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

Epidemiological data presented here indicate that cytomegaloviral (CMV) infection is one of the most common perinatal infections found in human beings. Transmission to the offspring occurs in utero at birth and postnatally. Intrauterine infection results from primary or recurrent maternal involvement, the latter being more common in populations where infection is initially acquired during childhood or adolescence, such as in low socioeconomic settings. Congenital infection is usually subclinical with either type of maternal involvement but primary infection has a greater tendency to produce disease in the fetus. About 20% of the offspring infected in utero are damaged, infrequently with generalized disease, but more often with auditory involvement. The latter can develop in utero or postnatally and can be progressive. The major cause of recurrent maternal infection according to restriction enzyme analysis is reactivation of latent virus, which occurs in the face of substantial maternal humoral immunity, even with intrauterine transmission of virus. Reinfection by exogenous virus remains a lesser possibility for maternal recurrences. Even more commonly, CMV can be transmitted at birth from the infected maternal genital tract and postnatally through infected breast milk, especially in highly immune populations. With the possible exception of early pneumonia, these infections appear to be innocuous.
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PMID:Natural history of perinatal cytomegaloviral infection. 23 56

From July, 1974 to February, 1978, we managed 12 infants with listeriosis. This infection presented in two distinct forms: an early-onset type (nine patients), often representing a congenital infection following maternal illness, and a late-onset type in which the patient presented with meningitis (three patients). Of our nine infants with early-onset disease, three died, three developed permanent sequelae, and only three were normal at follow-up. Appropriate early management in the perinatal period may improve the outlook in this condition. Affected infants were often premature and had pneumonia, rash, and hepatosplenomegaly at birth. Prenatal clues to the diagnosis included maternal fever, abdominal pains, and leukocytosis with meconium staining of the preterm amniotic fluid. Examination of gastric aspirate at birth showed gram-positive coccobacilli. Antibiotic therapy should be started prenatally and continue for three weeks after birth to prevent recurrences of the late-onset type. This late-onset disease presented as meningitis after the second week of life and responded well to antibiotics. Our three patients recovered without sequelae.
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PMID:Perinatal listeriosis--a review of twelve patients. 43 5

As part of a survey of the causes of perinatal mortality at Mpilo Maternity Hospital, 220 neonatal deaths and the mothers of 221 stillbirths were tested for HIV-1 antibodies. The HIV positive rate in neonatal deaths was 23.6% (95% confidence interval (CI) 18.0 to 29.2%), significantly higher than 15.4% (95% CI 10.6 to 20.1%) in stillbirths. Perinatal deaths from congenital malformations, birth asphyxia, pregnancy induced hypertension, placental abruption, and oFther non-infectious causes had similar low HIV positive rates averaging 8.1% (95% CI 3.9 to 12.3%). Deaths from septicaemia had a significantly greater rate of 39.3% (95% CI 27.0 to 51.6%) and the highest rate of 72.2% (95% CI 51.5 to 92.9%) was found in deaths from congenital infection other than syphilis, indicating that maternal HIV infection predisposes to neonatal septicaemia and congenital infection. Unexplained stillbirths also had a significantly greater rate of 22.4% (95% CI 10.7 to 34.1%), presumably because some died from unrecognised infection. The rate in deaths from congenital syphilis was 17.4% (95% CI 9.6 to 25.2%), indicating a significant but weak association between these two sexually transmitted diseases in Bulawayo. The rate in deaths from hyaline membrane disease was not significantly greater at 15.0% (95% CI 6.0 to 24.0%). By predisposing to infection, maternal HIV infection was estimated to increase the stillbirth rate by 1.6 times and the neonatal mortality rate by 2.7 times. It predisposed equally to early and late onset neonatal septicaemia, but more to infection from streptococci and staphylococci than from Gram negative enterobacteria. HIV positive deaths from congenital infection had respiratory distress and usually intrauterine growth retardation, hepatosplenomegaly, and congenital pneumonia on lung histology.
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PMID:HIV-1 infection and perinatal mortality in Zimbabwe. 159 95

A term newborn with Candida albicans infection of the lungs and blood is described. Although no maternal risk factors were identified, this patient's rapid clinical deterioration and postmortem findings suggest congenital infection. Related cases in the literature are reviewed. This case suggests that a diagnosis of fungal pneumonia should be considered in any infant presenting with severe respiratory distress.
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PMID:Congenital candida pneumonia and sepsis: a case report and review of the literature. 266 61

Cytomegalovirus is ubiquitous. While most infections are asymptomatic, infants and children acquiring CMV may excrete the virus for years in spite of significant antibody responses. CMV may be transmitted vertically or horizontally. Transplacental passage of CMV leads to congenital infection of the neonate. The most severely affected infants are born to mothers who develop a primary infection early in pregnancy and have a suboptimal cell-mediated response. During the perinatal period, the virus may be acquired by the infant from infected breast milk, passage through an infected birth canal, or by blood transfusion. Full-term infants infected during the perinatal period, though usually asymptomatic, may present with rash, hepatomegaly, lymphadenopathy, and/or pneumonia. Perinatally acquired infections in sick preterm infants may cause significant morbidity and mortality. Although specific therapy for infected individuals is currently unavailable, the outlook for an effective vaccine is promising.
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PMID:Cytomegalovirus infections of the neonate and infant. 284 Sep 29

Clinical details of 50 infants with congenital cytomegalovirus infection identified in a prospective study are reported. The mean birthweight, gestational age, and head circumference of children with congenital cytomegalovirus infection were not significantly different from those of controls. Three (6%) had symptoms at birth--two neurological and one pneumonitis. In the first four months of life transient hepatosplenomegaly occurred in two infected children and six suffered interstitial pneumonitis. Three congenitally infected children have major neurological handicaps including spastic quadriplegia, microcephaly, and psychomotor delay, and five (10%), including the one with quadriplegia, have sensorineural deafness which is bilateral in three (6%). Estimates based on these findings suggest that the impact of congenital cytomegalovirus infection is comparable to that of congenital rubella in the era before vaccination. Of the 42 children where the nature of maternal infection was classifiable, congenital infection followed primary maternal infection in 32 (76%) and recurrent infection in 10 (24%). Neurological defects followed exposure to primary maternal infection in all three trimesters of pregnancy and also recurrent maternal infection.
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PMID:Congenital cytomegalovirus infection. 609 25

A case of congenital infection by Torulopsis glabrata in a premature 0.52-kg female infant born at 23 weeks' gestation to a 37-year-old, gravida 7 mother is reported. The infant succumbed to an intrauterine pneumonia and fungemia. Acute chorioamnionitis was present. Budding yeasts were found in the lungs and amniotic membranes and in large numbers within the lumen of the gut. The role of a retained intrauterine contraceptive device in predisposing to the ascending infection is discussed.
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PMID:Congenital Torulopsis glabrata infection in man. 718 18

Human herpesvirus 6 (HHV-6), an important opportunistic pathogen in immunocompromised patients, causes fatal pneumonitis, encephalitis, and bone marrow suppression. Its ability to infect and destroy T lymphocytes may allow it to synergize with the human immunodeficiency virus in the destruction of lymphoid tissues in patients with AIDS. We describe herein an infant who had an immunodeficiency associated with thymic atrophy and severe T lymphocytopenia who developed fatal pneumonitis due to HHV-6. Dense and disseminated infection of T lymphocytes with HHV-6 was also documented. In the absence of any other documented cause of immunodeficiency, we hypothesize that congenital infection of this infant with HHV-6 may have caused progressive destruction of her cellular immune system, leading to the fatal pneumonitis. Thus, HHV-6 infection may have been the cause of both her immunodeficiency and her fatal opportunistic infection.
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PMID:Progressive immunodeficiency and fatal pneumonitis associated with human herpesvirus 6 infection in an infant. 774 49

Respiratory infections in young infants are common and can cause significant morbidity and mortality. The etiology of pneumonia in the neonate varies widely because of several modes of acquisition of infecting agents. Infants may develop pneumonia in utero as a part of a congenital infection; however, more often, infants are exposed to potential pathogens in the perinatal and postnatal periods. The management of neonates with pneumonia should include diagnostic evaluation and empiric therapy directed at the organisms commonly found in the maternal genital tract, and respiratory pathogens found in the community. For premature or critically ill term infants in neonatal intensive care units, one must consider the multitude of nosocomial pathogens that colonize and cause invasive disease in these immunocompromised hosts.
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PMID:Neonatal pneumonia. 888 73

Acanthamoeba culbertsoni is one of the free-living amoebae which are known to be pathogenic to man, causing granulomatous amoebic encephalitis (GAE). In this study, Acanthamoeba culbertsoni was isolated from a water sample of El-Mahmoudia Canal in Alexandria, in July-1993. This was used to infect mice intranasally to study the histopathological picture of the brain and lungs. The neuropathological features consisted of chronic granulomatous encephalitis in which cysts and trophozoites were found. Associated Acanthamoeba pneumonitis with massive consolidation was also observed. Congenital infection of offsprings was reported for the first time in this study.
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PMID:The possibility of congenital infection with Acanthamoeba culbertsoni. 891 32


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