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

Over a period of 11 months, 37 patients infected with the Human Immunodeficiency Virus (HIV) presenting with symptoms of bronchopulmonary disease were investigated. Patients presented with cough, weight loss, fever and dyspnoea. Investigations included fibreoptic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy. In eight patients (22%) Pneumocystis carinii was found. Pulmonary infiltrates were found on chest radiographs of six patients, while in the remaining two patients chest radiographs showed clear lung fields. P. carinii was found in two patients with pulmonary Kaposi's sarcoma. Infection with P. carinii often occurred with other pathogens: Streptococcus pneumoniae was found in four patients, Staphylococcus aureus in two and tuberculosis in two. P. carinii pneumonia does occur in patients with HIV infection in Africa and the diagnosis is relatively simple to make provided that transbronchial biopsy and bronchoalveolar lavage are carried out through a fibreoptic bronchoscope and specimens examined after appropriate staining. However, the prevalence of P. carinii in patients with HIV infection in Africa appears to be lower than that found in patients with HIV infection in Europe and North America.
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PMID:Pneumocystis carinii pneumonia in patients with AIDS in Central Africa. 169 54

Mycoplasma pneumoniae is a common causative agent of community acquired pneumonia. To assess its epidemiological, clinical and evolutive features in our area, we retrospectively analyzed 88 instances which occurred during 10 years. Both sexes were similarly involved, with a higher incidence in younger patients (mean age: 22 years). A clear seasonal predominance was not detected during the study period. In nearly one half of instance there were similar respiratory episodes in the same household. Cough was a constant symptom, followed by fever and headache. The absence of leukocytosis and the presence of cryoagglutinins were suggestive data. Pulmonary infiltration in the chest radiogram was unilateral in most cases, with a segmental distribution and predominating in the lower lobes. Hilar lymph nodes, pleural effusion and cavitation were present in a limited number of instances. All patients were cured without sequelae. The occurrence of particular epidemiological, clinical and laboratory data may be very helpful in suggesting the diagnosis of pneumonia due to Mycoplasma pneumoniae.
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PMID:[Pneumonia caused by Mycoplasma pneumoniae]. 249 Apr 46

Trichosporonosis due to Trichosporon beigelii or T. capitatum is an infrequent but potentially fatal invasive fungal infection in cancer patients. We studied epidemiologic, clinical, pathologic, and microbiologic features of this infection during a 7-year period at the University of Maryland Cancer Center. Fifteen patients with involvement by Trichosporon were identified: 5 were infected, 5 were possibly infected, and 5 were colonized but not infected by Trichosporon. Four of the infected patients had trichosporonemia and/or positive skin biopsy cultures as the first evidence of infection. The fifth infected patient had positive marrow and skin biopsy cultures. Serial surveillance cultures of infected patients showed preceding Trichosporon colonization in only 1 of 5 cases. Pulmonary infiltrates in 3 infected patients correlated at postmortem examination with Trichosporon pneumonia. Renal dysfunction marked by proteinuria, hematuria, red blood cell casts and azotemia correlated with widespread glomerular infiltration with the fungus. The five infected patients died of their infection, whereas the 2 possibly infected patients who died succumbed to their underlying illness. Trichosporonemia may have been averted in possibly infected patients because of a shorter median duration of profound (less than 100/microliter) neutropenia (5 days) when compared to that of infected patients (20 days). No environmental source of Trichosporon was found in environmental surveillance cultures of food, air, or inanimate surfaces. In vitro studies of three pathogenic strains showed resistance to 5-fluorocytosine but susceptibility to amphotericin B, ketoconazole, and miconazole. Norfloxacin augmented the in-vitro antifungal activity of amphotericin B. Trichosporon must be considered an opportunistic pathogen that can cause serious infections among patients with cancer.
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PMID:Trichosporonosis in patients with neoplastic disease. 352 14

The case histories of 72 subsequently treated patients - 44 with acute leukemia, 10 with chronic myeloid leukemia, 16 with severe aplastic anemia and 2 with neuroblastoma - were analyzed after bone marrow transplantation (BMT) with respect to pulmonary diseases. Thirty-eight patients suffered from a total of 51 pulmonary complications, which led to death in 20. Of 13 patients, 3 died of bacterial pneumonia, all of them during granulocytopenia; 2 of 6 patients died of fungal pneumonia and 2 out of 3 of a mixed bacterial-mycotic infection. Adult respiratory distress syndrome (ARDS) led to death in 2 patients. A granulocyte count under 500/microliter correlated significantly (P less than 0.002) with the fatal outcome of bacterial, fungal and ARDS pneumonia as well as with bronchitis. Viral pneumonia led to death in 8 of 9 patients; in each there was a significant correlation (P less than 0.05) with graft-versus-host disease (GvHD). Patients with repeated episodes of pulmonary illness had significantly more chronic GvHD (P less than 0.05); several of these patients displayed a reduction in helper T cells and an increase in suppressor T cells in the peripheral blood. The natural killer (NK) cells were reduced and the percentage of activated NK cell level lay between 6% and 69%. B-cells were absent or deficient. These findings explain in part the absence of specific antibody reactivity. Five of these patients also contracted GvHD-associated obstructive bronchiolitis, which did not respond to therapy. Pulmonary infiltrates of unknown origin (including idiopathic interstitial pneumonia) occurred in 8 of the patients (11.1%), with a fatal outcome in 3 patients. Significant changes (P less than 0.05) in lung function after BMT appeared in the form of reduced vital capacity (VC) increased residual volume (RV) and an increase in RV expressed as the percentage of total lung capacity. Pulmonary diseases were the most common complication and cause of death in our patients after BMT.
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PMID:Lung diseases after bone marrow transplantation. Results of a clinical, radiological, histological, immunological and lung function study. 352 53

The transmission rate and the clinical and pulmonary manifestations of serologically proven mycoplasma infections were reviewed in 34 patients from 11 families consisting of 30 children and adolescents aged 1 to 18 years, and four parents aged 30 to 41 years (total number of family members = 59:37 children, 22 adults). Twenty-seven of the 37 children had pulmonary involvement (73%). The total infection rate was 58%, and the infection rate in children 81%. The roentgenologic findings in children with pneumonia showed no pathognomonic features. The most common X-ray finding was bronchopneumonia (48%). Pulmonary infiltrates occurred in six children (20%) under four years of age. Three of the children (10%) had severe clinical and/or radiological manifestations. These findings depict a pattern of mycoplasma infection that is different from previous reports, i.e. high pulmonary infection rates in families, the occurrence of pneumonic infiltrations in young children and a quite severe clinical and radiological course in some of the patients.
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PMID:Pulmonary involvement in Mycoplasma pneumoniae infection in families. 395 33

From October 1983 to February 1984, five episodes of nosocomial pneumonia caused by Legionella bozemanii occurred in immunosuppressed patients at a 300-bed community hospital. Pulmonary infiltrates were predominantly patchy and present in multiple lobes and bilaterally; cavitation occurred in one patient. Patients responded promptly and completely to treatment with erythromycin and rifampin. Epidemiologic studies showed that all patients had been continuously or recently hospitalized at the same institution. Legionella bozemanii was cultured from four of the five infected patients, from tapwater in patient care areas, from the hospital's hotwater holding tank, and from soil in an area of excavation and new construction on hospital property. Chlorination and heat sterilization of the tank eliminated L. bozemanii from the water and no further cases were seen. This outbreak reaffirms that excavation and construction are risk factors for the outbreak of nosocomial legionella pneumonia and is the first description of nosocomial infection due to L. bozemanii.
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PMID:Waterborne Legionella bozemanii and nosocomial pneumonia in immunosuppressed patients. 401 2

Pulmonary involvement occurs in approximatively half of patients with allergic granulomatosis and angiitis (AGA). We studied bronchoalveolar cells from six patients with histologically proven AGA and compared our results with those obtained from four patients with chronic eosinophilic pneumonia (CEP), nine nonsmoking patients with bronchial asthma and blood eosinophilia, and 10 healthy nonsmokers. Pulmonary infiltrates were present in 5 out of 6 AGA patients. None of these patients was receiving corticosteroids at the time of entry to the study. Pulmonary function tests were normal in two cases, and demonstrated on obstructive ventilatory disorder with hypoxaemia in four cases. Total cell yield did not differ between AGA patients (22.4 +/- 4.9 x 10(4) cells.ml-1), asthmatics (9.6 +/- 1.7 x 10(4) cells.ml-1) and controls (11.3 +/- 1.5 x 10(4) cells.ml-1), whereas it was dramatically increased in patients with CEP (186.4 +/- 26.3 x 10(4) cells.ml-1). All six AGA patients demonstrated an increased percentage of alveolar eosinophils (mean: 31.1 +/- 9.9%; range 6-66%). In two patients evaluation of alveolar eosinophil subpopulations showed a low percentage (27 and 36%) of hypodense cells, when compared to the high levels (> 80%) found in CEP. No significant correlation could be established between bronchoalveolar (BAL) results and clinical data, pulmonary function abnormalities, or biological results. Sequential evaluation of alveolitis in two AGA patients undergoing corticosteroid therapy demonstrated persistent alveolar eosinophilia, despite disappearance of clinical, radiological and biological abnormalities. Our data demonstrate that eosinophils are present in the alveolar spaces of patients with AGA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bronchoalveolar lavage in allergic granulomatosis and angiitis. 847 32

Pulmonary infiltrates on chest radiographs are common findings in the pediatric age group and are generally associated with acute infectious pneumonias. Occasionally, however, these "pneumonias" fail to respond to appropriate antibiotic therapy. Under these circumstances, noninfectious conditions that may be associated with pulmonary infiltrates should be considered. Thus, it is important that physicians who care for children have some knowledge of these potential "mimickers" of childhood pneumonia.
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PMID:Foolers: things that look like pneumonia in children. 888 78

Although many human immunodeficiency virus-infected individuals develop lymphocytic interstitial pneumonia, the roles of host and viral factors in the pathogenesis of pneumonia are not well defined. Human immunodeficiency virus-infected children with lymphocytic interstitial pneumonia have human immunodeficiency virus-specific cytotoxic T cells in pulmonary infiltrates, increased survival time, and a reduced incidence of opportunistic infections, suggesting that lymphocytic interstitial pneumonia may reflect an effective antiviral immune response. In this study, 20 macaques were inoculated with related macrophage-tropic simian immunodeficiency viruses and examined for pulmonary lesions and virus gene expression. Ten macaques developed moderate to severe pneumonia characterized by perivascular, peribronchial, and interstitial infiltrates of lymphocytes and macrophages. Large numbers of pulmonary cytotoxic lymphocytes were demonstrated in macaques with moderate to severe pneumonia (P < 0.05) by immunostaining for TIA-1. There was no difference in viral load between macaques with moderate to severe pneumonia and those with mild to no pulmonary lesions. In five macaques inoculated with the same virus swarm, there was a significant (P < 0.05) inverse correlation between the percentage decline in CD4+ T-cell counts and the severity of pulmonary lesions. Pulmonary infiltrates of cytotoxic lymphocytes, the lack of correlation between severity of pulmonary lesions and virus gene expression, and the inverse relationship between pneumonia and inmune status suggest that simian immunodeficiency virus pneumonia may represent an immunopathological response to macrophage-tropic virus.
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PMID:Pathogenesis of simian immunodeficiency virus pneumonia: an immunopathological response to virus. 977 43

A 66-year old man was admitted to our hospital because of vomiting, diarrhea and progressive dyspnea. Acute respiratory distress syndrome (ARDS) due to bilateral pneumonia was diagnosed and he was also in septic shock. The patient had a history of partial hepatectomy for hepatoma, and suffered from liver cirrhosis. Emergency bronchoalveolar lavage (BAL) revealed abundant gram-positive cocci and polymorphonuclear leukocytes in the collected sample. Blood culture revealed corynebacterium. Treatment consisted of mechanical ventilation and administration of fluids, effective antibiotics, and high-dose methylprednisolone (MPS). MPS was administered from the onset of ARDS with a starting dose of 1,000 mg, which was gradually reduced to 60 mg over 8 days. Pulmonary infiltrates shown on the chest X-ray film were alleviated, and arterial blood gas data rapidly improved. The patient was successfully extubated on the 10th hospital day, and discharged on the 30th hospital day. Serial BAL and plasma levels of inflammatory cytokines decreased rapidly in parallel with the improvement of the patient's clinical condition. This is a case report of severe bacterial pneumonia that was successfully treated with effective antibiotics and high-dose MPS for several days from the onset of ARDS.
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PMID:[Successfully treated acute respiratory distress syndrome with serial plasma and bronchoalveolar measurement of inflammatory cytokines]. 984 90


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