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

Two children were hospitalized for severe chickenpox after intranasal use of corticosteroids for chronic sinusitis. One had unusually extensive cutaneous disease with delayed progression of lesions, dehydration, and prolonged fever; the other had hemorrhagic cutaneous lesions, hepatitis, and pneumonitis. Both were treated with intravenous acyclovir infusion and recovered. Systemic or local immunosuppression after intranasal corticosteroid administration may have predisposed the children to severe varicella infection.
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PMID:Severe chickenpox after intranasal use of corticosteroids. 804 Jul 89

A case of acute pneumonia due to Pasteurella multocida ssp multocida occurred in a young man with AIDS and chronic sinusitis. The pneumonia was diagnosed by bronchoscopy and responded to treatment with aztreonam. Epidemiologic investigation revealed the case was temporally related to nontraumatic exposure to cat secretions that the patient presumably had acquired via an aerosol. The cat's oral cavity was cultured and an isolate of P multocida ssp multocida with identical biochemical reactions, DNA restriction patterns, and nearly identical fatty acid profile to that of the patient's isolate was obtained suggesting they were identical strains and therefore epidemiologically linked. A control strain with identical biochemical reactions and antibiotic sensitivities exhibited different patterns. To our knowledge, this is the first such reported infection in a patient infected with human immunodeficiency virus.
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PMID:Pasteurella multocida pneumonia in a man with AIDS and nontraumatic feline exposure. 841 40

Management of the patient with otitis media, sinusitis or pharyngotonsillitis is based on information about the host, the organism and the antimicrobial agent. Otitis media (OM) is a common infection in children but selected children have recurrent and chronic OM. The predominant organisms responsible for OM are Streptococcus pneumonia, Haemophilus influenzae and Moraxella catarrhalis. Changes in the antimicrobial susceptibility govern the choice of antimicrobial agents. Surgical treatment should be considered if the child has persistent hearing loss in both ears. Sinusitis shares with OM similar pathogenesis, microbiology and choices of antimicrobial therapy. Endoscopic surgery is the treatment of choice for chronic sinusitis. Pharyngitis may be either viral or bacterial in origin. Penicillin remains the treatment of choice for bacterial pharyngotonsillitis. In patients with recurrent infection, the emergence of B-lactamase producing strains has to be considered and erythromycin or oral cephalosporins might be indicated.
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PMID:Upper respiratory tract infections - otitis media, sinusitis and pharyngitis. 891 62

In attempt to identify major clinical features of paranasal sinusitis following allogeneic BMT, we reviewed 44 consecutive cases diagnosed at the Hammersmith Hospital between August 1993 and December 1995. All patients had symptoms and signs characteristic of sinusitis. Plain radiographs and/or CT scans revealed fluid levels in 86.4% of patients, opacification in 9.1%, and marked mucosal thickening in 4.5%. Two-thirds of patients were diagnosed within 120 days of BMT. The WBC was less than 1 x 10(9)/1 in 16.3% of patients, the neutrophil count was less than 0.5 x 10(9)/1 in 18.6%, and serum immunoglobulins were depressed (< 6.7 g/l) in 40.6%. Grade III-IV acute GVHD was present in 25.6% of patients and grade I-II in 66.7%; 68.6% developed chronic GVHD. There were 70.5% of patients receiving corticosteroids. Specific pathogens could not be identified in most cases. Pneumonia was present in 10 patients, seven of whom had Aspergillus species identified by bronchoalveolar lavage. Parainfluenza virus was isolated in three patients and Pseudomonas aeruginosa in two. Although all patients received antimicrobial therapy, 70.5% developed chronic sinusitis. Fatal complications did not occur. In 94 consecutive patients receiving allografts for CML during the period of study, WBC and neutrophil counts were lower 3 months post-BMT in patients who developed sinusitis (P < 0.02). Patients receiving higher doses of total body irradiation (13.2 and 14.4 Gy) had a greater probability of developing sinusitis (P = 0.023). Sinusitis occurred in only one of 37 patients receiving autologous transplants in the same period. Sinusitis is common following allogeneic BMT. Leukopenia is often present, but microbiological diagnosis is difficult, and progression to chronic sinusitis common.
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PMID:Paranasal sinusitis following allogeneic bone marrow transplant. 901 32

To determine the association between trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis for Pneumocystis carinii pneumonia and risk of bacterial infections in persons with AIDS, we abstracted hospital records from 6496 adult admissions to 42 hospitals in western Washington state. Of these admissions, 570 involved 637 bacterial infections diagnosed among patients who had been prescribed prophylactic TMP-SMX or aerosolized pentamidine. Cases [admissions with bacteraemia, bacterial pneumonia, acute or chronic sinusitis, or urinary tract infection (UTI)] were compared to controls (admissions not associated with any of the 5 bacterial infections). After adjusting for CD4 lymphocyte count and presence of P. carinii pneumonia, TMP-SMX prophylaxis, relative to aerosolized pentamidine prophylaxis, was associated with a reduced risk of bacteraemia (adjusted OR = 0.5; 95% CI, 0.2-1.0; P = 0.04), bacterial pneumonia (adjusted OR = 0.5; 95% CI, 0.3-0.8; P = 0.01), acute sinusitis (adjusted OR = 0.5; 95% CI, 0.2-1.3; P = 0.2), chronic sinusitis (adjusted OR = 0.3; 95% CI, 0.1-0.7; P = 0.01), and UTI (adjusted OR = 0.5; 95% CI, 0.2-1.2; P = 0.1), and all 5 bacterial infections combined (adjusted OR = 0.6; 95% CI, 0.5-0.8; P < 0.001).
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PMID:Bacterial infections in adult patients hospitalized with AIDS: case-control study of prophylactic efficacy of trimethoprim-sulfamethoxazole versus aerosolized pentamidine. 929 45

EMPIRICAL STRATEGY: Antibiotic therapy of upper and lower respiratory tract infections is based on an empirical strategy. However, arguments favoring the probability of a given bacteria may be lacking and, since resistance of Streptococcus pneumoniae and Haemophilus influenzae against conventional antibiotics is becoming increasingly frequent, therapeutic strategies must be revisited. SINUSITIS: H. influenzae and S. pneumoniae are the most frequent causal agents in acute maxillary sinusitis. For chronic sinusitis, beta-lactamase producing anaerobic bacteria, S. aureus and peni-resistant pneumococci and H. influenzae must also be considered. ACUTE EXACERBATIONS OF CHRONIC BRONCHITIS: The main causal agents are H. influenzae and S. pneumoniae, followed by M. catarrhalis, S. aureus, enterobacteriaceae, and beta-hemolytic streptococci. COMMUNITY ACQUIRED PNEUMONIA: There are a wide range of pathogens, half of which are identified in different studies. RESISTANCES: For pneumococci, penicillin resistance is currently evidenced in 48% of the strains. For H. influenzae, 30% of the strains are ampicillin resistant.
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PMID:[Epidemiology of bacterial ENT and bronchopulmonary infection in 1998]. 1050 75

Although most cases of rhinosinusitis are benign, the disruption of quality of life due to disease symptoms leads patients to seek early medical care. Ongoing debates dispute the definition, bacteriology, and medical management of chronic sinusitis, while the criteria for acute sinusitis are relatively well established. Chronic rhinosinusitis remains poorly categorized, and authors differ in opinions of symptoms, time course, and bacteriology of the infections, as well as proper medical management. Recent studies from the Mayo Clinic even question the idea that chronic sinusitis is a bacterial disease and document the presence of fungal pathogens that are responsible for the inflammatory reaction and mucosal response. In general, medical management is based on physiologic principles of re-establishing natural mucociliary function and restoring proper aeration of the paranasal sinuses after an inflammatory insult. Injudicious use and indiscriminate overprescription of antibiotics has fostered the rapid development of penicillin-resistant organisms over the past two decades. Drug-resistant Streptococcus pneumonia and b-lactamase-producing Haemophilus influenzae and Moraxella catarrhalis are becoming the norm, forcing the need to consider alternatives in antibacterial management. Appropriate medical management of this common problem requires a systematic approach and consideration of adjunctive therapy. This article examines the current bacteriology of these common infections and reviews the management of acute and chronic infections.
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PMID:The Microbiology and Management of Acute and Chronic Rhinosinusitis. 1138 50

A woman with a long history of chronic bronchitis and chronic sinusitis, i.e., sinobronchial syndrome, was admitted with a fever. Radiologically, there were areas of longstanding consolidation in both lungs, with areas of active inflammation demonstrated by gallium-67 scintigraphy. Antineutrophil cytoplasmic antibody specific for myeloperoxidase was highly positive. Pulmonary hemorrhage and hematuria occurred 2 weeks after admission and responded to steroid therapy. However, the patient died of pneumonia. An autopsy revealed systemic necrotizing vasculitis affecting multiple organs, consistent with microscopic polyangiitis. The vasculitis might have been caused by the chronic inflammation in the lungs associated with sinobronchial syndrome.
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PMID:Microscopic polyangiitis associated with sinobronchial syndrome. 1144 66

The authors present a case of a soldier with Kartagener syndrome and bilateral purulent maxillary sinusitis with nasal polyps and pneumonia. Kartagener syndrome is originally described as the combination of situs inversus, bronchiectasis and sinusitis. Kartagener syndrome is a part of immotile cilia syndrome. Mild before the age of 18 recurrent pneumonia, chronic sinusitis, chronic rhinitis and nasal polyps occurred. Typical therapeutic management is discussed but infections prophylaxis, general treatment and physiotherapy are the base of good general condition and significantly improve prognosis.
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PMID:[A case of Kartagener's syndrome]. 1257 93

(1) The risk-benefit ratio of antibiotic therapy in exacerbations of chronic bronchitis is uncertain. If an antibiotic is considered, fluoroquinolones are at best second-line options, after betalactam agents such as amoxicillin, and macrolides. (2) For community-acquired pneumonia the first-line antibiotics are betalactam agents such as amoxicillin, and macrolides. Patients with severe disease should receive combination therapy with a betalactam and a macrolide or a fluoroquinolone. (3) Acute sinusitis generally resolves spontaneously. If an antibiotic is prescribed, fluoroquinolones are at best second-line options, after betalactam agents such as amoxicillin, and macrolides. The value of systemic antibiotic therapy is also controversial in chronic sinusitis and chronic otitis media; once again, fluoroquinolones are not agents of first choice. (4) Fluoroquinolones share many adverse effects, especially neuropsychiatric, cutaneous, tendon, and cardiac involvement. They can also damage cartilage in children. They are contraindicated in pregnant women. They potentiate oral anticoagulants.
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PMID:Fluoroquinolones in ambulatory ENT and respiratory tract infections: rarely appropriate. 1260 5


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