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

Clinical and pathological studies on organizing pneumonia (OP) were performed in 16 cases diagnosed by transbronchial lung biopsy (TBLB). All patients were elderly and poorly-nourished with underlying disease, and suffered from fever and various respiratory symptoms. Results of laboratory studies in these cases were positive for C-reactive protein, negative for tuberculin reaction and showed high complement levels. Pathological findings demonstrated that there were two kinds of organizing process classified according to whether fibrin exudation was detected in Masson bodies or not. Twelve of the 16 cases were treated with prednisolone, and two cases were observed without administration. In nine of the 16 cases, abnormal shadows in chest X-ray disappeared, although abnormal shadows remained in five. Regarding the relationship between pathological findings and shadows in chest X-ray, Masson bodies without fibrin were observed in nine cases in which abnormal shadows in chest X-ray disappeared, but Masson bodies containing fibrin were observed in five cases in which abnormal shadows remained. These results suggest that there are two kinds of organizing process in OP. Steroid therapy tends to be ineffective in OP demonstrating organization containing fibrin caused probably by infection. However, prednisolone is effective in the OP associated with a fibrosing process, similar to idiopathic BOOP, without or with unrelated fibrin exudation of unknown origin.
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PMID:[Clinical and pathological studies of organizing pneumonia]. 823 Aug 93

Sixty-one children were treated in hospital from 1981 to 1982 because of both radiologically and microbiologically verified viral or bacterial pneumonia. The chest radiographs were interpreted by two radiologists, not familiar with the clinical data, on two occasions three years apart, and only those patients with a definite alveolar (n = 27) or interstitial (n = 34) pneumonia at both evaluations were included in the present analysis. In addition, all patients had viral (n = 20), mixed viral-bacterial (n = 21) or bacterial (n = 20) infections diagnosed by viral or bacterial antibody or antigen assays. Viral infection alone was seen in 7 (26%), mixed viral-bacterial infection in 8 (30%) and bacterial infection alone in 12 (44%) of the 27 patients with alveolar pneumonia. The respective figures were 13 (38%), 13 (38%) and 8 (24%) for the 34 patients with interstitial pneumonia. C-reactive protein concentration was greater than 40 mg/l (a screening limit for viral and bacterial infections) in 15 (56%) of the patients with alveolar and in 11 (32%) of the patients with interstitial pneumonia. Thus 74% of the patients with alveolar and 62% with interstitial pneumonia had bacterial infection, either alone or as a mixed viral-bacterial infection. Our results suggest that the presence of an alveolar infiltrate in a chest radiograph is a specific but insensitive indicator of bacterial pneumonia. We conclude that patients with alveolar pneumonia should be treated with antibiotics. In patients with interstitial pneumonia, however, both viral and bacterial aetiology are possible. In those, the decision concerning antibiotic treatment should be based on clinical and laboratory findings.
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PMID:Comparison of radiological findings and microbial aetiology of childhood pneumonia. 831 3

We monitored the plasma elastase:alpha 1-proteinase inhibitor complexes during chemotherapy for cancer and investigated the relationship between the elastase burden and the onset of adult respiratory distress syndrome (ARDS) in 20 patients with primary lung cancer who received combination chemotherapy; 15 normal nonsmokers served as controls. Of the 20 patients, 6 developed pneumonia, and 6 developed ARDS. We measured peripheral WBCs, C-reactive protein (CRP), plasma elastase:alpha 1-proteinase inhibitor complex (complex), and the ratio of complex/WBC during chemotherapy for cancer. In patients who did not experience complications during combination chemotherapy, WBC counts changed, but levels of complex were normal. In patients who developed pneumonia, levels of complex were abnormally high during the WBC nadir, and the complex/WBC count increased along with the level of CRP. In patients who developed ARDS during chemotherapy for cancer, levels of complex were abnormally high immediately after chemotherapy and remained high after the onset of ARDS. In addition, complex/WBC counts and CRP levels increased at the onset of ARDS. The maximum complex concentration was significantly higher in patients with pneumonia (414.3 +/- 57.2 ng/ml) and ARDS (683.2 +/- 72.8 ng/ml), compared with normal nonsmokers (130.2 +/- 5.5 ng/ml; p < 0.01) and patients who did not develop complications (211.5 +/- 23.3 ng/ml; p < 0.01). The maximum complex/WBC count was also significantly higher in patients with pneumonia (0.56 +/- 0.12) and ARDS (1.03 +/- 0.27), compared with normal nonsmokers (0.03 +/- 0.002; p < 0.01) and patients without complications (0.09 +/- 0.01; p < 0.01). These findings suggested a possible correlation between increased levels of complex and the onset of ARDS.
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PMID:Serial measurements of plasma elastase alpha 1-proteinase inhibitor complexes in patients receiving cancer chemotherapy. 833 42

The acute phase C-reactive protein (CRP) was measured in serum of HIV-infected patients suffering from Pneumocystis carinii pneumonia (PCP) (32 patients), bacterial pneumonia (10 patients), and in 19 immunocompetent patients with bacterial pneumonia. The HIV-infected patients with bacterial pneumonia had a significantly lower CRP level than the immunocompetent patients (50% versus 95% had an s-CRP level > 80 mg/l). No significant difference was found in the CRP response to P. carinii or bacteria in HIV-infected patients with pneumonia due to these microorganisms (20% versus 50% had s-CRP > 80 mg/l). In the group of PCP patients, a significantly lower CRP level was found in those with CD4 positive lymphocyte counts below 50 x 10(6)/l. There was no correlation between the CRP response and the severity of the PCP as estimated by the degree of hypoxia. We conclude that the CRP level cannot be used to discriminate between PCP and bacterial pneumonia in HIV-infected patients.
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PMID:The C-reactive protein responses in HIV-infected patients with pneumonia. 836 26

In a case-control study in 398 neonates the value of measuring the levels of neutrophil elastase-alpha 1 proteinase inhibitor (EPI) for early diagnosis of neonatal infection was studied in comparison to the commonly used parameters of leukocyte count, ratio of immature to total granulocytes and C-reactive protein levels. Investigations were performed on day 1 or day 6 of life. On the basis of the clinical findings patients were allocated to one of the three following groups: healthy neonates (group A), neonates with local infections such as pneumonia or skin infection (group B) or neonates with septicemia as demonstrated by a positive blood culture (group C). The median EPI levels (with range) measured on day 1 were: group A 40 (15-65) micrograms/l, group B 120 (80-260) micrograms/l, group C225 (140-355) micrograms/l. The levels on day 6 were: group A 27.5 (5-55) micrograms/l, group B 105 (65-370) micrograms/l, group C 182.5 (74-450) micrograms/l. EPI thus discriminated well between healthy neonates and neonates with infection, but not between neonates with infection and neonates with septicemia.
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PMID:Value of measurement of neutrophil elastase-alpha 1 proteinase inhibitor levels in the early diagnosis of neonatal infection. 840 19

Viral and bacterial antigen and antibody assays were prospectively applied to study the microbial aetiology of community-acquired pneumonia in 195 hospitalised children during a surveillance period of 12 months. A viral infection alone was indicated in 37 (19%), a bacterial infection alone in 30 (15%) and a mixed viral-bacterial infection in 32 (16%) patients. Thus, 46% of the 69 patients with viral infection and 52% of the 62 patients with bacterial infection had a mixed viral and bacterial aetiology. Respiratory syncytial virus (RSV) was identified in 52 patients and Streptococcus pneumoniae in 41 patients. The next common agents in order were non-classified Haemophilus influenzae (17 cases), adenoviruses (10 cases) and Chlamydia species (8 cases). The diagnosis of an RSV infection was based on detecting viral antigen in nasopharyngeal secretions in 79% of the cases. Pneumococcal infections were in most cases identified by antibody assays; in 39% they were indicated by demonstrating pneumococcal antigen in acute phase serum. An alveolar infiltrate was present in 53 (27%) and an interstitial infiltrate in 108 (55%) of the 195 patients. The remaining 34 patients had probable pneumonia. C-reactive protein (CRP), erythrocyte sedimentation rate and total white blood cell count were elevated in 25%, 40% and 36% of the patients, respectively. CRP was more often elevated in patients with bacterial infection alone than in those with viral or mixed viral-bacterial infections. No other correlation was seen between the radiological or laboratory findings and serologically identified viral, bacterial or mixed viral-bacterial infections.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Aetiology of community-acquired pneumonia in children treated in hospital. 912 28

In 277 patients admitted to hospital for community-acquired pneumonia (CAP) an aetiologic diagnosis was established in 68% with S. pneumoniae being the predominating agent. Four percent of the patients (12/277) died during their hospital stay, and only one of these patients was below 60 years of age. On admission, the most important factor, independently associated with fatal disease was a low serum albumin concentration, which was also a negative prognostic factor for the course of the survivors. In patients admitted to hospital for CAP, the finding of a low serum albumin level should therefore lead to intensified observation and treatment. Of 241 patients discharged after treatment for CAP, 50 patients were readmitted to hospital with recurrence of pneumonia during a 31 month follow-up period. This pneumonia incidence rate was more than five times that in a control population. Fifty-one of the patients (21%) died during follow-up, with 13 (25%) of the deaths directly associated with pneumonia. Systemic treatment with corticosteroids was associated with a higher risk of recurrence of pneumonia and death, while airway colonisation with Gram-negative enteric bacteria and a serum albumin below 30 g/l during hospital treatment of the initial pneumonia were associated with death from pneumonia after discharge. In 97 middle-aged and elderly patients admitted to hospital for CAP, malnutrition reflected by low triceps skinfold (TSF) and body mass index (BMI) values was associated with death during a six-month follow-up period, as was severity of disease on admission classified according to acute physiology and chronic health evaluation (APACHE II). Admission serum concentrations of orosomucoid and alpha-1-antitrypsin were most closely correlated with in-hospital morbidity measured as days spent in hospital and duration of fever. The risk of readmission within six months of discharge was higher in patients with high admission levels of APACHE II and TSF. Measurement of serum concentrations of alpha-1-antitrypsin and orosomucoid on admission should be considered in order to better predict hospital morbidity in these patients. Measurements of APACHE II and TSF on admission may give additional prognostic information on the interval from admission to six months after discharge. On admission 64% of the patients were hypoalbuminaemic, but only 6-10% were so at follow-up visits. Admission serum albumin concentration correlated negatively with investigated acute-phase proteins, and positively with other serum transport proteins, but no association with investigated nutritional measurements was found. The main reason for depressed serum albumin in elderly patients with pneumonia thus seems to be not malnutrition, but the inflammatory reaction per se. In 203 hospital-treated patients with CAP, the diagnostic and prognostic value of admission serum levels of interleukin-6 (IL-6) and C-reactive protein was investigated. The highest levels of IL-6 and CRP were found in patients with pneumococcal pneumonia, especially when bacteraemic. Patients with high IL-6- or CRP levels had longer duration of fever, longer hospital stay, and fewer had recovered clinically or radiographically at follow-up eight weeks after discharge. A high IL-6, but not a high CRP, also seemed to be associated with a higher mortality. The type-specific antibody responses to six pneumococcal capsular polysaccharide antigens included in the 23-valent vaccine as well as antibodies against the vaccine were measured by use of an enzyme-linked immunosorbent assay in 65 middle-aged and elderly individuals treated in hospital for pneumonia eight weeks prior to vaccination. The antibody concentrations before and after the vaccination were comparable with those in a vaccinated age-matched control group who had not recently been treated for pneumonia...
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PMID:Community-acquired pneumonia requiring hospitalisation. Factors of importance for the short-and long term prognosis. 858 66

A 71-year-old Japanese female, was found unconscious by drawing, in a hot spring spa, at around noon of 20 October 1994. She recovered by emergency cardiopulmonary resuscitation, and admitted to the Takinomiya General Hospital, with adult respiratory distress syndrome (ARDS). Although she recovered from ARDS within 4 days after her admission, she developed severe pneumonia accompanied with the second attack of ARDS. Ordinary bacteriological culture of her respiratory specimens failed to yield any significant pathogen for her pneumonia, and neither cefazolin nor imipenem/cilastatin was effective. Thus minocyclin was given on the 7th hospital-day and this was effective for blood gas and C-reactive protein (CRP) levels. Intratracheal exsudate inoculated on BCYE alpha agar plate yielded grayish white colonies. Cells of the colonies were clearly agglutinated by anti-Legionella pneumophila serogroup (SG) 3 serum. Antibody titers of patient's paired sera against the strain L. pneumophila SG3 Bloomington-2 and the patient's strain (Y-1) were determined by microplate agglutination test, and a significant rise from 1:20 to 1:320 was demonstrated. Patient recovered by erythromycin treatment and was discharged on the 59th hospital day. L. pneumophila SG3 organisms were again isolated from the spa water where the patient drawn. From these findings described above, we diagnosed the patient as pneumonia due to L. pneumophila SG3, and the spa water was the most probable source of infection.
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PMID:[Legionella pneumophila serogroup 3 isolated from a patient of pneumonia developed after drowning in bathtub of a hot spring spa]. 858 87

The diagnostic and prognostic value of admission serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) was investigated in 203 hospital-treated patients with community-acquired pneumonia (CAP). In serum samples obtained during the first 24 h after admission, IL-6 was detectable in 198 patients (98%), with a median value of 50 ng/l. Ten % of the patients had IL-6 values of 1000 ng/l. A clear positive correlation between IL-6 and CRP was found (r = 0.29, p < 0.0001). Patients with high IL-6 or CRP levels had longer duration of fever, longer hospital stay, and had less often recovered clinically or radiographically on follow-up weeks after discharge. A high IL-6, but not a high CRP, also seemed to be associated with a higher mortality. Bacteremic pneumococcal pneumonia had the highest levels of IL-6 (mean 2852 and median 420 ng/l) and CRP (mean 292 and median 285 mg/l). High IL-6 values were also seen in patients with non-bacteremic pneumococcal pneumonia, while all patients with pneumonia due to other bacterial, or viral, aetiology had IL-6 levels of < or = 300 ng/l. In conclusion, IL-6 and CRP are promising diagnostic and prognostic tools in the management of CAP. Further studies are needed to establish the usefulness of repeated measurements early in the hospital course of the disease.
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PMID:Diagnostic and prognostic value of interleukin-6 and C-reactive protein in community-acquired pneumonia. 858 35

C-reactive protein (CRP) in the patients with eosinophilic pneumonia was examined compared with that of bacterial pneumonia. While no difference between erythrocyte sedimentation rate (ESR) in eosinophilic pneumonia (mean +/- SE: 74.5 +/- 10.6 mm/hr) and that in bacterial pneumonia (86.2 + 7.7 mm/hr) was observed, serum CRP level (3.87 +/- 1.24 mg/dL) and alpha 2-macroglobulin level (182.53 +/- 13.00 mg/dL) in eosinophilic pneumonia were lower in comparison with those in bacterial pneumonia (14.89 +/- 1.34 mg/dL, 315.65 +/- 11.54 mg/dL, respectively), suggesting that the pathogenesis of eosinophilic pneumonia might involve defective secretion of certain cytokine related to the production of acute-phase reactant proteins such as interleukin-6.
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PMID:Possible low response of C-reactive protein production in eosinophilic pneumonia. 873 34


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