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

Chest radiographs can reflect increasing pulmonary insufficiency of shock lung. In the early and intermediate stages, there is almost pure interstitial oedema which, in the later stages becomes alveolar-interstitial. In addition one may find evidence of broncho-pneumonia. Respiratory insufficiency is due to abnormalities of perfusion and distribution and is aggravated by disturbance of oxygen diffusion. The latter is due to an increase in the alveolo-capillary diffusion distance in the presence of interstitial oedema. It was not possible to demonstrate quantitatively significant precapillary shunts greater than 25 mu.
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PMID:[Radiological lung changes in progressive pulmonary insufficiency (author's transl)]. 13 Oct 60

The results of 97 autopsy cases of lymphogranulomatosis showed the causes of death to be either progression of the disease (78 cases), complications of treatment (12) or other diseases (7). The immediate causes of death in the progression of the disease were toxicity (29%), pulmonary insufficiency (22%), pulmonary-cardial insufficiency (12%), hepatic insufficiency (21%), peritonitis (3.4%), sepsis (5.8%), uremia (3.4%), posthemorrhagic anemia (1.7%), cerebral edema (1.7%). The immediate causes of death in complications of therapy were secondary infection (5 cases), posthemorrhagic anemia (3), pulmonary insufficiency (3), cerebral edema (1). In 7 observations death was not due to lymphogranulomatosis: in 2 cases it was caused by disseminated hematogenic tuberculosis, in 2 pneumonia (with cured lymphogranulomatosis, in 1 myocardial infarction, in 1 uremia (aterosclerotic nephrosclerosis) and 1 patient died accidentally.
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PMID:[Causes of death in lymphogranulomatosis]. 45 24

Chronic pulmonary histoplasmosis is best regarded as an opportunist or saprophytic infection of abnormal pulmonary spaces by a fungus of very low human pathogenicity. Tissue disease results from host immune response to dispersions of soluble antigen from these focal sources. There are two distinct types of clinical and radiological response. One is an acute or subacute illness manifested by often large segmental pneumonic lesions which tend to heal and are designated as early lesions. The other, usually developing as a complication of the first, is a chronic disease marked by persistent cavitation, low gard chronic illness, and a tendency to promote pulmonary fibrosis and often progressive pulmonary insufficiency. The early lesion is a segmental interstitial pneumonitis with central areas of infarct-like necrosis often adjacent to bullous disease and often outlining prominent emphysematous spaces which appear as radiolucencies. These radiological findings are further characterized by early clearing of the interstitial components, infarct-like contraction of the necrotic zones, obliteration of much of the contained emphysematous and bullous spaces, and healing attended by considerable loss of lung volume. Symptoms are variable but tend to be mild. Malaise, fatigability, low-grade fever, aching chest pain and mild cough lasting a few days to a few weeks are usual. Symptoms are ameliorated by rest. Rest and diminished activity are recommended as treatment. Under these circumstances, 80% of early lesions heal completely and probably most of these would heal spontaneously. Any subsequent course of the disease depends on whether or nor large air spaces, adjacent to or contained within the area of pneumonitis, become infected and persist as cavities. This occurs in 20% of early lesions. Once established, an infected cavity tends to persist and to be attended by symptoms of chronic bronchitis with chronic cough and sputum, fatigability, anorexia, and weight loss. Persisting thickwalled cavities often induce gradual development of pulmonary fibrosis, particulary in the lung bases, apparently from aspiration of antigenic material. This and the accelerated obstructive bronchopulmonary disease often lead to progressive pulmonary insufficiency. The use of amphotericin B is recommended for all persistent thick-walled cavities and in some circumstances surgical resection may be indicated.
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PMID:Chronic pulmonary histoplasmosis. 79 26

An 18-year-old woman with stage IIIB Hodgkin's disease presented with minimal shortness of breath and progressed to fatal pulmonary insufficiency in five days. Biopsy and necropsy lung tissue specimens established the diagnosis of acute radiation pneumonitis. The diagnosis of radiation pneumonitis should be considered in the presence of a nonproductive cough, dyspnea, mixed interstitial and alveolar infiltrates on chest roentgenogram, negative cultures, and the characteristic findings on lung biopsy of macrophage accumulation and alveolar fibrin deposition in the face of minimal cellular infiltrate. A trial of steroid treatment may be warranted.
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PMID:Acute febrile illness associated with bilateral pulmonary infiltrates after irradiation in a patient with Hodgkin's disease. 84 87

Rheopneumographic examinations were conducted in 54 patients with chronic pneumonia (stage I and II pulmonary insufficiency) prior to and following exercise tests. It was demonstrated that in normal individuals physical exercises cause a compensatory increase of the pulmonary blood flow without elevating the pressure in the pulmonary circulation system. The progression of pulmonary insufficiency is accompanied by a reduction of the adaptation capacity of the heart, of the pulmonary vessels, by an increase of pulmonary hypertension, and impairment of the contractile function of the right ventricular myocardium. The severity of changes in the pulmonary system haemodynamics, as shown by rheopneumography, correlates with the disorders in the oxygen regimen (oxygen consumption and oxygen pulse).
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PMID:[Characteristics of hemodynamics of the lesser circulation in chronic pneumonia according to ergometric data]. 89 3

Temporary extrapulmonary oxygenation may benefit selected patients with Pneumocystis carinii pneumonia who exhibit severe respiratory insufficiency. Four persons were considered candidates for extrapulmonary oxygenation with a membrane lung while under treatment for pneumocystis pneumonia. In one patient, attempts to institute membrane lung circulation were postponed until his condition was terminal. In another individual, membrane lung support was discontinued prematurely because of complications of anticoagulation. A third patient died of cardiac failure even though her oxygenation had improved during respiratory assistance. In the fourth, the membrane lung was used successfully to maintain the patient through therapy until lung recovery was adequate to resume vital function. The four cases presented are examples of the immunosuppression that creates susceptibility to pneumocystis pneumonia: In two patients, immunodeficiency was caused by lymphoma and combination chemotherapy for the underlying disease; in two others, immunosuppression was induced for the purposes of transplantation. Two patients underwent veno-venous perfusion for prepulmonary oxygenation, and one underwent venoarterial bypass with the membrane lung. Indications for, and techniques of, membrane lung bypass are reviewed. This method of extrapulmonary membrane lung support may save some patients with transient severe pulmonary insufficiency due to P, carinii pneumonia, and the membrane lung may be an adjunct to antimicrobial therapy.
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PMID:Pulmonary and extrapulmonary support for patients with Pneumocystis carinii pneumonia. 108 54

Progressive pulmonary insufficiency appears to be a universal response to the lung to a variety of injuries which damage the pulmonary-capillary emdothelium. Persistent hyperventilation, unresponsive to the administration of oxygen, is the earliest clinical sign of this complication of trauma and should prompt close monitoring of pulmonary function (measurement of arterial blood gas and pH levels, Vd/Vt A-aDo2, minute ventilation, vital capacity and inspiratory force) to assess the severity of the disease, the need for mechanical ventilatory support and the effectiveness of treatment. Other pulmonary complications of burn injury range from carbon monoxide poisoning and narcotics overdosage in the immediate postburn period through marked hyperventilation directly related to burn size occurring in the absence of significant parenchymal change to later occurring hematogenous and airborne pneumonia. Inhalation injury, a chemical tracheobronchitis which significantly increases the mortality of a given-sized burn, may be present immediately postburn but clinically inapparent for 48-72 hours. 133Xenon lung scans permit early diagnosis of this pulmonary injury and the timely institution of a graduated therapeutic response keyed to the severity of pulmonary disability. Knowledge of the pathogenesis of each of these complications is requisite for the physician caring for burn patients and permits the employment of rational preventive and therapeutic measures.
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PMID:Progressive pulmonary insufficiency and other pulmonary complications of thermal injury. 109 77

The aim of this study was to evaluate whether the amount of Pneumocystis carinii organisms found at fiberoptic bronchoscopy (FB) performed on HIV-positive patients correlated to the character of the P. carinii pneumonia (PCP). A consecutive series of 105 patients presented with 131 episodes of pulmonary symptoms requiring FB, and in 75 of these episodes a diagnosis of PCP was made. Specimens were stained with Giemsa and methenamine silver nitrate and the number of parasites found was given as: numerous, many, few or none. The following signs and symptoms were registered: cough, dyspnoea, fever, loss of weight, chest radiograph, haemoglobin, WBC, CD4 cell count, PO2 and HIV p24 antigen. The PCP was characterized by the clinical course: mild, moderate, severe, and by the outcome: pulmonary healthy, pulmonary insufficiency and death. No correlations between the number of P. carinii organisms and the clinical course or outcome of the PCP, the symptoms before the FB or the paraclinical examinations were found. In conclusion, the routinely obtained quantitative results of the microbiological examinations of material from the lungs were not correlated to the severity of the PCP.
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PMID:Pneumocystis carinii pneumonia in AIDS patients: clinical course in relation to the parasite number found in routine specimens obtained by fiberoptic bronchoscopy. 150 34

Two middle-aged women showed typical erythematous heliotrope eruption and Gottron's sign without any symptom of myositis. The patients were diagnosed as 'amyopathic dermatomyositis' because of normal serum CPK levels, normal EMG and no histological abnormality by muscle biopsy. Clinical manifestations improved by the treatment with corticosteroids. During tapering of corticosteroids, however, intersititial pneumonitis developed and rapidly progressed. The first patients was treated with methylprednisolone pulse therapy, azathiopurine and methotrexate. The second patients was treated with betamethazone, methlprednisolone pulse therapy and cyclosporin A. In spite of these extensive immunosuppressive therapies, both patients died of pulmonary insufficiency a few months after admission. In the literature there has been only several cases of amyopathic dermatomyositis and only one case with fatal rapidly progressive interstitial pneumonitis. A new approach to the treatment of this disease should be made.
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PMID:[Two cases of amyopathic dermatomyositis with fatal rapidly progressive interstitial pneumonitis]. 224 55

Two cases of fatal pneumonitis induced by pepleomycin, a new antitumour antibiotic analogous to bleomycin, are described. In the first case, the patient received radiation in combination with intra-arterial administration of pepleomycin to a total dose of 100 mg. for the treatment of an epidermoid carcinoma of the maxilla. The pulmonary changes were noted two weeks after cessation of the chemotherapy and the patient died of pulmonary insufficiency despite intensive therapy with antibiotics and a steroid. The other case with an epidermoid carcinoma of the cheek and oropharynx was treated by radiation and pepleomycin given to a total dose of 205 mg. Pepleomycin was replaced by predonin soon after bilateral shadows were noticed on a chest radiograph, but the patient died of pneumonitis 10 months later. Various factors which may affect the development of pulmonary toxicity by pepleomycin are discussed.
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PMID:Pepleomycin-induced pneumonitis resulting in death. 620 13


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