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)

The human herpesvirus-6 (HHV-6) causes exanthema subitum ("e.s."). "E.s." is characterized by fever, exanthem (rash), in many cases gastroenteritis, occasionally cerebral convulsions (but more frequently general cerebral irritability) and enlargement of all lymph nodes; usually there are mild catarrhal respiratory symptoms of the upper airways (ARD). So-called "complications" of an ARD (pneumonia, acute purulent otitis media, acute sinusitis) due to bacterial infections are very unusual as sequelae of a HHV-6 infection. Here we report the case of 2 small children (toddlers) suffering from bronchopneumonia or pneumonia and acute sinusitis maxillaris associated with an acute HHV-6 infection. It seems that HHV-6 (like other respiratory tract viral pathogens) also can lead to secondary bacterial infections of the lower respiratory tract. So far it is not known, why such complications are so rare, although the extreme granulocytopenia accompanying "e.s." suggests a transient disturbance of the antibacterial defence mechanisms.
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PMID:[Complications of acute respiratory tract infection (pneumonia, sinusitis) in young children associated with acute HHV 6 infection]. 132 58

These guidelines deal with the evaluation of anti-infective drugs for the treatment of respiratory tract infections. Five clinical entities are described: streptococcal pharyngitis and tonsillitis, otitis media, sinusitis, bronchitis, and pneumonia. A wide variety of microorganisms are potentially pathogenetic in these diseases; these guidelines focus on the bacterial infections. Inclusion of a patient in a trial of a new drug is based on the clinical entity, with the requirement that a reasonable attempt will be made to establish a specific microbial etiology. Microbiologic evaluation of efficacy requires isolation of the pathogen and testing for in vitro susceptibility. Alternatively, surrogate markers may be used to identify the etiologic agent. The efficacy of new drugs is evaluated with reference to anticipated response rates. Establishment of the microbial etiology of respiratory tract infections is hampered by the presence of "normal flora" of the nose, mouth, and pharynx, which may include asymptomatic carriage of potential pathogens. This issue is addressed for each category of infection described. For example, it is suggested that for initial phase 2 trials of acute otitis media and acute sinusitis tympanocentesis or direct sinus puncture be used to collect exudate for culture. Acute exacerbations of chronic bronchitis also present difficulties in the establishment of microbial etiology. These guidelines suggest that clinical trials employ an active control drug but leave open the possibility of a placebo-controlled trial. For pneumonia, the guidelines suggest the identification and enrollment of patients by the clinical type of pneumonia, e.g., atypical pneumonia or acute bacterial pneumonia, rather than by etiologic organism or according to whether it was community or hospital acquired. For each respiratory infection, the clinical response is judged as cure, failure, or indeterminate. Clinical improvement is not acceptable unless quantitative response measures can be applied.
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PMID:Evaluation of new anti-infective drugs for the treatment of respiratory tract infections. Infectious Diseases Society of America and the Food and Drug Administration. 147 53

Branhamella catarrhalis is an important cause of acute sinusitis and otitis media in children and of acute tracheobronchitis in older persons with underlying chronic lung disease or a suppressed immune system. Clinical presentation of B catarrhalis infection varies from a mild, self-limiting disease to severe pneumonia, but most cases are mild to moderate in severity. Infection occurs sporadically, and endogenous spread from the oropharynx is the likely mechanism. The keys to diagnosis are a high index of clinical suspicion, correct interpretation of Gram's stain of sputum, and subsequent confirmation on culture. Because most strains of B catarrhalis produce beta lactamase, antibiotics that resist beta-lactamase production, eg, amoxicillin-clavulanic acid (Augmentin), erythromycin, ciprofloxacin (Cipro), are recommended. Mild infections can be self-limiting and may not require antibiotic therapy.
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PMID:Branhamella infections. An increasingly common respiratory illness. 249 49

Pneumonia counts as one of the most frequent severe Haemophilus influenzae infections to afflict adults. 60% of patients with pneumonia caused by type b H. influenzae are more than 50 years old, 30% to 40% are alcoholics, and 30% to 40% have chronic pulmonary disease or other concurrent illness. In the majority of cases there is multilobular, maculate, diffuse and usually bilateral involvement of the pulmonary tissue. The mortality rate due to type b H. influenzae pneumonia ranges between 30% and 40%. In patients with non-bacteriaemic pneumonia caused by non-encapsulated strains of H. influenzae it is rare for several lobes to be involved, there is little exudation and the mortality rate is low. H. influenzae is a significant pathogen in acute epiglottitis in adults and it also appears to play an important role in acute exacerbations of chronic obstructive lung disease (COLD) and acute sinusitis. beta-lactamase production mediated by R-factors or plasmids of gram-negative bacteria is responsible for ampicillin resistance. In 1978 the overall rate of resistance of H. influenzae to ampicillin in American hospitals amounted to 18%. H. influenzae are found in the nasopharynx of people exposed to others infected with H. influenzae. The risk of secondary infection in children who come into contact with patients infected with type b H. influenzae amounts to approximately 2.1%. Adults in close contact with children suffering from severe H. influenzae infections must be warned of the possible risks of secondary infection.
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PMID:[Respiratory tract infections caused by Haemophilus influenzae in adults]. 349 6

Microbiological, pharmacokinetic and clinical studies on sulbactam/cefoperazone (SBT/CPZ) were carried out in the field of pediatrics. Antimicrobial activity The MIC80 of SBT/CPZ was 6.25 micrograms/ml for clinically isolated 24 strains of S. aureus (24 beta-lactamase producing strains), 0.39 micrograms/ml for 17 strains of S. pyogenes, 3.13 micrograms/ml for 24 strains of E. coli (22 beta-lactamase producing strains), 3.13 micrograms/ml for 22 strains of K. pneumoniae (22 beta-lactamase producing strains), 1.56 micrograms/ml for 22 strains of P. mirabilis and 0.20 microgram/ml for 15 strains of H. influenzae (13 beta-lactamase producing strains). In comparison with CPZ in respect to the MIC, SBT/CPZ exhibited synergistic effect on 31 strains out of 81 beta-lactamase producing strains (included 6 strains of S. aureus, 9 of E. coli, 5 of K. pneumoniae and 11 of H. influenzae) which was scarcely observed against 43 non-beta-lactamase producing strains. Absorption and excretion Serum levels and urinary excretion of SBT/CPZ were studied in 7 children aged 5 to 12 years. The mean serum concentration of SBT at 15 minutes following a single intravenous injection of 10 mg/kg of SBT/CPZ was 14.2 micrograms/ml and that of CPZ was 30.4 micrograms/ml. The mean urinary recovery rates at 6 hours following the intravenous injection were 57.8% and 18.3%, respectively. The mean serum concentrations of SBT and CPZ after 1-hour infusion of 10 mg/kg of SBT/CPZ were 10.9 micrograms/ml and 17.6 micrograms/ml, respectively. The urinary recovery rates of SBT and CPZ at 7 hours after the infusion were 100.0% and 27.7% on average, respectively. The mean serum levels of SBT and CPZ at 15 minutes after a single intravenous injection of 20 mg/kg of SBT/CPZ were 25.6 micrograms/ml and 66.0 micrograms/ml, respectively and urinary elimination until up to 6 hours were 72.5% on average for SBT and 21.1% for CPZ. Clinical study SBT/CPZ was used for the treatment of a total of 20 pediatric patients aged 1 month to 14 years to evaluate its clinical effectiveness, bacteriological efficacy and adverse effects. The clinical efficacy in 6 patients with acute pneumonia, 3 with staphylococcal scalded skin syndrome, 2 each with acute purulent tonsillitis and acute pyelonephritis, 1 each with acute purulent lymphadenitis, acute sinusitis, acute bronchitis, peritonitis and acute enteritis was judged to be excellent in 15 cases and good in 3 cases with an efficacy ratio of 100%. The clinical efficacy in 6 patients whose infections were caused by beta-lactamase producing strains was judged to be excellent in all the cases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Studies on sulbactam/cefoperazone in the field of pediatrics]. 609 65

Antibiotics account for 15 percent to 20 percent of all new and refill prescriptions issued in ambulatory community practice. Antibiotic-prescribing practices in our emergency room for common outpatient infections-pharyngitis, bronchitis, sinusitis, otitis media, cellulitis, cutaneous abscesses and pneumonia-were evaluated. Antibiotic selection was compared with recommendations representing current standards for care, and the cost of each was approximated. Antibiotic agents were judged to be overused in patients with pharyngitis, bronchitis and cutaneous abscesses. Patients who had acute sinusitis and otitis media often did not receive antibiotics or received an antibiotic not active against Hemophilus influenzae. A simple audit of antimicrobial drug usage for common outpatient infections proved to be a cost-effective way to identify excessive or inappropriate drug use. This approach could be used for evaluating the use of other drugs, and the results of these evaluations could serve to focus continuing educational programs.
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PMID:Patterns of antibiotic use in a busy metropolitan emergency room: analysis of efficacy and cost-appropriateness. 641 May 88

The main pathogens of gram-negative infections are Neisseria gonorrhoeae, Neisseria meningitidis and Moraxella catarrhalis infection. N. Gonorrhoeae infection is one of the STD, but the chemotherapy for this infection is very easy because this pathogen is very susceptible to new quinolones. Meningococcal infection is very rare in Japan. Since 1980, M. catarrhalis is one of the important pathogen of respiratory infections such as acute bronchitis, pneumonia, chronic bronchitis. This pathogen also causes acute sinusitis and otitis. Most pathogenic strains of M. catarrhalis are beta-lactamase producing.
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PMID:[Gram-negative coccus infection]. 812 87

Acute sinusitis is a frequent complication in ventilated intensive care patients and may be a possible source of pneumonia or septicemia. A study of 49 ventilated intensive care neurosurgical patients without previously known disease of the paranasal sinuses or midface fractures was conducted retrospectively from 1989-1990. The kind of intubation used (naso- or orotracheal) was taken into account and the period of ventilation examined in order to determine the genesis of inflammatory changes in the paranasal sinuses (as defined by computed tomography). Intensive care patients suffering from sinusitis showed a characteristic early opacity of the sphenoid sinuses, with lesser involvements in the ethmoid and maxillary sinuses. Only in rare cases and after very long periods of ventilation were the frontal sinuses found to be opaque. Nasotracheal ventilation was observed to produce an earlier attack on the intubated ipsilateral sinuses. These findings indicate that nasotracheal intubation should be avoided if possible or the method of intubation changed as early as feasible. If conservative measures fail sinusitis should best be treated by means of endonasal microsurgical open sinostomy.
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PMID:[The pathogenesis of sinusitis in intensive care patients]. 822 16

Although the pulmonary complications of advanced human immunodeficiency virus (HIV) infection have been well described, there is little information on respiratory manifestations of earlier disease. This report describes the respiratory disorders diagnosed over an 18-month period in a cohort of persons with or at risk for HIV infection with variable immunologic status. Cohort members were followed routinely and evaluated for respiratory disease by standard diagnostic algorithms. The 18-month incidence of each respiratory diagnosis was determined, and for frequent diagnoses, incidence by transmission category, location of residence, smoking status, CD4 count, and performance score at entry were compared. The most frequent respiratory diagnoses in HIV-seropositive cohort members were common to the general population: upper respiratory infection (33.4%), acute bronchitis (16.0%), acute sinusitis (5.3%), and bacterial pneumonia (4.8%). Pneumocystis carinii pneumonia occurred in 3.9%. Ambulatory respiratory illnesses were reported frequently regardless of immunologic status. The rates of P. carinii pneumonia and bacterial pneumonia were significantly greater in cohort members with entry CD4 counts < 250. Bacterial pneumonia occurred more frequently in injecting drug users and in cohort members with entry Karnofsky scores < 90. Disease stage and demographic and exposure factors are important variables affecting the respiratory manifestations of HIV infection.
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PMID:Respiratory illness in persons with human immunodeficiency virus infection. The Pulmonary Complications of HIV Infection Study Group. 825 94

To assess the clinical presentation and outcome of infectious sinusitis in HIV-infected patients, we analyzed in a retrospective study, the records of HIV-infected patients hospitalized from June 1986 to November 1989. Twenty-eight episodes of infectious sinusitis, defined by radiological signs, were recorded in 20 HIV-infected patients. Clinical presentation suggestive of acute sinusitis was inconstant and in 6 episodes a persistent fever was the only symptom. Concomitant pneumonia was detected in 8 episodes. Bacteria were isolated in 8 episodes, and in 4 of them, Haemophilus influenzae was identified. Clinical relapses occurred in 8/20 patients, requiring a surgical drainage in 3 cases. The frequency of relapses and the possibility of chronicity justify a more prolonged and aggressive therapy in infectious sinusitis occurring in HIV-infected patients.
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PMID:[Infectious sinusitis in HIV infection. Clinical and therapeutic data on 20 patients]. 837 79


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