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

A case of Kaposi's sarcoma in a 86-year female farmer is presented in view of the epidemiological data, currently changed biology of Kaposi's sarcoma, and its importance related to an association with acquired immunodeficiency syndrome (AIDS). In this particular case, the clinical course of the disease was very rapid with skin lesions on the upper and lower extremities and on mucous membranes of the oral cavity and epiglottis. Immunologic disorders caused afebrile pneumonia, prolonged healing of the post-traumatic wound and fracture of the shaft of the radius and ulna. Progressive cachexia and weakness have led to the loss of the waking ability and self-care.
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PMID:[Kaposi's sarcoma ]. 263 32

We report the case of a patient with AIDS, Kaposi's sarcoma and persistent herpes simplex type 2 proctitis who died of herpes simplex 2 pneumonitis following an episode of nonspecific interstitial pneumonitis. This rare complication of persistent herpes simplex mucosal infection must be considered in patients with AIDS suffering from severe pneumonitis with negative bronchoalveolar lavage.
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PMID:[Herpes simplex type 2 pneumonitis in an AIDS patient]. 279 40

Clinical and necropsy findings in 13 intravenous drug abusers who died of the acquired immunodeficiency syndrome (AIDS) were reviewed and compared with findings in eight patients who acquired the infection through sexual exposure, the most common mode of transmission in AIDS. No differences were found in lymphocyte counts or duration of survival, despite reports that the degree of immunosuppression in intravenous drug abusers with AIDS differs from that in homosexuals. Neoplasms were found in 25 per cent of patients with sexual risks, but not in any drug abusers (0 per cent). Two opportunistic infections (toxoplasmosis and cytomegalovirus pneumonia and esophagitis) were more common in the intravenous drug abuser group. Although cytomegalovirus has been associated with Kaposi's sarcoma, this association was not found in this study. The postmortem findings in both groups were otherwise similar.
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PMID:The acquired immunodeficiency syndrome in intravenous drug abusers and patients with a sexual risk: clinical and postmortem comparisons. 282 21

Opportunistic pneumonias are a life-threatening complication in patients with AIDS. Early diagnosis and therapy is necessary to improve prognosis. This study was designed to assess the value of 67Ga scintigraphy in the primary detection and follow-up of these special pneumonias. 67Ga scintigraphy was performed in 40 patients: 10 normal controls and 30 HIV-positive patients with AIDS or AIDS-related complex (ARC). 67Ga scan results were compared with current chest radiographs and the results of pathogen detection. The evaluation of positive scans was based on a quantification of the pulmonary uptake, expressed as a pulmonary/soft-tissue uptake ratio. Only 8/30 patients had a normal scan, 22/30 showed diffuse (13/22) or focal (9/22) increases of pulmonary uptake. In 7/8 patients with normal scans the chest radiograph was negative as well. The one patient with negative scan but positive chest radiograph had pulmonary Kaposi's sarcoma. In 11/22 patients the 67Ga scan and chest radiograph were positive simultaneously. In the other 11/22 patients with positive scans chest radiographs were initially negative but showed pathology in 5 cases within 1-2 weeks. The reason for positive scans in most cases was an opportunistic lung infection; other forms of pneumonia were only observed in two cases. The defined uptake ratio demonstrated to be a highly sensitive parameter for monitoring pneumonia and the effects of therapy in follow-up studies. In conclusion, quantitative 67Ga scintigraphy proved to be a reliable and highly sensitive method for primary detection and follow-up of opportunistic pneumonias in patients with AIDS.
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PMID:[The place of 67Ga scintigraphy in the primary diagnosis and follow-up evaluation of opportunistic pneumonia in patients with AIDS]. 284 24

Acyclovir (Zovirax) and zidovudine (Retrovir) dominate antiviral therapy. They interfere with the multiplication of herpes viruses (acyclovir) and HIV (zidovudine) by incorporation into nascent DNA chains and interruption of the further linking of nucleotides. All types of infection caused by herpes simplex virus are potentially treatable by acyclovir, but treatment has to start to be effective. It is especially important to treat immunosuppressed patients because their infections are more prolonged and severe. A typical attack of herpes zoster in an immunocompetent patient is shortened by about 2 days if high doses of acyclovir are given within 3 days of the start of the skin lesions, but unfortunately the incidence of post-herpetic neuralgia is not diminished. Zidovudine lowers early mortality in patients with AIDS and pneumocystis carinii pneumonia. However, much of the effectiveness of zidovudine is lost later; the average prolongation of life in treated patients is estimated to be about 1 year. Some two thirds of patients with AIDS can be treated with zidovudine; in the others the drug is ineffective (Kaposi's sarcoma) or contraindicated. Frequent blood counts are necessary to monitor myelotoxicity.
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PMID:[Antiviral drugs--1988]. 285 Nov 67

Necropsy findings in 101 adult patients with the acquired immunodeficiency syndrome (AIDS) from two metropolitan hospitals were compared retrospectively with the antemortem clinical diagnoses. 94% of the patients were male and 68% were homosexual or bisexual. 75 (74%) patients had AIDS-related diseases at necropsy that were not suspected clinically. The commonest of the unsuspected AIDS-related diseases were cytomegalovirus infection (49% of all cases), systemic fungal infection (20%), systemic Kaposi's sarcoma (14%), Mycobacterium avium intracellulare infection (11%), and systemic herpes infection (9%). Cryptococcal infection and cytomegalovirus retinitis were always diagnosed antemortem; and Pneumocystis carinii pneumonia went undiagnosed in only 5 of 58 (9%) patients who had proven infection either clinically or at necropsy. 8 patients who died with fungal pneumonia had undergone bronchoscopy; however, in only 1 patient was it diagnosed antemortem. Tuberculosis was undiagnosed in 4 patients. 4 cases of central nervous system lymphoma diagnosed only at necropsy had been treated empirically for toxoplasmosis. Bacterial pneumonias contributed considerably to mortality in 30% of the patients.
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PMID:Value of necropsy in acquired immunodeficiency syndrome. 289 7

Tumor necrosis factor (TNF) has demonstrated antitumor activity against a variety of tumors and is particularly cytotoxic to capillary endothelial cells, which are the presumed cell of origin of Kaposi's sarcoma. We evaluated the toxicity and clinical antitumor and antiretroviral effects of recombinant TNF administered at a once weekly dose of 100 micrograms/m2 intravenously for 8 weeks in five men with AIDS-related Kaposi's sarcoma and without prior opportunistic infection. One patient was removed from study at week 4 due to rapid progression of Kaposi's sarcoma, another patient with stage IV disease and a pretreatment CD4 count of 11 developed fever, hypotension, and pneumonia at week 7 and died 8 days after discontinuing recombinant TNF. No pathogenic organisms were isolated. He had marked eschar formation of his Kaposi's sarcoma lesions, particularly in areas previously exposed to radiation therapy. Uniform toxicities included fevers, rigors, and headaches during drug infusion that were ameliorated by prophylactic meperidine hydrochloride and acetaminophen. All experienced fatigue and three had arthralgias. One patient had transient hypotension which corrected with i.v. fluids. No significant hematologic, hepatic, or renal toxicities were seen. All patients had some progression of their Kaposi's sarcoma on study. There was no change in CD4 or CD8 count or in CD4:CD8 ratios. Serum human immunodeficiency virus (HIV) p24 antigen levels increased greater than 50% in three patients. We conclude that, as a single agent, at a dose of 100 micrograms/m2 recombinant TNF by i.v. infusion has no obvious antitumor or antiretroviral effects in patients with AIDS-related Kaposi's sarcoma.
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PMID:Intravenous recombinant tumor necrosis factor in the treatment of AIDS-related Kaposi's sarcoma. 291 61

Four patients suffering from immune deficiency related to HTLV III developed psoriasis vulgaris. All patients showed lymphadenopathy and cutaneous hypergy or anergy. In three of them, the count of peripheral helper cells was critically decreased (less than 400/microliter), and they showed oral candidosis. One patient suffered from disseminated Kaposi's sarcoma and developed pneumocystis carinii pneumonia. The psoriasis was extensive, exsudative, and almost refractory to therapeutical approaches. The bulk of dermal infiltrating mononuclear cells were T lymphocytes, mostly the T 8 positive phenotype. The majority of these cells were HLA-DR positive, so were many epidermal cells. OKT6 positive epidermal Langerhans' cells were not diminished. Thus we observed the development of psoriasis in spite of severe disturbances of cellular immunity. We suppose that immune mechanisms mediated by T cells--after having got out of control--might play some role in the pathogenesis of the disease.
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PMID:[Psoriasis in HTLV-III-induced immunologic defect--status of cellular immunity and immunohistologic findings]. 294 41

Over a four-year period, 130 patients with the acquired immune deficiency syndrome were studied to assess the incidence and spectrum of pulmonary disease associated with this illness. In 61 patients (47 percent), respiratory abnormalities were either present on admission or later developed. Multiple pathologic processes were present simultaneously in 24 patients and serial pulmonary problems developed in seven patients. Infection was the most common cause of pulmonary parenchymal disease and was due to Pneumocystis carinii (35 patients), cytomegalovirus (21 patients), Mycobacterium avium-intracellulare (13 patients), and bacteria (four patients). Noninfectious causes of parenchymal lung diseases were also frequently seen and included Kaposi's sarcoma (eight patients), non-specific pneumonitis (seven patients), and adult respiratory distress syndrome (four patients). Significant pleural disease was present in six cases and was usually related to Kaposi's sarcoma. A bronchospastic disorder developed in four patients. Pulmonary function tests, in particular the diffusing capacity and the difference between rest and exercise alveolar-arterial oxygen tension, were helpful in screening for pulmonary diseases. Patterns of clinical features and radiographic abnormalities were recognized and suggested specific diagnoses. Overall mortality from respiratory causes identified during the study was 41 percent, but varied markedly with the etiologic agent. Respiratory failure, however, carried a 100 percent mortality despite the underlying cause.
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PMID:Spectrum of pulmonary diseases associated with the acquired immune deficiency syndrome. 298 48

The Conference of State and Territorial Epidemiologists (CSTE) approved the following definitions regarding the case definition of acquired immunodeficiency syndrome (AIDS) at its annual meeting in June 1985. 1st, the case definition of AIDS used for national reporting will continue to include only the more severe manifestations of human T-lymphotropic virus type III (HTLV-III) infection. 2nd, Centers for Disease Control (CDC) will develop more inclusive definitions and classifications of HTLV-III infection for diagnosis, treatment, and prevention, as well as for epidemiologic studies and special surveys. 3rd, a number of refinements will be adopted in the case definition of AIDS used for national reporting. In the absense of the opportunistic diseases required by the current case definition, disseminated histoplasmosis, isosporiasis, bronchial or pulmonary candidiasis, non-Hodgkin's lymphoma of high-grade pathologic type, and histologically confirmed Kaposi's sarcoma in patients 60 years or over will be considered indicative of AIDS if the patient has a positive serologic or virologic test for HTLV-III. Also, in the absence of the required opportunistic diseases, a histologically confirmed diagnosis of chronic lymphoid insterstitial pneumonitis in a child under 3 years of age will be considered indicative of AIDS unless HTLV-III antibody tests are negative. Patients who have a lymphoreticular malignancy diagnosed more than 3 months after the diagnosis of an opportunistic disease used as a marker for AIDS will no longer be excluded as AIDS cases. Finally, to increase the specificity of the case definition, patients will be excluded as AIDS cases if they have a negative result on testing for serum antibody to HTLV-III, have no other test for HTLV-III with a positive result, and do not have a low number of T-helper lymphocytes or a low T4:T8 ratio.
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PMID:Revision of the case definition of acquired immunodeficiency syndrome for national reporting--United States. 298 77


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