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

Eight documented cases of pulmonary zygomycosis were analyzed retrospectively with regard to radiographic and clinical features. Predisposing factors were diabetes mellitus in six cases, lymphoblastic lymphoma in one case, and surgery to correct a tracheoesophageal fistula in one case. Two of the patients with diabetes had also undergone renal transplantation for diabetic nephropathy and were immunosuppressed. The more usual radiographic findings of pulmonary zygomycosis represent a spectrum that comprises a normal chest radiograph, a lung abscess, subacute or chronic pneumonia that often evolves into a lung abscess, and rapidly progressive fatal pneumonia. Awareness of the various presentations of pulmonary zygomycosis is important because early diagnosis and appropriate therapy clearly have been shown to improve the survival rate of these patients. Zygomycosis should be included in the differential diagnosis when patients with diabetes mellitus, patients with leukemia or lymphoma, or immunocompromised patients present with or develop perplexing pulmonary abnormalities.
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PMID:Pulmonary zygomycosis: a radiographic and clinical spectrum. 140 48

The following unusual diseases were diagnosed in birds submitted to the Veterinary Research Institute, Victoria, between 1978 and 1987: the viral diseases beak and feather disease of psittacines, infectious laryngotracheitis in peafowls, a papovavirus-like inclusion body disease in psittacines, and pox; chlamydiosis; the bacterial diseases actinomycosis, listeriosis and mycobacteriosis; the fungal diseases favus, yeast infections and systemic zygomycosis; the protozoan diseases cryptosporidiosis, hexamitiasis, suspected leucocytozoonosis, sarcosporidiosis, toxoplasmosis, trichomoniasis and an unidentified protozoan-like organism which caused pneumonia in ducks; a variety of parasites; the metabolic disorders curled-toe paralysis in pheasant poults, encephalomalacia and parenchymatous goitre; toxicity due to dimetridazole and the ingestion of the leaves of the tobacco tree; and other non-infectious conditions including asphyxiation, burns, cataracts, cerebellar degeneration and atrophy, cystic right oviducts and exertional rhabdomyolysis.
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PMID:Some unusual diseases in the birds of Victoria, Australia. 156 52

Cunninghamella bertholletiae is a fungus of the Zygomycetes class, Mucorales order. Only very few cases of disseminated infection have been reported. We observed a new case in a 19 years old man with severe aplastic anemia, due to pulmonary primoinfection and hematologic dissemination. This aplastic anemia failed to respond first to an antithymocyte globulin and steroid treatment and then to cyclosporine A. Deferoxamine was infused weekly to prevent iron overload. During a second antithymocyte globulin and steroid treatment, the patient developed bilateral pneumonia. Culture of the broncho-alveolar washing fluid established the diagnosis by isolation of C. bertholletiae. Despite amphotericin B and 5-fluorocytosine intravenous therapy, the patient died of disseminated infection six days after diagnosis, which was confirmed by necropsy. Underlying conditions, diagnosis and treatment are discussed, together with a review of the literature.
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PMID:Cunninghamella bertholletiae: an uncommon agent of opportunistic fungal infection. Case report and review. 178 Feb 37

We describe the clinical course of a patient with invasive polymycotic pneumonia due to Rhizopus arrhizus and Candida albicans. Both organisms were recovered from antemortem sputum cultures, and their clinical significance was confirmed by histologic examination of the lungs at autopsy. Circumstances leading to polymycotic infection are discussed, with special attention given to polymycotic infections involving Zygomycetes.
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PMID:Invasive polymycotic pneumonia in an uncontrolled diabetic. 202 22

Systemic fungal infections were identified in 13 of 1468 necropsies of infants dying in the 1st year of life in a south Indian hospital. Candidiasis was present in 11 infants, most often as pneumonia or enteritis. Spread to other organs occurred in four cases. Intestinal candidiasis was associated with zygomycosis of the intestine in one infant and with aspergillosis of the lungs and intestine in another. One case of aspergillosis of the myocardium and one of gastric zygomycosis were also diagnosed. Septicaemia, broad spectrum antibiotic therapy, surgery and congenital abnormalities, including immune deficiencies, were important predisposing factors.
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PMID:Systemic fungal infections in south Indian infants. 244 51

Therapies differ for invasive infection due to the various filamentous fungi. However, histopathologic identification of Aspergillus, Pseudallescheria, Fusarium, Trichosporon, dematiacious Hyphomycetes, Candida, and Zygomycetes may be confused, and microbiologic isolation is often delayed. To improve diagnosis, we examined the utility of polyclonal and monoclonal antibodies to identify Aspergillus organisms by peroxidase immunohistochemical techniques. Tissues obtained from 68 infected patients were examined. Fungal antigen was detected in all 26 cases of aspergillosis by the monoclonal immunohistochemical test. Hyphae of Aspergillus organisms exhibited strong intracellular and cell wall staining, and extracellular localization was also observed. In contrast, negative tests were observed in tissues from five cases of infection with Pseudallescheria boydii, three with Trichosporon, three with Zygomycetes, six with Candida species, and one with Curvularia, from as well as 20 cases of nonfungal pneumonia. However, cross-reactivity to Coccidioides immitis spherules was noted in three cases. Staining of Candida was observed with the polyclonal antibody but not the monoclonal reagent. This is the first immunohistochemical demonstration of aspergillus antigen with a monoclonal reagent. The study indicates that the monoclonal immunohistochemical technique can distinguish Aspergillus species from other filamentous fungi and may facilitate the clinical diagnosis of invasive aspergillosis.
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PMID:Invasive aspergillosis diagnosed by immunohistochemistry with monoclonal and polyclonal reagents. 330 79

Fungi of the genera Aspergillus, Candida, and Cryptococcus and the class Zygomycetes are the most common causes of thoracic opportunistic mycoses in immunocompromised patients. Candidiasis and zygomycosis usually manifest as severe, often life-threatening, pneumonias. Aspergillus species are commonly implicated as the causative organisms in a broad spectrum of pulmonary disorders, ranging from hypersensitivity lung disease in atopic patients to invasive pneumonia in immunocompromised patients. Cryptococcus neoformans infects both immunologically normal and abnormal patients, with variable clinical and radiologic findings. The diagnosis of an opportunistic mycosis requires familiarity with the epidemiology of the disease, the various modes of clinical presentation, and the full spectrum of radiologic manifestations. Because many of these fungi may normally colonize in the upper respiratory tract, sputum cultures are considered diagnostically unreliable. Instead, definitive diagnosis hinges on either culture of the fungus from infected tissue or demonstration of the organism at microscopic examination.
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PMID:Thoracic mycoses from opportunistic fungi: radiologic-pathologic correlation. 776 33

This report describes eight cases of proventriculitis and ventriculitis in ostrich chicks less than 2 months old. Clinical signs included acute onset of lethargy and anorexia in three cases, and chronic weight loss with lethargy and anorexia in four cases; no history was available in one case. There was limited antibiotic therapy in two cases; a third case was treated for giardiasis. Concurrent bacterial, yeast, and viral infections were common. Lymphoid depletion and/or necrosis of bursa, thymus, and spleen suggested severe immune challenge or immunosuppression in many cases. Histologically, there was severe ulcerative proventriculitis and ventriculitis with intralesional fungal hyphae. In two chicks with granulomatous pneumonia, similar fungal hyphae were also observed in the lung. Fungal hyphae were rarely septate, with irregular, non-parallel walls, and ranged in diameter from 7 to 20 microns. Occasional globoid distentions of the hyphae were present. Fungi were identified morphologically as species in the Zygomycetes class; in one case a Mucor sp. was cultured. Zygomycetes appear to be potentially serious opportunistic pathogens of ostrich chicks.
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PMID:Proventriculitis and ventriculitis associated with zygomycosis in ostrich chicks. 783 20

Limited information is available regarding the pathogenesis and clinical manifestations of infection with Cunninghamella bertholletiae. In this report, we describe the clinical courses of three patients with leukemia and fatal C. bertholletiae infection and review the literature. In all patients, the infection developed in the setting of severe neutropenia following high doses of cytotoxic chemotherapy. Clinical presentation always consisted of fever and pneumonia and could be associated with dissemination to numerous organs. The course of infection was very rapid, and the diagnosis was made around or after the time of death. The most important risk factors for C. bertholletiae infection described in the literature include corticosteroid administration and prolonged severe granulocytopenia. Four infectious syndromes due to Zygomycetes have been described: rhinocerebral, pulmonary, cutaneous and soft tissue, and disseminated. The outcome of disseminated infection with C. bertholletiae has been almost uniformly fatal. Most previously described patients, however, did not receive aggressive treatment consisting of amphotericin B administration, resection of infected tissues, and, most importantly, control of the underlying disease.
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PMID:Infections due to Cunninghamella bertholletiae in patients with cancer: report of three cases and review. 808 54

Cryptococcosis is an epidemiological and immunological indicator due to the absence of Cryptococcus neoformans as a saprophyte in immunocompetent humans and the advantage of specific C. neoformans culture. On this basis, a report is presented on the CD4 lymphocyte count of 36 AIDS patients suffering from cryptococcosis and other concomitant or missing opportunistic AIDS-defining infections. In 26 out of 36 patients, i.e. 72%, a CD4 lymphocyte count of < or = 50/microL (mean value 39.5%) was found. Cryptococcosis as the sole opportunistic infection was diagnosed in 5 cases (13.9%). In 31 cases, various combinations of AIDS-associated diseases were found: Pneumocystis carinii pneumonia (PCP) (n = 19), cytomegalovirus infection (CMV) (n = 10), Kaposi's sarcoma (n = 6), Mycobacterium avium intracellulare infection (MAI) (n = 5), pneumonia (n = 2), toxoplasmosis (n = 2), Candida esophagitis (n = 1), tuberculosis (n = 1), lambliasis (n = 1), salmonellosis (n = 1) and wasting syndrome (n = 5). The conspicuous simultaneous occurrence or succession of pneumocystosis and cryptococcosis and the contrasting absence of aspergillosis and mucormycosis (zygomycosis) are commented. Based on the present observations in HIV-infected persons in Berlin, a CD4 lymphocyte count of < 150/microL may be used as a parameter indicating a predisposition for cryptococcosis as an airborne AIDS-defining infection. Attention is drawn to bird droppings as the sole habitat of C. neoformans and accidental niche of various other microorganisms.
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PMID:Cryptococcosis in HIV infection of man: an epidemiological and immunological indicator? 883 78


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