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

To investigate the role of BALT in chronic respiratory infection, we established a rat model of chronic bronchiolitis caused by Pseudomonas aeruginosa, and the light microscopic findings of the BALT were studied. Experimental pneumonia was produced in SD rats by intratracheal inoculation of 10(6) colony forming units (cfu) of mucoid P. aeruginosa enmeshed in agar beads. The mean cfu recoverable from the lung increased up to 10(8) cfu at day 1. The number of bacteria remained fairly constant at 10(4) cfu until day 28. Histologically, infiltration of neutrophils could be seen around the agar beads containing P. aeruginosa in the lung from day 1 to day 7. From day 14 to day 28. the histological changes in the lungs were characterized by accumulation of foamy cells accompanied with lymphocyte infiltrations and granulation tissues around the respiratory bronchioles, but without involved alveoli. These chronic inflammatory histologic changes were similar to those of diffuse panbronchiolitis (DPB). At the same time, there were massive accumulation of lymphocytes in lymphatics and in high endothelial venules of the BALT at day 7. The development of germinal centers in the follicular area was found from day 7 to day 28. The airway was narrowed as a result of BALT hyperplasia protruding to the bronchial lumen. These results suggest that histological changes represent the model of chronic bronchiolitis and BALT may have a specific role in developing the local immune responses against chronic respiratory infection due to P. aeruginosa.
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PMID:[A rat model of chronic bronchiolitis due to Pseudomonas aeruginosa--a histopathological study of bronchus-associated lymphoid tissue (BALT)]. 212 Mar 70

During 9 months (from January 1988 to September 1988), we experienced 82 patients (94 episodes) of respiratory infections with Branhamella catarrhalis in 5 different hospitals. There were 11 patients of acute bronchitis, 8 patients of pneumonia, 56 patients of chronic bronchitis (68 episodes), 3 patients of bronchiectasis, 3 patients of bronchial asthma with infection and chronic pulmonary emphysema in one patient. Ten cases of acute bronchitis and 3 cases of pneumonia had a recent history of common cold, with no underlying disease. There were 68 episodes of acute exacerbation of chronic bronchitis, the highest among 94 episodes of all respiratory infection. In chronic bronchitis the single pathogen B. catarrhalis was more than B. catarrhalis associated with other pathogens. H. influenza was associated with B. catarrhalis in in most cases of polymicrobial infection. beta-lactamase producing B. catarrhalis was 71% and oral penicillin was not effective in 8 cases of infection by beta-lactamase producing strains. These results show that B. catarrhalis is very important as a common pathogen of respiratory infection.
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PMID:[Respiratory infections caused by Branhamella catarrhalis in 5 different hospitals]. 212 Apr 97

Five cases of bacteremic infections due to Haemophilus influenzae type f in adults are described, and previous reports of type f disease in nonpediatric patients are reviewed. Respiratory tract infections were most common in our series (two cases of pneumonia, one of epiglottitis, and one of nosocomial septicemia probably resulting from aspiration pneumonitis). All of these patients had factors predisposing them to respiratory tract infections, e.g., neurologic disease, congestive heart failure, or cigarette smoking. A fifth patient, who was bacteremic without an apparent primary focus, had dysgammaglobulinemia. Six episodes of bacteremia occurred in five patients; 11 of 13 cultures of blood obtained before parenteral antibiotic therapy were positive. All isolates were biotype I and susceptible to ampicillin. Antibiotic therapy was curative in cases of proved respiratory tract infection but failed in the setting of nosocomial septicemia, perhaps because of delayed initiation. The brevity of antibiotic treatment of the cryptogenic bacteremia permitted infection of a prosthetic vascular graft and recurrent bacteremia. Graft removal and repeated antibiotic therapy were curative.
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PMID:Bacteremic disease due to Haemophilus influenzae capsular type f in adults: report of five cases and review. 220 Oct 66

Ofloxacin is highly active against common respiratory pathogens including Haemophilus influenzae and Branhamella catarrhalis and has clinically applicable activity against Streptococcus pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa. Sputum, lung tissue and bronchial mucosal concentrations of ofloxacin equal or, in most cases significantly exceed the MICs of such pathogens. These in vitro attributes are reflected in the results of the worldwide ofloxacin clinical trial program which achieved overall response rates of 98% in lower respiratory tract infections, 83% in pneumonias and 87% to 95%, in open and comparative studies respectively, in patients with acute exacerbations of chronic bronchitis (CB). Overall bacterial eradication rates ranged from 70% for pneumococci and 84.5% for B. catarrhalis to 88.5% for H. influenzae. In lower respiratory infection ofloxacin gave equal or superior clinical results to amoxycillin or erythromycin therapy together with an overall bacterial eradication rate of 100%. Clinical results comparable with standard agents were also obtained in pneumonia, cure rates ranging from 77-89% at various dosages. Eradication rates proved greatest for H. influenzae (92%) and were satisfactory for Klebsiella spp. (80%), although less so for pneumococci (73%). Bacteriological eradication rates in acute exacerbations of chronic bronchitis ranged from 68% for pneumococcal infections, to 85% in B. catarrhalis and 94% in H. influenzae infections. Ofloxacin compared favourably with pivampicillin, co-trimoxazole and doxycycline clinically. A daily oral ofloxacin dose of 400 mg produced a good clinical response in 92% of patients or more. The available clinical data therefore substantially confirm the claim of ofloxacin to offer an effective alternative in many forms of acute bacterial respiratory infection, especially where H. influenzae and B. catarrhalis are involved.
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PMID:Overview of experience with ofloxacin in respiratory tract infection. 221 24

In 809 infants and children with acute respiratory infection, HEp-2 cells were used for the isolation of respiratory syncytial virus (RSV) and an indirect immunofluorescence technique (IIF) was used for the detection of RSV antigen in the epithelial cells of nasopharyngeal secretions. While RSV was detected in culture in only 87 subjects, IIF was positive for viral antigen in 158 subjects. In children with bronchiolitis and in those with pneumonia 57 and 19 per cent respectively, had evidence of RSV infection by culture or IIF. The frequency of virus antigen detection by IIF was above 90 per cent irrespective of the duration of symptoms before specimen collection. The frequency of virus isolation in culture was 86 per cent in children with less than 2 days duration of symptoms and 42 to 69 per cent in those with duration of symptoms of 2 days or more. However, this difference was not statistically significant. In conclusion, the IIF test was not only rapid, but also more sensitive for the detection of RSV infection than culture.
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PMID:Comparison of immunofluorescence & culture for the diagnosis of respiratory syncytial virus infection. 222 50

Bacterial tracheitis, previously referred to as nondiphtheritic laryngitis with marked exudate, was commonly discussed in pediatric textbooks before 1940. It seemed to disappear as a clinical entity after that time, but it has been recorded with increasing frequency in the pediatric literature since 1979. We describe eight new cases and review 110 previously described cases. The clinical course consists of a prodromal upper respiratory illness with stridor, fever, and a variable degree of respiratory distress. Unlike patients with croup, patients with bacterial tracheitis do not respond to aerosolized racemic epinephrine. Most patients require endotracheal intubation; some require tracheostomy. Reported complications include pneumonia, pneumothorax, formation of pseudomembranes, toxic shock syndrome, and cardiopulmonary arrest. Bacterial tracheitis is a secondary bacterial infection following a primary viral respiratory infection. The most common preceding viral infection is parainfluenza. Staphylococcus aureus and Haemophilus influenzae are the predominant causes of bacterial tracheitis. Secondary bacterial infection may occur as a result of tracheal mucosal injury or impairment of normal phagocytic function due to viral infection.
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PMID:Bacterial tracheitis: report of eight new cases and review. 223 9

A 39 year old man who was HIV positive and was treated with trimethoprim-sulfamethoxazole for pneumocystis with hypoxaemia. During the acute episode he had a persistent fever of 38 degrees and hypoxaemia with a PaO2 of 65 mm/Hg and bilateral opacities both radiologically and on a CT scan, which were of alveolar type, with bronchograms identical to those observed before the treatment of the pneumocystis. In view of the negative evidence for a respiratory or extra respiratory infection, a surgical biopsy was performed and this revealed lesions of bronchiolitis obliterans with an organising pneumonia (BOOP). After the thoracotomy, there was a spontaneous clinical cure in a few days and radiological clearance in a month. This very rare diagnosis should be added to the list of causes of alveolar pneumopathy with infiltration and fever occurring during the course of an HIV infection.
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PMID:[Bronchiolitis obliterans, pneumocystosis and HIV infection]. 227 Mar 52

Virtually only researchers from developed countries have done studies of risk factors for acute respiratory infections (ARIs) since these countries have an infrastructure that can support large multidimensional epidemiologic studies while developing countries do not. Yet results from these countries studies are not always relevant to developing countries since risk factor exposures in developing countries. For example, the predominant problem in developing countries is that ARIs in children is that ARIs in children 5 years old often result in death whereas in developed countries morbidity predominates. Based on studies in developed countries, there is plenty of evidence that strong associations exist between ARIs and chronic disease in adults, direct and passive smoking, and breast feeding. Thus policy need not request additional studies to base proper changes in public health policy. Yet researchers do need to collect more data on the associations between ARIs and HIV infections, low birth weight, and other possible risk factors. In fact, some are now examining relationships between ARIs and malnutrition, vitamin A supplementation, and indoor air pollution in developing countries. Some of the more important issues in developed countries are the links between maternal antibody levels and passive immunity in infants, the links between air pollution and ARIs, and the reasons for a rise in pneumonia in the aged. Another area that scientists need to explore is the association between respiratory infection (especially between 1-12 months old) and subsequent ARI. Further epidemiologists should standard data collection methods in both developed and developing countries. For example, the chronic respiratory questionnaire of the American Thoracic Society can serve as a model for acute symptom questionnaires.
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PMID:The epidemiology of acute respiratory infections in children and adults: a global perspective. 228 16

The aim of this study was to assess the effect of acute bronchitis and pneumonia on the FEV1 decline rate in a random sample of Cracow inhabitants followed over a 13-year period. A total of 718 males and 1029 females completed the spirometric testing and interview in 13-year follow-up period. Acute chest diseases diagnosed and treated by doctors and reported by respondents in surveys were the source of data on broncho-pulmonary infections. The rate of FEV1 change, expressed in ml per year was estimated for each person in 13-year follow-up period. Persons who reported recurrent bronchitis and pneumonia had significantly lower initial FEV1 levels than those without infections. The effect was controlled for confounders like age, height, smoking and chronic chest symptoms. The initial low ventilatory function by itself was not a predisposing factor for chest infections, unless they were associated with chronic respiratory symptoms. Lung function in men decreased steeply after pneumonia infection, but the effect appeared to be reversible. This effect was not limited to people with pre-existing chronic respiratory disease. The data indicated that in some subjects who reported new symptoms of dyspnea on effort, the acceleration of FEV1 decline due to pneumonia was greater than in people without the symptoms. This may result from the fact that in lower respiratory infection, bacterial or viral agents can produce serious dysfunction of small airways.
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PMID:The effect of acute broncho-pulmonary infections on the FEV1 change in 13-year follow-up. The Cracow Study. 234 73

In a prospective hospital-based study of 328 children under 5 years of age with acute lower respiratory infections, 114 (35%) were diagnosed to have acute bronchiolitis. Of them, 87 (76%) were less than 1 year and 107 (94%) were less than 2 years of age. Signs of severe lower respiratory infections, namely tachypnea (respiratory rate greater than 50/min) and subcostal retraction, were present in 95% and 93%, respectively. Of 88 children of whom roentgenographs were taken, 30 (34%) had evidence of pneumonia. No clinical signs discriminated between those with and without pneumonia. By culture or immunofluorescence antigen detection, viruses were found in 81 (71%) children with bronchiolitis; respiratory syncytial virus was the most common agent, found in 65 (57%). Parainfluenza viruses were the next most common, found in 12 (11%). Most cases of bronchiolitis occurred in outbreaks during the rainy months of August through November, coinciding with respiratory syncytial virus outbreaks. Although bacterial culture of blood was done in 56 children, no respiratory pathogen was isolated. In one child with bronchiolitis and consolidation, postmortem lung aspirate yielded Staphylococcus aureus. Thus, bronchiolitis is primarily a viral syndrome in this tropical region, just as it is in temperate regions. Eight (7%) children died (all were infants); 5 had roentgenographic pneumonia and the remaining had other abnormalities contributing to death; all had been treated with antibiotics. Since one third of lower respiratory infections are bronchiolitis, and among infants under 1 year of age bronchiolitis comprises 47% of all lower respiratory infection cases, criteria for antibiotic management must take into account the availability of roentgenographic investigation.
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PMID:Bronchiolitis in tropical south India. 239 17


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