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

Rhodococcus equi is a rare but well-documented cause of cavitary pneumonia in immunocompromised patients. In this report the first case of R. equi infection manifesting as vertebral osteomyelitis is described. A 39-year-old liver transplant recipient presented with recurrent pneumonia and a pleura-based lung abscess and subsequently developed osteomyelitis of the lower thoracic spine. Surgical debridement and prolonged treatment with rifabutin and clarithromycin resulted in clinical cure. In the literature, 12 other cases of R. equi infection in solid-organ transplant recipients have been reported. Ten of these patients had documented pulmonary disease and seven had extrapulmonary manifestations. Prolonged antibiotic therapy and surgical drainage resulted in clinical improvement in > 90% of the reported cases.
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PMID:Vertebral osteomyelitis due to Rhodococcus equi in a liver transplant recipient. 952 54

Results are submitted of analysis of the external respiration function in rest, under cold test and berotec test in 308 patients with primary pneumonia and 233 patients with recurrent pneumonia. A prominent feature of recurrent pneumonia (unlike the primary one) is the presence of obstruction of the lungs and middle bronchi presenting with hyperreactivity to the cold test and poor response to the broncholytic berotec.
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PMID:[Bronchial reactivity in patients with primary and recurrent pneumonias]. 969 67

Inhalation of a foreign body (FB) into the bronchial tree rarely occurs asymptomatically and, if leading to recurrent pneumonia, can be very difficult to diagnose. The present report deals with the case of a 10-year-old boy who had three episodes of pneumonia in the left lower lobe caused by the asymptomatic inhalation of a FB 12 months before. Standard thoracic CT, done during the third episode, revealed a slight reduction in the volume of the left lung with air bronchograms, multiple areas of bronchiectasis, and parenchymal consolidation of a segment of the lower lobe. Flexible fiberoptic bronchoscopy revealed a FB at the distal end of the left lower lobar bronchus, surrounded by granulation tissue and fully obstructing the anterior basal segmental bronchus. High-resolution CT (HRCT) images showed an inverted C-shaped image obstructing a bronchus. Removal of the FB was successful only with rigid bronchoscopy under total anesthesia. The FB was an air-pistol rubber bullet that the boy remembered playing with 12 months before. Two months after removal of the FB (ie, 14 months from its asymptomatic inhalation) and treatment with oral steroids, antibiotics, and respiratory physiotherapy, the patient recovered completely, and HRCT showed complete normalization of the lung. We conclude that, when the radiographic density of the FB is greater than the surrounding pulmonary parenchyma, HRCT can reveal the FB, and diagnostic flexible fiberoptic bronchoscopy can be avoided.
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PMID:Extraction of a rubber bullet from a bronchus after 1 year: complete resolution of chronic pulmonary damage. 1020 35

The aim of this study was to analyze the predisposing factors for bronchiectasis in 69 patients hospitalized in the 3rd Dept. of the Institute of TB and Lung Diseases in Warsaw in years 1995-1999. Bronchiectasis was diagnosed on the basis of the high resolution computed tomography (HRCT) scan. Among 69 patients at the age of 15-72 years there were 45 women (65%) and 24 men (35%). Fifty patients were nonsmokers. The most frequent predisposing factors of bronchiectasis in that group of patients were as follows: pneumonia (30.1%, in it recurrent pneumonia--19.3%, a single pneumonia--10.8%), sinobronchial syndrome (19.3%), pulmonary tuberculosis (12.1%), nontuberculous mycobacterial lung infections (7.2%), recurrent pneumonia and bronchitis in childhood (7.2%) and connective-tissue diseases (3.6%). Among other predisposing factors there were allergic bronchopulmonary aspergillosis, foreign body in bronchus, hypogammaglobulinemia and colitis ulcerosa.
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PMID:[Predisposing factors for bronchiectasis--analysis of 69 patients treated in the years 1995-1999]. 1064 81

Although bronchiectasis has become a rare condition in U.S. children, it is still commonly diagnosed in Alaska Native children in the Yukon Kuskokwim Delta. The prevalence of bronchiectasis has not decreased in persons born during the 1980s as compared with those born in the 1940s. We reviewed case histories of 46 children with bronchiectasis. We observed that recurrent pneumonia was the major preceding medical condition in 85% of patients. There was an association between the lobes affected by pneumonia and the lobes affected by bronchiectasis. Eight (17%) patients had surgical resection of involved lobes. We conclude that the continued high prevalence of bronchiectasis appears to be related to extremely high rates of infant and childhood pneumonia. Pediatr Pulmonol. 2000;29:182-187. Published 2000 Wiley-Liss, Inc.
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PMID:Bronchiectasis in Alaska Native children: causes and clinical courses. 1068 38

The paper presents multiorgan manifestations of AIDS syndrome in an infant at the age of 8 months. The child was admitted to the Clinic with enteric disorder, anaemia, hepatosplenomegaly and pneumonia. The diagnosis of those anomalies and the treatment of pneumonia took much time. Infection with CMV was recognized but, despite the treatment and elimination of the virus, the child's condition did not improve and general emaciation progressed. The diagnosis of AIDS syndrome was based upon indicator illnesses: chronic recurrent pneumonia, cytomegaly and emaciation syndrome as well as upon the results of additional examinations, first of all including the presence of p24 antigen in the serum. In children with chronic diseases and manifesting non-specific multiorgan symptoms we should take into consideration AIDS syndrome in the differential diagnosis.
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PMID:[AIDS syndrome in an eight-month-old infant]. 1080 May 76

Nosocomial pneumonia is a leading cause of morbidity and mortality in the surgical and trauma patient. Inadequate treatment can lead to the complications of acute respiratory distress syndrome (ARDS), empyema, and lung abscess. The prevention and treatment of these complications revolve around several key principles. Complete treatment of pneumonia requires appropriate antimicrobial therapy, as well as mechanical pulmonary hygiene and proper airway management. Despite advances in treatment of pneumonia, complications arise necessitating treatment. This article reviews the treatment of ARDS, empyema, and lung abscesses. In particular, the many options for treatment of empyema are discussed in detail. Additionally, the treatment of pulmonary contusion and hemopneumothorax in the trauma patient is discussed. The understanding of sound treatment principles in the critically ill postsurgical patient helps prevent complicated or recurrent pneumonia and allows the surgeon to intervene effectively when such complications occur.
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PMID:Complications of nosocomial pneumonia in the surgical patient. 1080 69

Nosocomial pneumonia is a leading cause of morbidity and mortality in the surgical and trauma patient. Inadequate treatment can lead to the complications of acute respiratory distress syndrome (ARDS), empyema, and lung abscess. The prevention and treatment of these complications revolve around several key principles. Complete treatment of pneumonia requires appropriate antimicrobial therapy, as well as mechanical pulmonary hygiene and proper airway management. Despite advances in treatment of pneumonia, complications arise necessitating treatment. This article reviews the treatment of ARDS, empyema, and lung abscesses. In particular, the many options for treatment of empyema are discussed in detail. Additionally, the treatment of pulmonary contusion and hemopneumothorax in the trauma patient is discussed. The understanding of sound treatment principles in the critically ill postsurgical patient helps prevent complicated or recurrent pneumonia and allows the surgeon to intervene effectively when such complications occur.
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PMID:Complications of nosocomial pneumonia in the surgical patient. 1087 18

Laryngopharyngeal sensory testing can predict aspiration risk in adult patients. Its feasibility and potential role in the evaluation of pediatric swallowing is undetermined. The goals of this study were to determine the feasibility of performing laryngopharyngeal sensory testing in awake pediatric patients and to assess whether the sensory testing results correlated with aspiration during a feeding assessment or correlated with a history of pneumonia. Fiberoptic endoscopic evaluation of swallowing with sensory testing was performed in 100 pediatric patients who were evaluated for feeding and swallowing disorders. The swallowing function parameters evaluated were pooled secretions, laryngeal penetration, and aspiration. The laryngopharyngeal sensory tests were performed by delivering a pressure-controlled and duration-controlled air pulse to the aryepiglottic fold through a flexible laryngoscope to induce the laryngeal adductor response (LAR). The air pulse stimulus ranged in intensity from 3 to 10 mm Hg. The patients tested ranged from 1 month to 24 years of age, with a median age of 2.7 years. Sensory testing was completed in 92% of patients. Patients who had an LAR at less than 4 mm Hg rarely if ever had episodes of laryngeal penetration or aspiration. Those with an LAR at 4 to 10 mm Hg had variable amounts of aspiration and laryngeal penetration. The LAR could not be elicited at the maximum level of intensity (10 mm Hg) in 22 patients, who demonstrated severe laryngeal penetration and/or aspiration. Elevated laryngopharyngeal sensory thresholds correlated positively with previous clinical diagnoses of recurrent pneumonia, neurologic disorders, and gastroesophageal reflux, and correlated positively with findings of pooled secretions, laryngeal penetration, and aspiration. Laryngopharyngeal sensory testing in children is feasible and correlative.
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PMID:Pediatric laryngopharyngeal sensory testing during flexible endoscopic evaluation of swallowing: feasible and correlative. 1105 29

In the course of complicated pneumonia in children diffuse inflammatory infiltrations with the risk of durable destruction of lung parenchyma are confirmed clinically and radiologically. The aim of the study was an evaluation of the general health state and respiratory problems in 55 children who had been earlier hospitalized for pneumonia with signs of localized changes and severe symptoms. The evaluation was done 2-10 years after the onset of the disease. In 89.1% of children a planned treatment was continued after hospital discharge. The period of recovery lasted over 6 weeks in 50.8% of examined children, and it was shorter than 2 weeks only in 23.6% of children. The relapses of the lower respiratory tract inflammation occurred in 43.6% of children in the form of bronchitis and in 9.1% of children a recurrent pneumonia was diagnosed. Only 12.7% of children needed subsequent hospitalization for respiratory problems. In 34.5% of children a limitation of physical activity was noted. 40 children underwent a functional examination of the respiratory system. In this group 35% of children ventilation problems of restrictive character were stated, whereas in 17.5% spirometry revealed bronchial obstruction. Presented results suggest the necessity of the specialistIc care of children after severe pneumonia including the monitoring of clinical and spirometric parameters of respiratory function and adequate rehabilitation.
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PMID:[Respiratory problems in children after severe pneumonia]. 1157


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