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

We reviewed the records of all patients in the intensive care unit (ICU) who had Pseudomonas aeruginosa pneumonia over a 2.5-year period. Of patients with P aeruginosa pneumonia, 20 of 34 survived the initial episode of pneumonia. Ten of these 20 developed recurrence. In the nonrecurrent group, nine of ten survived hospitalization, compared to only four of ten in the recurrent group. Comparing the recurrent to the nonrecurrent group, factors associated with recurrence were the APACHE 2 score (12.3 +/- 2.7 vs 8.6 +/- 4.2 [p less than 0.03]), APS score (7.0 +/- 3.5 vs 2.7 +/- 2.1 [p less than 0.01]), and chronic pulmonary disease (8/10 vs 2/10 [p less than 0.05]). The recurrent P aeruginosa group was younger (63 +/- 10 vs 74 +/- 11 years old [p less than 0.03]) and spent more time receiving mechanical ventilation (95 +/- 64 vs 26 +/- 36 days [p less than 0.01]), in the ICU (101 +/- 61 vs 33 +/- 35 days [p less than 0.01]), and in the hospital (144 +/- 77 vs 84 +/- 32 days [p less than 0.03]). Although not statistically significant, in the recurrent group, eight of ten patients had tracheostomy and seven of ten had COPD, vs three of ten and two of ten, respectively, in the nonrecurrent group. Recurrent P aeruginosa pneumonia in the ICU is associated with increased morbidity and mortality and does not appear to be related to the adequacy of antibiotic treatment. Chronic lung disease appears to predispose patients to recurrent P aeruginosa pneumonia.
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PMID:Recurrent Pseudomonas aeruginosa pneumonia in an intensive care unit. 172 69

In a prospective study of 170 adult patients with acute pneumonia, Haemophilus influenzae was found to be the aetiological agent in 15 cases (8.8%). The diagnosis in all cases was based on positive cultures of blood or percutaneous lung aspirate, or both. Chronic lung disease was significantly more common in patients with H influenzae pneumonia than in patients with pneumonia due to other organisms but age, sex, and smoking history did not differ significantly. Lobar consolidation was the most common radiological pattern, being present in 10 of the 15 cases. Type b was the commonest serotype isolated, but three cases were due to non-typable (non-capsulate) strains. All patients survived, responding well to treatment with penicillin, ampicillin, or chloramphenicol. Haemophilus influenzae should be considered as a possible cause of pneumonia in adults, particularly those with underlying chronic lung disease.
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PMID:Haemophilus influenzae pneumonia in Melanesian adults: report of 15 cases. 332 45

To add information about sporadic Legionnaires' disease, 87 cases of L. pneumophila pneumonia were reviewed. Twenty cases were nosocomial infections and 67 cases were community-acquired. Most cases (64%) occurred between July and October. The mean age of patients was 51.4 years and males outnumbered females 2.5:1.0. Thirty-one percent of patients were receiving corticosteroid, immunosuppressive, or antineoplastic chemotherapy when illness began. Immunosuppression at onset of illness was more common in nosocomial infections (90%) than in community-acquired infections (14%). Seventy percent of patients had underlying diseases. Malignancies, renal failure, and transplantation were the most common conditions underlying nosocomial infections. Chronic lung disease and malignancies were the most common diseases underlying community-acquired infections. The case-fatality rate in nosocomial infection (70%) was greater than that in community-acquired disease (22%). Clinical, laboratory, and radiologic features of the cases were examined. Illness ranged from mild to severe. Extrapulmonary findings of encephalopathy and renal failure were more common in fatal than in non-fatal cases. Indirect immunofluorescent and microagglutination antibody responses plateaued by the fourth week of illness. Twenty-nine patients died. The case-fatality rate of patients receiving erythromycin (6%) was less than that of patients receiving penicillin (36%), ampicillin (28%), cephalosporin (32%), or aminoglycosides (41%). Despite erythromycin therapy, the case fatality rate for nosocomial L. pneumophilia pneumonia was unacceptably high (25%).
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PMID:Sporadic Legionnaires' disease: clinical observations on 87 nosocomial and community-acquired cases. 646 87

Chronic lung disease (CLD) in children represents a heterogeneous group of many distinct clinicopathological entities. The prevalence of CLD has increased in the past decade because of the more advanced and intensive respiratory support provided for compromised children and additionally the overall improved survival of preterm babies. The disorders which constitute CLD generally have a slow tempo of progression over many months or even years. The most common causes of CLD in children are cystic fibrosis (CF), and other causes of bronchiectasis (such as immunodeficiency, and in the third world, post-infective bronchiectasis, for example, measles), bronchopulmonary dysplasia (BPD) (or lung disease of prematurity), asthma, chronic gastro-oesophageal reflux/aspiration pneumonitis, and constrictive obliterative bronchiolitis.
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PMID:The radiology of chronic lung disease in children. 1590 25

The development of chronic lung disease is common in HIV-infected children. The spectrum of chronic HIV-associated lung disease includes lymphocytic interstitial pneumonia (LIP), chronic infections, immune reconstitution inflammatory syndrome (IRIS), bronchiectasis, malignancies, and interstitial pneumonitis. Chronic lung disease may result from recurrent or persistent pneumonia due to bacterial, mycobacterial, viral, fungal or mixed infections. In high tuberculosis (TB) prevalence areas, M. tuberculosis is an important cause of chronic respiratory illness. With increasing availability of highly active antiretroviral therapy (HAART) for children in developing countries, a rise in the incidence of IRIS due to mycobacterial or other infections is being reported. Diagnosis of chronic lung disease is based on chronic symptoms and persistent chest X-ray changes but definitive diagnosis can be difficult as clinical and radiological findings may be non-specific. Distinguishing LIP from miliary TB remains a difficult challenge in HIV-infected children living in high TB prevalence areas. Treatment includes therapy for specific infections, pulmonary clearance techniques, corticosteroids for children with LIP who are hypoxic or who have airway compression from tuberculous nodes and HAART. Children who are taking TB therapy and HAART need adjustments in their drug regimes to minimize drug interactions and ensure efficacy. Preventative strategies include immunization, chemoprophylaxis, and micronutrient supplementation. Early use of HAART may prevent the development of chronic lung disease.
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PMID:Chronic lung disease in human immunodeficiency virus (HIV) infected children. 1804 Oct 77

Primary antibody deficiencies (PADs) are the most common form of primary immunodeficiency and predispose to severe and recurrent pulmonary infections, which can result in chronic lung disease including bronchiectasis. Chronic lung disease is among the most common complications of PAD and a significant source of morbidity and mortality for these patients. However, the development of lung disease in PAD may not be solely the result of recurrent bacterial infection or a consequence of bronchiectasis. Recent characterization of monogenic immune dysregulation disorders and more extensive study of common variable immunodeficiency have demonstrated that interstitial lung disease (ILD) in PAD can result from generalized immune dysregulation and frequently occurs in the absence of pneumonia history or bronchiectasis. This distinction between bronchiectasis and ILD has important consequences in the evaluation and management of lung disease in PAD. For example, treatment of ILD in PAD typically uses immunomodulatory approaches in addition to immunoglobulin replacement and antibiotic prophylaxis, which are the stalwarts of bronchiectasis management in these patients. Although all antibody-deficient patients are at risk of developing bronchiectasis, ILD occurs in some forms of PAD much more commonly than in others, suggesting that distinct but poorly understood immunological factors underlie the development of this complication. Importantly, ILD can have earlier onset and may worsen survival more than bronchiectasis. Further efforts to understand the pathogenesis of lung disease in PAD will provide vital information for the most effective methods of diagnosis, surveillance, and treatment of these patients.
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PMID:Lung Disease in Primary Antibody Deficiencies. 2783 55