, Y, Z, W-135, and Z'. Most isolates from the respiratory tract were from the new serogroups, especially Z and Z' (some from patients with pneumonia), as were most of those from the genitourinary tract, anal canal, and miscellaneous sites. Group X was infrequently seen. Although most of the isolations of these groups of N meningitidis are apparently from asymptomatic carriers, Y and W-135 do cause a substantial number of acute symptomatic infections, in particular, septicemia.
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PMID:Meningococcal disease in New York City, 1973 to 1978. Recognition of groups y and W-135 as frequent pathogens. 677 3

Thirty-four cases of meningococcal disease were identified in a retrospective survey of nine US Army posts in the southeastern United States from June 1977 to August 1979. Group B organisms predominated in dependents and civilian communities surrounding two of the posts, while active-duty personnel had a greater variety of organisms, with groups Y and C predominating. The spectrum of clinical presentation and severity was diverse. Six cases of pneumonia with bacteremia occurred, all in basic trainees. A case of chronic meningococcemia was identified, as was one case of dermatitis-arthritis in a pregnant woman, which mimicked gonococcemia. Clinicians should be alert to the possibility of sporadic meningococcal disease in military personnel and their dependents.
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PMID:Sporadic military meningococcal disease: a diversity of presentations. 678 Oct 70

Meningococcemia caused by serogroup W135 occurred in four patients during a period of nine months. Three of the patients had hypogammaglobulinemia with normal hemolytic complement levels; the fourth had normal immunoglobulin levels one year after her illness. None of the patients had classic meningitis. One patient had pneumonia; one appeared to have encephalitis with mild meningismus; and two had sepsis without localizing signs or symptoms. Patients with hypogammaglobulinemia are predisposed to the development of meningococcemia, and the incidence of W135 carriage in the population is increasing.
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PMID:Meningococcemia caused by serogroup W135. Association with hypogammaglobulinemia. 678 88

Five adults had infection caused by Neisseria meningitidis serogroup W135. Their ages ranged from 19 to 74 years, and the spectrum of illness included meningitis, pneumonia, and acute peritonitis. Two patients had systemic lupus erythematosus and were receiving corticosteroids at the time of their infection. One patient died of fulminant meningococcemia. All isolates were sensitive to sulfonamides. The recent increase in the national incidence of N meningitidis serogroup W135 infections emphasizes the need for continuing surveillance and justifies its inclusion in a polyvalent meningococcal vaccine.
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PMID:Neisseria meningitidis serogroup W 135 disease in adults. 679 41

Vecuronium bromide (Norcuron, Organon, Inc., West Orange, NJ) is a common neuromuscular blocking agent used to facilitate mechanical ventilation. Cases have been reported in which prolonged use of vecuronium resulted in severe motor neuropathy, with or without myopathy. However, the time course of recovery, the functional prognosis, and the use of inpatient rehabilitation is not well-established. We are reporting the functional recovery of two cases with the diagnosis of severe vecuronium motor neuropathy and/or myopathy. The patients presented with pneumonia and meningococcemia, respectively, and received vecuronium during ventilatory support, which lead to quadriparesis. In one patient, vecuronium toxicity occurred while neuromuscular junction monitoring was in place. Significant improvement was noted during an average of 3 to 4 wk in a comprehensive inpatient rehabilitation program, documented by the improvement in total motor Functional Independence Measure scores for patient 1 (from 15 to 71) and for patient 2 (from 65 to 84). In addition, the distal compound motor amplitudes showed a 4-fold increase for the ulnar, a 7-fold increase for the median, an 11-fold increase for the peroneal, and a 3-fold increase for the tibial nerves on follow-up nerve conduction studies correlating with neurologic recovery. In summary, even when patients present with quadriparesis, the recovery after vecuronium toxicity appears to be favorable.
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PMID:Neurologic recovery and functional improvement after vecuronium-induced quadriparesis. 757 15

Fifty-eight cases of meningococcal pneumonia were included in this review. Fifty cases previously described in the literature from 1974 through 1998 and 8 new cases were included in this series. The median age of patients was 57.5 years, and pleuritic chest pain was described in 21 (53.9%) of 39 cases. Blood cultures were positive in 42 (79.3%) of 53 cases for which results were mentioned. Despite the presence of bacteremia, patients did not develop the syndrome of meningococcemia with its associated complications. Serogroup Y meningococci were most commonly recovered and accounted for 44.2% of identified isolates. Therapy has dramatically changed over the past 25 years; prior to 1991, penicillin antibiotics were most often used. Since 1991, 12 (80%) of 15 patients received cephalosporin antibiotics. Only 5 (8.62%) of 58 patients died. Secondary cases of meningococcal infections following exposure to patients with meningococcal pneumonia were noted in 2 instances.
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PMID:Meningococcal pneumonia: characterization and review of cases seen over the past 25 years. 1061 38


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