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

Many patients with illnesses that once were fatal at birth or during childhood now survive into adult life. This article considers four respiratory illnesses of early life in which long-term survival now occurs frequently: cystic fibrosis, diaphragmatic hernia, esophageal atresia-tracheoesophageal fistula, and bronchopulmonary dysplasia. In cystic fibrosis, although the median age at death is now 25 years, chronic pulmonary infection due ultimately to the abnormal composition and clearance of airway mucus is still the usual cause of death. Earlier survivors of congenital diaphragmatic hernia had only minor diminution of perfusion and ventilation of the lung on the side of the hernia as adolescents or young adults; however, as infants with greater degrees of pulmonary hypoplasia have successful repair of their hernias, more long-term respiratory impairment will probably be found. The esophageal atresia tracheoesophageal fistula complex leaves all esophagi and many tracheas permanently abnormal; recurrent aspiration, repeated pneumonia, and an unduly collapsible trachea are the result, although symptoms may be few. Survivors of bronchopulmonary dysplasia have decreased exercise capacity, wheezing, and recurrent pneumonia, although their chest radiographs may become normal or almost normal.
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PMID:Caldwell Lecture. Respiratory problems of early life now allowing survival into adulthood: concepts for radiologists. 835 26

Abnormalities in IgG subclass distribution were sought in serum samples and bronchoalveolar lavage fluid from 15 patients with alcoholic liver disease to explain their increased susceptibility to bacterial respiratory infections. Serum IgG4 deficiency alone or in association with low IgG2 levels was revealed in approximately 30% of patients with alcoholic liver disease. This fact prompted us to further investigate the immunoglobulin concentrations in broncho-alveolar lavage fluid, paying special attention to the distribution of IgA and IgG subclasses. IgA levels were found to be normal or slightly elevated. However, there were substantial defects in total IgG and IgG1 concentrations, often associated with reduced IgG2 and IgG4 levels, in approximately 70% of patients with alcoholic liver disease, which proved to be closely correlated with the number and type (pneumonia) of bacterial respiratory infections. A prospective study of intravenous immunoglobulin substitutive therapy involving two patients with recurrent pneumonia and very low serum IgG2 values demonstrated a reduction in the number of respiratory infectious episodes as well as an increase in both serum and, to a lesser extent, bronchoalveolar lavage fluid IgG1 and IgG2 levels. We identified immune defects that may represent an important pathogenetic mechanism that, when considered together with the alcohol-related suppression of alveolar macrophage and ciliary functions and the inhibition of leukocyte migration into the lungs, should help clarify the complex relationships between alcohol and immune defense.
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PMID:IgG subclass deficiency and sinopulmonary bacterial infections in patients with alcoholic liver disease. 172 35

We have used flexible fibreoptic bronchoscopy using sedation and local anaesthesia in 50 children aged 2-19 years (median 10) using an Olympus BFP20 instrument. Indications were opportunistic pneumonias (n = 11), persistent atelectasis (n = 11), recurrent pneumonia (n = 7), miscellaneous lower airway disease (n = 7), recurrent wheezing (n = 3), haemoptysis (3), to diagnose infection or rejection of heart-lung transplants (n = 3), stridor (n = 2), suspected airway compression (n = 1), evaluation of tracheostomy (n = 1), and suspected foreign body (n = 1). In 43 cases (86%) the diagnosis was related to the primary indication. In five (10%) unrelated abnormalities were found, and five (10%) were normal. In 13 (26%) treatment was altered as a result of flexible fibreoptic bronchoscopy. Complications were transient respiratory arrest (n = 2), hypoxia (n = 2), pneumonia (n = 2), and laryngospasm (n = 1). All complications were followed by complete recovery. Our results suggest that flexible fibreoptic bronchoscopy is safe. Advantages over rigid bronchoscopy include greater visual range, fewer complications, and the avoidance of a general anaesthetic. Though invasive it can yield important diagnostic and therapeutic information.
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PMID:Fibreoptic bronchoscopy without general anaesthetic. 203 4

Initially a right sided pulmonary hypoplasia was diagnosed in our patient at the age of 9 years. The previous years were characterized by recurrent pneumonia, bronchitis and daily coughing fits. Findings of the chest radiograph suggested the diagnosis of right sided hypoplasia. The right hemithorax was small with mediastinal structures being pushed to the right and a clearly reduced blood flow on the same side. DSA of the arteria pulmonalis showed hypoplasia of the right arteria pulmonalis and confirmed our diagnosis. In addition to that an obstructive airway disease was assessed by measurement of lung function. Since the time when the diagnosis was found our patient has inhaled DSCG and beta 2-adrenergic drugs and no surgical treatment has been required as there have been no further episodes of pneumonia.
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PMID:[Right-sided lung hypoplasia in a 13-year-old boy]. 232 50

This is a report on the clinical courses and pathological findings in two gay male patients with acquired immunodeficiency syndrome (AIDS) infected in Japan. Case 1. A 39 year-old Japanese homosexual male was diagnosed as amebic dysentery complicated with liver abscess on admission. He was placed on Metronidazole with complete relief. Serological tests was positive for AIDS. On second admission, he was found to have pneumocystis carinii pneumonia (PCP) and cytomegalo-viral uveitis. Administration of Pentamidine was partially effective, however the therapy with Azidothimidine was discontinued by bone marrow suppression. On his third admission, he suffered from cryptococcal meningitis and therapy-resistant fungusemia. Finally he died of recurrent pneumonia regardless of appropriate therapies. Autopsy proved extended cryptococcal infection in the brain, meninx, lungs, liver and kidney, and cytomegalo-infection in the lungs, liver and kidney. Furthermore, atypical mycobacteriosis was found in the lymph nodes. There was no active findings compatible with PCP. Case 2. A 44 year-old Japanese homosexual male was admitted with oral candidiasis and diagnosed as AIDS related complex. He suffered from pneumonia with marked improvement on sulfamethoxazole-Trimethoprim. On his second admission, he developed diarrhea and was found to be infected with Giardia lambia. In addition, cytomegalo-viral infection damaged his eye sight. He died of pneumonia and meningitis shortly there after. Autopsy proved a cytomegalo-viral infection in the lung and colon, old lesions possibly caused by PCP in the lungs, and suppurative meningitis in the meninx. These experiences confirm that AIDS patients can be exposed to several opportunistic infections at the same time in the multiple organs. Furthermore, it is suggested that homosexual patients with AIDS may have unique opportunistic infections such as amebic dysentery or Giardia lamblia unlike other AIDS patients related to hemophilia.
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PMID:[Clinical courses and pathological findings in two gay male patients with acquired immunodeficiency syndrome infected in Japan]. 233 6

A case of benign fibrous histiocytoma of the lung in a 8 years old boy was presented. He was first admitted in May, 1983, with recurrent pneumonia. Chest X-ray showed a ill-defined mass in the right lower lobe. Bronchoscopy revealed a round tumor, 1 cm. in maximum diameter, with complete obstruction of the Truncus Intermedius. Endoscopic resection was performed and partial obstruction of the Truncus Intermedius remained. He was re-admitted with pneumonia of the right middle lobe in March, 1986. Bronchoscopy showed severe stenosis of the Truncus Intermedius. Right middle and lower lobectomy was performed. The 4 X 4 X 3 cm tumor was located in the median of the Truncus Intermedius. Microscopically, the lesion composed of fibroblast-like cells and histiocyte-like cells. The patient's post-operative course was uneventful. He has no signs of local recurrence or metastasis. We believe, this is the first reported primary benign fibrous histiocytoma of the lung in a child in Japan.
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PMID:[A case of benign fibrous histiocytoma of the lung in a child]. 254 28

We describe two otherwise healthy subjects with many years sequelae due to lung aspiration. In both, diagnosis was delayed due to lack of history of aspiration. Recurrent pneumonia in the same segment in one, and migratory pneumonia in the other, could have suggested the diagnosis. Review of the literature shows that occult foreign body aspiration poses difficulties in diagnosis and that often a history of aspiration is lacking. However, the recurrent nature and the localization of the pneumonia, as well as the findings during bronchoscopy, should alert the physician to the possibility of foreign body aspiration.
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PMID:Foreign body aspiration in the adult: an occult cause of chronic pulmonary symptoms. 269 9

Phrenic nerve palsy (PNP) is seen in infants and young children usually resulting from operative trauma or birth injury. Spontaneous recovery usually occurs, but occasionally surgical plication is necessary. Twenty-three cases of PNP over a 10-year period were managed surgically. Patient ages ranged from 1 day to 30 months (median, 4 months), 18 were male and five female. Cause was operative trauma in 18 (17 cardiac surgery, one neuroblastoma), birth trauma in two, and idiopathic in three. The right side was involved in 14, the left in eight, and both in one. Indications for plication were inability to wean from the ventilator (group 1, 16 patients), recurrent pneumonia (group 2, four patients), and respiratory distress (group 3, three patients). The 16 patients in group 1 were intubated for a median of 18.5 days from onset of PNP to plication. Postoperatively, three had continuing congestive heart failure (one died at 16 days of age, one was still chronically ventilated at 22 months, one was extubated at nine days); the other 13 were extubated at a median of two days postoperatively. All the patients in groups 2 and 3 were extubated within two days of surgery. Twelve plications were transthoracic and 11 were transabdominal. Postoperative complications included pneumonia (2), wound infection (1), pneumothorax (2), and mucous plug with pulmonary collapse (1). One patient died of cardiac failure at 16 days. One patient in group 3 developed recurrent respiratory distress 4 months postoperatively; he had a recurrent elevated hemidiaphragm requiring a second plication.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plication of the diaphragm for infants and young children with phrenic nerve palsy. 317 45

During a period a 9 months, 125 individuals with pneumonia due to infection with Mycoplasma pneumoniae were identified among 1,242 individuals in two Israeli kibbutzim. The monthly incidence of M. pneumoniae pneumonia (MPP) was 13.3/1,000 population. Of those infected, 93 (74.4%) were under the age of 18 years. The clinical course of MPP was mostly benign. The prominent signs and symptoms of disease were cough (100%), fine respiratory crepitations (77%), fever (37%), and diminished breathing sounds (25%) above affected lung areas. Leukocytosis was rare (9.6%); however, eosinophilia was observed in 23% of 53 tests performed. Exacerbations of bronchial asthma was observed among 36% of 11 patients with a previous history of asthma. The average duration of disease was 13.5 days, under treatment. A recurrence rate of 11.2% was noted among all MPP patients, with a very high (42.3%) rate among patients treated with cotrimoxazole. All patients with recurrent pneumonia were children under the age of 10 years.
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PMID:An outbreak of Mycoplasma pneumoniae pneumonia in two kibbutzim: a clinical and epidemiologic study. 335 39

Two groups of newborns and infants with gastroesophageal reflux (GER) were retrospectively analyzed for the diagnostic accuracy and therapeutic guidance offered by extended intraesophageal pH monitoring. There were 28 patients in group I whose major presenting sign was recurrent pneumonia due to GER, and 22 patients in group II, with apnea caused by GER. The pH probe was 100% accurate in identifying the presence of GER. Barium esophagram was accurate 46% of the time. The pH probe accurately identified the appropriate mode of therapy in all patients. In the medically treated GER/Pneumonia group, the mean number of episodes of GER per 24 hours was 24, whereas in the surgical group the mean number was 63. Similarly, in the medically treated GER/Apnea group, the mean number of reflux episodes per 24 hours was 26, whereas the surgical group experienced 64. Had the pH probe been used to guide therapy, no patient would have been treated inappropriately. The number of patients in this report is not large. Prospective verification of these observations is required before this methodology can be utilized routinely in patients with GER.
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PMID:Gastroesophageal reflux. pH probe-directed therapy. 370 32


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