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

Thirty cases of Haemophilus influenzae pneumonia with clinical and laboratory features have previously been recorded in adults. During the past three years, we have examined 18 patients in whom this diagnosis was established by transtracheal aspirate or blood culture. Our study suggests that H influenzae, both typable and nontypable strains, is a more frequent cause of pneumonia in adults than previously appreciated. We found no clinical values that distinguished H influenzae pneumonia from other bacterial pneumonias. A properly performed Gram's stain of a transtracheal aspirate specimen is classical in its appearance and facilitates instritution of appropriate initial treatment. The emergence of both typable and nontypable organisms resistant to ampicillin makes it important that organisms be isolated from reliable samples for sensitivity testing. With appropriate therapy, the prognosis for patients with H influenzae pneumonia appears to be good.
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PMID:Haemophilus influenzae pneumonia in adults. 30 74

Twenty-four cases of Hemophilus influenzae pneumonia diagnosed by positive blood or pleural fluid cultures are compared to 43 cases previously reported in the literatrue. Frequently associated illnesses in both series include alcoholism, chronic airways obstruction and preceding respiratory tract infection. Moderate temperature elevation and slight leukocytosis were common on admission in both groups. Chest roentgenograms in our series revealed both bronchopneumonia (75 per cent) and lobar consolidation (38 per cent). Pleural disease occurred frequently, with two empyemas noted on admission and nine additional effusions developing during therapy. Treatment of choice was ampicillin. All five patients who did not receive ampicillin died, whereas 16 to 19 who received this drug survived. High mortality (33 per cent) in our series may be attributed to the advanced age of the patients and the presence of associated illnesses. In addition, a 10 year review suggests a true increase in the incidence of H. influenzae pneumonia in adults.
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PMID:Bacteremic hemophilus influenzae pneumonia in adults. A report of 24 cases and a review of the literature. 83 1

Pneumonia caused by common pyogenic bacteria occurs frequently in HIV-infected patients. Its clinical presentation has been described as being similar to that seen in non-immunosuppressed hosts but clearly different to that of opportunistic pneumonias. An atypical presentation has rarely been seen. In a 10-month period, we saw 12 HIV-infected patients who presented with Haemophilus influenzae pneumonia which was clinically and radiologically indistinguishable from Pneumocystis carinii pneumonia. Ten of the patients were intravenous drug users and were in different stages of HIV disease. The clinical picture was characterized by a prolonged course (median 4 weeks), non-productive cough, dyspnoea, and absence of findings usually present in bacterial pneumonia. Laboratory data frequently showed absence of leukocytosis, increased lactate dehydrogenase levels, hypoxaemia, and decreased CD4+ cell counts. All presented with interstitial or mixed bilateral infiltrates. Resistance to ampicillin and trimethoprim-sulphamethoxazole were each found in seven cases. Eleven patients were cured with antibiotic therapy, although five relapsed. H. influenzae pneumonia should be considered in HIV-infected patients who present with pulmonary symptoms and bilateral infiltrates of subacute or chronic onset. Clinical resolution of pneumonia is the usual outcome, but recurrences of infection are frequent.
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PMID:Latent Haemophilus influenzae pneumonia in patients infected with HIV. 177 77

The role of viruses and atypical organisms in pneumonia is well known in western populations, yet very little documentation is available about their role in pneumonia in developing countries. In a study of 175 adults with community-acquired pneumonia in Papua New Guinea, serological methods were used to assess this issue. Five patients had high influenza A titres suggestive of recent infection. Adenovirus titres rose significantly in one patient with Haemophilus influenzae pneumonia, whilst no evidence of past or recent infection was found in the remainder of patients when tested for all pathogens. Bacterial cultures revealed the continued predominance of Streptococcus pneumoniae in the pathogenesis of pneumonia in this population. We conclude that viruses and atypical organisms (including Mycoplasma and Legionella) play a very limited role in this setting.
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PMID:The role of viruses and atypical organisms in the pathogenesis of adult pneumonia in Papua New Guinea. 205 97

Bacteremic Hemophilus influenzae pneumonia is an uncommon infection in the adult. It usually affects chronically ill patients, especially those with chronic obstructive lung disease, although healthy individuals can also be affected. The condition carries a significant mortality, reaching 57% in one series. We describe ten adult patients with bacteremic H influenzae pneumonia with some unique features: no deaths occurred, half of the involved patients were previously fit individuals, and a beta-lactamase producing strain was isolated in five out of ten patients. An interesting finding was the isolation of a beta-lactamase negative H influenza from the sputum of two patients whose blood cultures were positive for a beta-lactamase positive H influenza. The overall incidence of beta-lactamase production among bacteremic isolates was 50%--a finding with a great deal of impact on the treatment of this disease.
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PMID:Bacteremic Hemophilus influenzae pneumonia in the adult. 265 32

The new quinolones are rarely indicated for the treatment of community-acquired pneumonia in the normal host. For nosocomial pneumonia they may be used when a Gram-negative aerobic bacillus is the causative organism. Pneumonia in the compromised host may be an indication for a quinolone. In the hypogammaglobulinaemic patient with Haemophilus influenzae pneumonia, the quinolones may be used, especially when the organism is resistant to other drugs. For the neutropenic patient with Gram-negative pneumonia the quinolones may be a good choice. However, more clinical studies are needed. In treatment for exacerbations of chronic bronchitis, failures seem to be associated with pneumococcal infections. For patients with cystic fibrosis, the quinolones offer successful ambulatory treatment for their Pseudomonas and Haemophilus infections. The information regarding dosage schedules is still incomplete.
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PMID:The place of quinolones in the treatment of respiratory tract infections. 267 85

The addition of hypothermia to regimens to control cerebral edema in children at our institution has been associated with a substantial incidence of infectious complications. Of the 13 children maintained at 30 degrees C to prevent cerebral edema, 3 developed Haemophilus influenzae pneumonia and 2 developed Streptococcus pneumoniae sepsis (one with pneumonia). The importance of neutrophil (PMN) function for elimination of bacterial pathogens prompted in vitro studies of PMN function at clinically attainable hypothermic temperatures. Neutrophils at 30 degrees C had significantly less ability to migrate towards a chemotactic stimulus (45 +/- 10% inhibition; P less than 0.02), to ingest staphylococci (22 +/- 5% inhibition; P less than 0.01) and to be metabolically activated as measured by superoxide production (35 +/- 10% inhibition; P less than 0.01) or by chemiluminescence (18 +/- 8% inhibition; P less than 0.05). These in vitro findings support the clinical observation that persons with decreased body temperature may be at an increased risk for bacterial infections secondary to PMN dysfunction.
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PMID:Increased susceptibility to infection in hypothermic children: possible role of acquired neutrophil dysfunction. 299 67

Rokitamycin dry syrup (RKM), a new macrolide antibiotic preparation, was evaluated for its safety, efficacy and pharmacokinetics in 19 children. RKM was effective in mycoplasmal pneumonia, Chlamydia trachomatis pneumonitis and Campylobacter gastroenteritis. Efficacies of RKM in streptococcal pharyngitis and Haemophilus influenzae pneumonia, however, were insufficient. Pharmacokinetic observations seemed to indicate that RKM achieved higher blood concentrations than older macrolides, but a large individual variation was observed. Diarrhea which was the only type of side effect observed in our cases, was encountered in 2 of 17 evaluable cases. From these data, RKM seems to have a place in the treatment of pediatric infectious diseases.
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PMID:[Clinical and pharmacokinetic studies of rokitamycin in children]. 322 33

To determine if there are any unique features of nursing home-acquired pneumonia we carried out a case-control study wherein each patient admitted with nursing home-acquired pneumonia was age- and sex-matched with a patient with community-acquired pneumonia. There were 36 men and 38 women in the nursing home group. The mean age of both groups was 74 years. The mortality rate for nursing home-acquired pneumonia it was 40.5%, whereas for community-acquired pneumonia it was 28% (P = NS). Patients with nursing home-acquired pneumonia had a significantly higher incidence of dementia and cerebrovascular accidents, and patients with community-acquired pneumonia were more likely to be smokers and to have chronic obstructive pulmonary disease. Aspiration pneumonia was more common among patients with nursing home-acquired pneumonia (P less than .001), and Hemophilus influenza pneumonia more common among the patients with community-acquired infection (P less than .01). Sputum for culture could be obtained in only 31 and 39% of the patients--contributory to the high rates of pneumonia of unknown etiology 63.5 and 56.1% for the nursing home group and the control subjects, respectively. Patients with nursing home-acquired pneumonia received cloxacillin and aminoglycosides more frequently than patients with community-acquired pneumonia (P less than .05), and patients with community-acquired pneumonia received erythromycin more frequently than patients with nursing home-acquired pneumonia (P less than .05). Complications were common during the hospital stay of these patients--the most frequent being congestive heart failure, urinary tract infection, renal failure, and respiratory failure.
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PMID:Nursing home-acquired pneumonia. A case-control study. 348 49

An experimental murine model of bacteraemic Haemophilus influenzae pneumonia was used to evaluate the therapeutic efficacy of ciprofloxacin, as compared with ampicillin and chloramphenicol. An ampicillin-sensitive (AS) and an ampicillin-resistant (AR) challenge strain were employed. Ciprofloxacin treatment produced intrapulmonary killing of H. influenzae which was superior to that achieved with ampicillin (P less than 0.001, both strains) and chloramphenicol (P less than 0.001, strain AS; P less than 0.005, strain AR). Likewise, survival from strain AS pneumonia was 61% in the ciprofloxacin-treated animals, as compared with 43% for the chloramphenicol-treated, and 22% for the ampicillin-treated groups. We conclude that ciprofloxacin may be an effective agent in treating pneumonia caused by either ampicillin-sensitive or ampicillin-resistant strains of H. influenzae.
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PMID:Comparative efficacies of ciprofloxacin, ampicillin and chloramphenicol in treatment of experimental Haemophilus influenzae pneumonia. 349 16


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