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

Branhamella catarrhalis has been recovered from various sites of infection in the respiratory tract. These include chronic otitis media, tonsillitis, adenoiditis and pneumonia. This organism was recovered in many of these infections mixed with other aerobic, facultative anaerobic and anaerobic bacteria. Increasing numbers of isolates of this organism have been noted to produce beta-lactamase. This may contribute to the high failure rate of penicillins in eradicating polymicrobial respiratory infections.
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PMID:Direct and indirect pathogenicity of Branhamella catarrhalis. 348 2

From 1974 to 1990, 336 Bacteroides isolates were obtained from 312 specimens from 274 patients. They comprised 180 (54%) B. fragilis isolates, 55 (16%) B. theta-iotaomicron, 36 (11%) B. vulgatus, 34 (10%) B. distasonis, 21 (6%) B. ovatus and 10 (3%) B. uniformis. Infections in 253 (92%) patients were polymicrobial, but in 21 (8%) children, a Bacteroides sp. was isolated in pure culture. Most Bacteroides isolates were from peritoneal fluid (114), abscesses (110), wound infections (20), blood cultures (10) and from patients with pneumonia (14) or chronic otitis media (8). Predisposing conditions were present in 145 (53%) children; these were previous surgery (46), trauma (28), malignancy (21), prematurity (19), immunodeficiency (18), steroid therapy (12) foreign body (10), diabetes (9) and sickle cell disease (7). The micro-organisms isolated most commonly mixed with Bacteroides spp. were anaerobic cocci (221), Escherichia coli (122), Fusobacterium spp. (38) and Clostridium spp. (30). All patients received antimicrobial therapy in conjunction with surgical drainage or correction of pathology in 197 (72%) cases. All but 12 (5%) patients recovered. These data illustrate the importance of Bacteroides spp. in infections in children.
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PMID:Bacteroides infections in children. 762 59

A retrospective study was conducted to examine the laboratory, clinical features and outcome of 206 adult acute bacterial meningitis patients (218 episodes) during the years 1985-1996. Pneumonia (8.7 per cent), head trauma (7.8 per cent) and chronic otitis media (6.0 per cent) were identified as the main predisposing factors for acute bacterial meningitis. Aetiology was described only in 61 episodes (28.0 per cent). Streptococcus pneumonia was the most commonly identified pathogen overall, causing 33 of the 218 episodes (15.2 per cent). Antibiotic treatment before admission was given to 48.4 per cent of patients. On admission, the following symptoms of meningitis were predominant: 83 per cent had neck stiffness, 81 per cent had a headache and 73 per cent had fever. Case fatality rate was 27.1 per cent (59 patients). The important factors in mortality were as follows: old age, a long duration of symptoms before admission, a lack of neck stiffness, obtunded mental state on admission, low glucose levels in first CSF, low CSF/blood glucose ratio, and abnormality in computerised tomography scanning.
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PMID:Acute bacterial meningitis in adults: analysis of 218 episodes. 939 72

Quinolones, because of their excellent pharmacokinetic properties, high antimicrobial activity and low incidence of side-effects, have been broadly accepted for the treatment of many infections. Because of perceived limitations against Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus there has been some reluctance to use them for respiratory tract infections. Ciprofloxacin is the drug of choice for malignant external otitis, a disease caused by Pseudomonas aeruginosa, and it has also been used successfully for the treatment of chronic otitis media where P. aeruginosa, S. aureus and Proteus mirabilis are main pathogens. Quinolones are as efficacious as the beta-lactams and cephalosporins in the treatment of acute sinusitis but most clinicians will not use quinolones for this indication. Acute bacterial exacerbations of chronic bronchitis respond to antimicrobial therapy and quinolones have been demonstrated to be at least equivalent to second- and third-generation cephalosporins, co-amoxiclav and beta-lactams. Recently published guidelines in Canada, USA and Great Britain do not recommend quinolones for the treatment of community-acquired pneumonia except for patients with life-threatening disease requiring ICU admission. A quinolone in combination with an aminoglycoside and macrolide is a regimen that can be used as initial empirical therapy until the results of microbiological investigations are available. For patients with severe hospital-acquired pneumonia, where multiply resistant aerobic Gram-negative bacilli are a consideration, a quinolone in combination with an antipseudomonal penicillin or cephalosporin has been recommended. In the absence of P. aeruginosa, monotherapy with a quinolone is at least as effective as third-generation cephalosporins or imipenem. Early switch therapy from parenteral antibiotics to oral fluoroquinolone has been demonstrated to be very successful.
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PMID:The role of fluoroquinolones in respiratory tract infections. 948 74

Meningiomas arising in or presenting as middle ear lesions are relatively uncommon. This study retrospectively reviews the clinicopathologic features of six meningiomas arising in or extending into the middle ear. The patients comprise five women and one man ranging in age from 45 to 67 years (median, 55 years) at the time of surgery. Five tumors arose in the posterior fossa or temporal bone region and one tumor arose from the auditory canal itself. Three tumors arose on the right side and three on the left. Duration of symptoms before surgery involving the middle ear was known in five patients and ranged from 2 to 13 years (median, 10 years). Symptoms at presentation included gait or balance problems (n = 3), chronic otitis media (n = 2), diplopia (n = 2), hearing loss (n = 2), pain (n = 1), aural polyp (n = 1), and tinnitus (n = 1). Histologically, all six tumors resembled a syncytial (meningotheliomatous) meningioma. Psamomma bodies were noted in two tumors and two tumors demonstrated mild nuclear pleomorphism. None of the tumors demonstrated histologic features of atypical meningioma. Follow-up information was available in five patients. Four patients had prior surgery for removal of posterior fossa temporal bone meningiomas and developed recurrences involving the auditory canal 60 to 84 months after surgery. At the time of most recent follow-up examination, three patients were alive with evidence of tumor (65, 112, and 214 months), one patient was alive with no evidence of tumor (99 months), one patient died in the postoperative period of sepsis and pneumonia following resection of a middle ear recurrence (64 months), and one patient was lost to follow-up analysis. Meningiomas arising in or extending to the middle ear canal are unusual. They more commonly arise in woman and in most cases involve extension of intracranial/cranial tumors into the canal.
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PMID:Middle ear meningiomas. 1091 84

(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

In order to determine the clinical and laboratory features of X-linked agammaglobulinemia, the records of 33 male patients with XLA were reviewed during 22 years (1980-2002) in the Iranian referral center of primary immunodeficiency disorders. The patients' ages ranged from 20 to 360 months (median 113 months). The median age at the onset of the disease was 8 months and the median age of diagnosis was 48 months, with a median diagnosis delay of 33 months. Almost all of the patients presented common infectious diseases, which were: pneumonia, otitis, diarrhea, sinusitis, and arthritis. During the course of illness, infections in the respiratory tract, gastrointestinal tract, central nervous system, and musculoskeletal system were seen in 93.9%, 75.8%, 33.3%, and 21.2% of XLA patients, respectively. The most common complications of these patients were chronic infections in 75.8% of them, including: chronic otitis media, chronic sinusitis, chronic diarrhea, and bronchiectasis.
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PMID:X-linked agammaglobulinemia: a survey of 33 Iranian patients. 1501 35

Mycoplasma pneumoniae and Chlamydia pneumonie are important etiological agents responsible for human respiratory tract diseases. Recently, these atypical microorganisms received much attention regarding their role in bronchial asthma pathogenesis, which is one of the most frequent chronic diseases in children. The aim of the study was to investigate the association between infections caused by these pathogens and respiratory tract diseases in children. Levels of M. pneumoniae and C. pneumoniae-specific antibodies were determined in serum samples obtained from 30 patients suffering from bronchial asthma exacerbations, 10 patients with pneumonia, 28 patients with chronic otitis media with effusion (COME) and 22 sinusitis patients. Specific anti-M. pneumoniae antibodies were detected more frequently in the patients enrolled in the study than in control subjects. The highest percentage of the serum samples, which demonstrated the presence of M. pneumoniae-specific antibodies was demonstrated in patients with asthma (60%) and it was twofold higher than in control subjects. Serologic profile of 26.6% patients with asthma, 50% of patients with pneumonia, 39.2% of patients with COME, 45.4% of patients with sinusitis and 10% of control subjects was consistent with a possible acute infection caused by M. pneumoniae. The presence of specific anti-C. pneumoniae antibodies was demonstrated in a smaller percentage of patients--in 13.3% of children with asthma, 10% of children with pneumonia and in 7.1% of patients with COME; the level of specific antiobodies was suggestive of acute chlamydial infection only in COME patients. Analysis of serologic markers for atypical bacteria infections indicates a possible association between infections caused by M. pneumoniae and bronchial asthma exacerbations and other respiratory tract disorders including pneumonia, sinusitis and COME.
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PMID:Evaluation of the association between atypical bacteria infections and respiratory tract diseases with emphasis on bronchial asthma exacerbations in children. 1614 64

Several pathogens associated with chronic infections, including Pseudomonas aeruginosa in cystic fibrosis pneumonia, Haemophilus influenzae and Streptococcus pneumoniae in chronic otitis media, Staphylococcus aureus in chronic rhinosinusitis and enteropathogenic Escherichia coli in recurrent urinary tract infections, are linked to biofilm formation. Biofilms are usually defined as surface-associated microbial communities, surrounded by an extracellular polymeric substance (EPS) matrix. Biofilm formation has been demonstrated for numerous pathogens and is clearly an important microbial survival strategy. However, outside of dental plaques, fewer reports have investigated biofilm development in clinical samples. Typically biofilms are found in chronic diseases that resist host immune responses and antibiotic treatment and these characteristics are often cited for the ability of bacteria to persist in vivo. This review examines some recent attempts to examine the biofilm phenotype in vivo and discusses the challenges and implications for defining a biofilm phenotype.
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PMID:Evolving concepts in biofilm infections. 1937 53

A prospective clinical cohort study was established to investigate the humoral immune response in middle ear fluids (MEF) and serum against bacterial surface proteins in children suffering from recurrent acute otitis media (rAOM) and chronic otitis media with effusion (COME), using Luminex xMAP technology. The association between the humoral immune response and the presence of Moraxella catarrhalis and Streptococcus pneumoniae in the nasopharynx and middle ear was also studied. The levels of antigen-specific IgG, IgA, and IgM showed extensive interindividual variation. No significant differences in anti-M. catarrhalis and anti-S. pneumoniae serum and MEF median fluorescence intensity (MFI) values (anti-M. catarrhalis and antipneumococcal IgG levels) were observed between the rAOM or COME groups for all antigens tested. No significant differences were observed for M. catarrhalis and S. pneumoniae colonization and serum IgG levels against the Moraxella and pneumococcal antigens. Similar to the antibody response in serum, no significant differences in IgG, IgA, and IgM levels in MEF were observed for all M. catarrhalis and S. pneumoniae antigens between OM M. catarrhalis- or S. pneumoniae-positive and OM M. catarrhalis- or S. pneumonia-negative children suffering from either rAOM or COME. Finally, results indicated a strong correlation between antigen-specific serum and MEF IgG levels. We observed no significant in vivo expressed anti-M. catarrhalis or anti-S. pneumoniae humoral immune responses using a range of putative vaccine candidate proteins. Other factors, such as Eustachian tube dysfunction, viral load, and genetic and environmental factors, may play a more important role in the pathogenesis of OM and in particular in the development of rAOM or COME.
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PMID:Comparative analysis of the humoral immune response to Moraxella catarrhalis and Streptococcus pneumoniae surface antigens in children suffering from recurrent acute otitis media and chronic otitis media with effusion. 2253 68


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