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

The diagnosis and management of chronic and recurrent pneumonia in children may present a significant challenge for the primary care physician. Successful management depends on a careful evaluation of each episode, with a complete review of all available chest radiographs. Timing, location, and prodromes to recurrence can all provide important clues to the etiology of infection. Infiltrates that recur in a single lobe or segment of the lung may be caused by local airway obstruction, or by anatomic abnormalities of the lung itself. Pneumonias that occur in varied locations, or affect more than one lobe, suggest the presence of a more generalized abnormality, such as swallow dysfunction or aspiration, immunodeficiency or asthma. The pattern, frequency of recurrence, and severity of the infections can guide the practitioner in choosing the diagnostic studies most likely to identify an underlying etiology for recurrent episodes of pneumonia. With diligence and patience, most children with recurrent lower respiratory disease can be treated effectively.
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PMID:Chronic and recurrent pneumonias in children. 1189 21

Two hundred and eight children with recurrent pneumonia were studied over a 5-year period. Among these patients we found 10 cases with primary immunodeficiency disease: 6 cases of IgA deficiency, 1 case of X-linked agammaglobulinemia, 1 case of common variable immunodeficiency, 1 case of hyper IgM syndrome, and 1 case of Wiskott-Aldrich syndrome. This study describes the clinical features of these cases and assesses the usefulness of our immunodeficiency screening protocol. In this group 6 were males; the mean age at first episode of pneumonia was 3 years (range 3 months to 18 years), and the age of diagnosis ranged between 10 months and 19 years. The average number of episodes of pneumonia in each patient was 5 (range 2 to 12), and the number of hospitalizations ranged up to 13. The etiologic agents isolated from this recurrent pneumonia were S. pneumoniae, Moraxella, adenovirus, respiratory syncytial virus, and influenza B virus. Intravenous immunoglobulin was used in four cases. Two patients had chronic pulmonary damage with bronchiectasis and interstitial pneumonia. Only one patient died (Wiskott-Aldrich syndrome) during the follow-up from an intracranial hemorrhage. We found that the screening protocol applied to patients with recurrent pneumonia is a useful tool for ruling out the primary immunodeficiency disorders.
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PMID:Recurrent pneumonia as warning manifestation for suspecting primary immunodeficiencies in children. 1190 19

A 66-year-old female had been treated by hemodialysis since 1996. She was admitted to our hospital with acute pneumonia in January 2001. During admission, ischemic heart disease was identified. Her condition deteriorated and organic pneumonia of the right middle lobe progressed. She recovered after 6 months and coronary arteriography was performed. A 90% stenosis was detected at the ostium of the right coronary artery. An aberrant tortuous artery arose from the distal sinus node artery, and drained into the lung network, but also partially drained to the right segmental pulmonary artery branch. The diagnosis was significant stenosis of the right coronary artery, and pulmonary pseudosequestration or pulmonary sequestration receiving arterial supply from the sinus node artery. Surgical revascularization, ligation of the aberrant artery, and partial resection of the right middle lobe were performed. However, intraoperative findings did not identify the pulmonary sequestration. This rare case of pulmonary pseudosequestration received the arterial supply from the sinus node artery, originating from the right coronary artery with a significant stenotic lesion, and developed without recurrent pneumonia.
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PMID:[Pulmonary pseudosequestration receiving arterial supply from the right coronary artery: a case report]. 1204 4

Undiagnosed and retained foreign bodies may result in serious complications such as pneumonia, atelectasis, or bronchiectasis. We reviewed a total of 174 children with foreign body aspiration (FBA). Clinical, radiological, and bronchoscopic findings of these patients were evaluated according to the nature of foreign body and elapsed time from aspiration to diagnosis. Significant differences were noted between patients with organic and inorganic FBA in terms of clinical and radiological findings. Cough, recurrent pneumonia, and fever were the most common presenting symptoms in patients with delayed diagnosis. Long-term follow-up was available for 110 patients for a mean duration of 37.8 +/- 23.7 months (range, 1-88 months). We evaluated the course of recovery after bronchoscopic removal. Organic FBA was of comparable duration as for inorganic FBA, and prolonged follow-up was associated with increased risk of persistent symptoms and bronchiectasis (P < 0.001). The risk of long-term complications increased with increasing elapsed time from aspiration to diagnosis; complications were as high as 60% in children who were diagnosed 30 days after FBA (P = 0.0035). Bronchiectasis was a major complication, found in 25% of patients whose diagnosis was delayed by more than 30 days (P = 0.0001). Three patients with bronchiectasis underwent lobectomy. Patients with persistent asthma-like symptoms such as cough and wheezing required treatment with inhaled corticosteroids and bronchodilators. The positive response to this treatment was thought to be a confirmation of the development of transient bronchial hyperresponsiveness induced by foreign bodies. We conclude that timely diagnosis and appropriate treatment of FBA is important to prevent long-term complications in affected children.
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PMID:Foreign body aspiration: what is the outcome? 1211 94

Patients with severe neurological impairment may develop recurrent pneumonia due to aspiration. Laryngotracheal separation and tracheoesophageal diversion are one of the surgical treatments to prevent salivaly aspiration. We report anesthetic management for laryngotracheal separation and tracheoesophageal diversion of five pediatric patients with severe cerebral palsy. Anesthetic problem was that all patients was repeating intractable pneumonia. And when the trachea was resected from esophageal mucosa, we experienced temporary ventilatory disturbance. So airway management was most important during anesthesia. Perioperative complications were postanesthetic seizure and postoperative brief apnea. Recurrent fever and aspiration pneumonia subsided in all of them. Our impression is that laryngotracheal separation and tracheoesophageal diversion are not so invasive surgical treatment for intractable pneumonia. But perioperative management should be concerned about both respiratory and neurological problems.
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PMID:[Anesthetic management for laryngotracheal separation and tracheoesophageal diversion]. 1238 87

A 50-year-old male, diabetic, post transplant patient had recurrent pneumonia. The first episode responded well to antibiotics, while on the second occasion he had a necrotising pneumonia, which developed into a thick-walled cavity. Despite antibiotics, his condition rapidly deteriorated precluding bronchoscopy or percutaneous biopsy. Post-mortem lung biopsy revealed typical hyphae of mucormycosis.
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PMID:Pulmonary mucormycosis in a diabetic renal transplant patient. 1243 44

The authors present a case of a soldier with Kartagener syndrome and bilateral purulent maxillary sinusitis with nasal polyps and pneumonia. Kartagener syndrome is originally described as the combination of situs inversus, bronchiectasis and sinusitis. Kartagener syndrome is a part of immotile cilia syndrome. Mild before the age of 18 recurrent pneumonia, chronic sinusitis, chronic rhinitis and nasal polyps occurred. Typical therapeutic management is discussed but infections prophylaxis, general treatment and physiotherapy are the base of good general condition and significantly improve prognosis.
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PMID:[A case of Kartagener's syndrome]. 1257 93

We report a case of bronchial gland cell-type adenocarcinoma with recurrent pneumonia and hemoptysis. After persistent hemoptysis since the summer of 1999, a 26-year-old female patient was admitted to our hospital because of bacterial pneumonia of the left lower lobe in March 2000. Treatments with antibiotics resulted in only a transient improvement of the pneumonia, and so she was re-admitted for an investigation of the recurrent pneumonia accompanied with hemoptysis. Bronchofiberscopy revealed a polypoid lesion at the orifice on the left B10 bronchus. Although the microscopic examination of the biopsied specimens showed only non-specific inflammatory changes, a left lower lobectomy was performed. The pathological examination of the resected lung confirmed that the polypoid region was bronchial gland cell type adenocarcinoma at the stage of pT1N0M0.
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PMID:[A case of bronchial gland cell-type adenocarcinoma with relapsed pneumonia and hemoptysis]. 1269 51

The aim of this study was to determine the relative frequency of underlying illnesses for recurrent pneumonia in children. Children who had two or more episodes of pneumonia per year, or three or more episodes in a lifetime were investigated retrospectively at Ankara University Medical School, Department of Pediatric Infectious Diseases, between January 1997 and October 2002. Out of 788 children hospitalized for pneumonia, 71 (9 per cent) met the criteria for recurrent pneumonia. An underlying illness was demonstrated in 60 patients (85 per cent). In this group, the underlying illness was diagnosed prior to pneumonia in 11 patients (18.3 per cent), during the first episode in 12 patients (20 per cent), and during recurrence in 37 patients (61.7 per cent). Underlying diseases were bronchial asthma (32 per cent), gastroesophageal reflux (15 per cent), immune disorders (10 per cent), congenital heart defects (9 per cent), anomalies of the chest and lung (6 per cent), bronchopulmonary dysplasia (4 per cent), cystic fibrosis (3 per cent), tuberculosis (3 per cent), and aspiration syndrome (3 per cent). No predisposing illness could be demonstrated in 11 patients (15 per cent). In conclusion, approximately one-tenth of hospitalized children with pneumonia in our hospital had recurrent pneumonia. Most of these children had an underlying illness, which was demonstrated by intensive investigation. Bronchial asthma in children aged more than 2 years and gastroesophageal reflux in children aged less than 1 year were the most common underlying illnesses for recurrent pneumonia.
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PMID:Underlying causes of recurrent pneumonia in Turkish children in a university hospital. 1292 81

To examine clinical features of pneumonia in schizophrenics, its course was analysed in 115 patients of a mental hospital (91 men, 24 women, mean age 54.4 +/- 1.2 years). 63.3% patients stayed in hospital for more than a year, 70.4% had schizophrenia for 20 years. 86% pneumonia patients were at the age older than 40 years, 35%--older than 60 years. Unfavourable premorbid factors were dementia, weight loss, anemia, recurrent pneumonia and intestinal infections. Pneumonia was characterized by rare fever, pains in the chest, frequent hypotension, systemic symptoms. 58.2% of patients suffered from pneumonia longer than 4 weeks. Lethality was 23.5%. In patients who had schizophrenia up to 10 years lethal outcomes were absent. In lethal outcome, pneumonia was initially diagnosed as severe, it was accompanied by arterial hypotonia in 91.7% of cases, by leukopenia in 40.5% (below 10(9)/l). Lethal outcome was caused by rapid development of brain edema in vascular failure in more than half of the cases. Pneumonia in mental patients was connected with many factors: the disease as such, psychotropic therapy, conditions in the hospital stay.
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PMID:[Clinical characteristics of pneumonia in schizophrenics]. 1293 15


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