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

A murine model of lethal cytomegalovirus pneumonia following intratracheal inoculation of normal mice was used to study the effects of antiviral therapy with acyclovir (ACV) and interferon (IF), alone and in combination. Five hundred units of fibroblast IF administered intraperitoneally the day prior to infection and 100 mg/kg/day ACV administered intraperitoneally for 7 days beginning within 3 h of infection were both highly effective in preventing mortality. Compared to the condition of untreated animals, each drug reduced viral titers in lung homogenates of the treated animals 7 days after infection. However ACV, unlike IF, diminished viral growth in the lung at 14 days, prevented viral dissemination to spleens and salivary glands in some animals, and significantly protected animals from reactivation of virus during immunosuppression 2 months after infection. The combination of ACV + IF offered no increased antiviral activity compared to ACV alone and failed to protect animals from reactivation. In these experiments the overall antiviral activity of ACV alone was greater than IF and the combination of ACV + IF.
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PMID:Treatment of murine cytomegalovirus pneumonia with acyclovir and interferon. 618 51

The results of combined therapy of patients with influenza complicated with pneumonia using levamisole (decaris) as an interferon inducer are presented. The study group included 39 subjects, the control 35. The group of patients receiving the drug showed in the convalescent period a higher titre of the antiviral activity of serum interferon (1 : 24) than the control group (1 : 17). The antiviral activity of interferon in the blood serum was determined in patients with different degrees of severity of the disease course, and comparative clinical observations in relation to the levels of its antiviral activity and its content in the blood serum were carried out. No rise of interferon content was observed in the protracted course of the disease. In severe forms ending lethally there was a considerable decline of interferon levels (down to 0 units). A rise in its concentration in the blood serum was conducive to a more rapid recovery and favourable outcome of the disease. The drug is recommended for combined therapy of complicated forms of influenza, particularly those with a severe course.
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PMID:[Results of combined therapy using levamisole for patients with influenza complicated by pneumonia]. 620 28

A 36-year-old man had chronic, debilitating diarrhea due to cryptosporidiosis. This patient had longstanding common variable hypogammaglobulinemia and recurrent bacterial infections. Immunologic evaluation after discovery of Cryptosporidium showed lymphopenia with persistently reduced numbers of helper/inducer cells (OKT-4), variable numbers of suppressor/cytotoxic cells (OKT-8), OKT-4/OKT-8 ratio of 0.09, and increased levels of serum alpha-interferon, all of which describe the acquired immunodeficiency syndrome. Oocysts of Cryptosporidium were found in feces from the patient's cat, thus identifying a possible source of his infection. The patient had disseminated candidiasis, cytomegalovirus pneumonia, and cryptosporidiosis when he died.
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PMID:Cryptosporidiosis in a patient with hemophilia, common variable hypogammaglobulinemia, and the acquired immunodeficiency syndrome. 622 62

The significance of the natural killer (NK) cell response to murine cytomegalovirus (MCMV) infection was evaluated in C3H/HeN mice. This strain was selected for study after preliminary demonstration that the NK cell response, occurring between 3 and 6 days post-infection was relatively high in comparison to other mouse strains studied. A dose-response effect of hydrocortisone treatment on suppression of this response was found. A dose of hydrocortisone, given subcutaneously on two successive days, which was found to markedly inhibit the NK cell response, had no effect on development of serum interferon or antibody levels, or spleen cytotoxic T cell activity under the conditions studied. Suppression of the NK cell response by this treatment, however, was accompanied by enhanced spleen and pulmonary virus replication in vivo and increased susceptibility of mice to lethal infection. MCMV interstitial pneumonitis was characterized histologically and lung lymphocytes studied at 4 days post-infection were found to have increased NK cell activity. Treatment of mice with hydrocortisone was found to inhibit development of gross and histological evidence of pneumonitis. These findings indicate that NK cells are involved in the pathogenesis of MCMV interstitial pneumonitis and may function early in infection to restrict the extent of virus replication.
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PMID:Involvement of natural killer cells in the pathogenesis of murine cytomegalovirus interstitial pneumonitis and the immune response to infection. 629 42

Cytomegalovirus (CMV) was repeatedly isolated from urine and saliva of a 20-month-old male child with recurrent episodes of pneumonia, high fever, rash, lymphadenopathy, oral ulceration, and neutropenia. Immunologic evaluation revealed decreased serum IgG and IgA, increased IgM, depressed T- and B-lymphocyte functions, and decreased natural killer (NK) activity for herpes simplex-type I virus-infected targets. NK activity was augmented following exposure of the patient's lymphocytes to interferon (IF) in vitro. The child was treated with interferon (four courses, dosage varying from 2 million U/day to 1 million U three times/week for periods of 10, 28, 80, and 67 days, respectively, interspersed over 9 months) and hyperimmune plasma infusions every 3 weeks. Toward the end of interferon therapy oral Levamisole was started and a feeding gastrostomy was inserted to provide nutritional support. Clinical recovery was associated with reversal of immunologic abnormalities except for the hypogammaglobulinemia. Aggressive antiviral therapy (e.g., with IF) followed by immunostimulation (e.g., with Levamisole) may prove effective in controlling certain viral infections in immunodeficiency disorders.
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PMID:Persistent cytomegalovirus infection: association with profound immunodeficiency and treatment with interferon. 630 74

Six marrow-transplant patients with serious virus infections (four with cytomegalovirus and two with adenovirus) were treated with recombinant leukocyte alpha interferon at daily doses of 6,000,000-50,000,000 units to determine safety and tolerance. Fever and gastrointestinal side effects attributable to interferon occurred in two patients each. Hepatic function abnormalities were observed in all six patients, although five had such abnormalities before treatment. Treatment of one patient was stopped because of apparent suppression of marrow activity. Natural cytotoxic activity increased in the four patients treated for cytomegalovirus infection. All six patients died of pneumonia, with four proven to have cytomegalovirus-related pneumonia at autopsy. Except for the presence of abnormal hepatic function, recombinant leukocyte alpha interferon was well tolerated after marrow transplantation. Efficacy remains to be established in treatment or prophylactic trials.
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PMID:Recombinant leukocyte A interferon for the treatment of serious viral infections after marrow transplant: a phase I study. 631 15

Thirteen recipients of bone marrow transplants were given high-dose acyclovir and alpha-interferon (Cantell interferon) for the treatment of biopsy-proven cytomegaloviral pneumonia. Three patients survived. Doses of acyclovir between 500 and 1,000 mg/m2 of body surface area (peak plasma levels, 7-86 micrograms/ml) and doses of interferon between 2 X 10(4) and 40 X 10(4) units/kg per day (peak serum levels, 5-608 units/ml) were given. No consistent antiviral effect was seen despite the large doses employed. Possible marrow toxicity associated with this regimen occurred in five patients, neurologic symptoms in two, and nephrotoxicity in one. Thus, treatment with high-dose acyclovir plus alpha-interferon was moderately toxic but ineffective against cytomegaloviral pneumonia after bone marrow transplantation.
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PMID:Treatment of cytomegaloviral pneumonia with high-dose acyclovir and human leukocyte interferon. 631 16

Despite the lack of virus-specified thymidine kinase activity, human cytomegalovirus may be sensitive to acyclovir in vitro at concentrations between 10 and 25 mg/l. The inhibitory effect of acyclovir can be further increased by the presence of small amounts of human alpha or beta interferon. Twenty-one allogeneic marrow graft recipients with biopsy-proven cytomegalovirus pneumonia were treated with either high doses of acyclovir (eight patients) or the combination of acyclovir and human alpha (leukocyte) interferon (13 patients). Acyclovir doses of 400 to 1200 mg/m2/dose and interferon doses of 2 to 40 X 10(4) units/kg/day were used. There was no consistent effect of treatment on the likelihood or duration of survival, titre of virus in paired lung specimens, or shedding of virus. However, four patients survived and four others had 2-log or greater decreases in the amount of virus in paired lung specimens, suggesting a possible effect on cytomegalovirus strains with increased sensitivity to these agents. Acyclovir treatment of cytomegalovirus infection may be more effective in patients with lesser degrees of immunosuppression, but was not effective in the treatment of marrow transplant patients with cytomegalovirus pneumonia.
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PMID:The use of acyclovir for cytomegalovirus infections in the immunocompromised host. 631 97

Therapeutic intervention of varying potency and toxicity is now available for bacterial, fungal, parasitic, and viral pneumonia, but the problem of establishing the precise origin to evaluate treatment protocols remains. Antibacterial agents reduce postinfluenzal morbidity and mortality. Earlier appropriate treatment of gram-positive coccal infections has reduced mortality to less than 10 percent unless bacteremia is present. Gram-negative bacillary pneumonia remains a major problem and response rates do not exceed 65 percent except in selected series in which two effective antimicrobial agents have been used. Nevertheless, the superiority of two agents has not convincingly been demonstrated in any retrospective series or prospective randomized trial; more efficacy data in patients with gram-negative pneumonia treated with the newer beta-lactam agents would be useful. Little information is available on the laboratory correlates of successful treatment of gram-negative pneumonia, such as sputum antibiotic levels. Moreover, aerosolization of antimicrobial agents has been used with reported success by some investigators, but this therapeutic approach remains controversial. Pneumonia or lung abscess due to anaerobes may require increasingly larger doses of penicillin or alternative antianaerobe agents. Parasitic pneumonias such as those due to Pneumocystis carinii have responded well to trimethoprim-sulfamethoxazole. Acyclovir appears effective against some herpes viruses (simplex and varicella zoster), but it has failed to affect cytomegalovirus pneumonia even when combined with interferon. Opportunistic fungal pneumonias are poorly treated with all available agents and usually do not respond unless there is amelioration of predisposing factors or improvement in underlying disease. The latter statement appears relevant in most patients with severely compromised host defenses and pulmonary infection.
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PMID:Treatment of respiratory infections in the patient at risk. 637 80

This paper presents clinical data on 41 patients (29 male and 12 female) from Haiti who presented with acquired immunedeficiency syndrome (AIDS). Their mean age was 32 years (range 17-61 years). 4 of thes cases were homosexual or bisexual; none was an illicit drug user or a hemophiliac. In addition, 3 of the female patients had sexual contact with a male partner with AIDS. 4 patients had received blood transfusions before their illness. The most prominent clinical symptom in this series was chronic diarrhea of 2-33 months' duration, which occurrred in 39 patients (95%). Also reporte were marked weight loss (95%), fatigue (95%), prolonger fever (90%), and nodular or maculopapular skin lesions (54%). Opportunistic infections in this series included oroesophageal candidiasis (88%) and intestinal cryptosporidiosis (31%). Tuberculosis developed in 22% of patients. Immunologic evaluation revealed profoundly depressed T-helper cells and an inverted T-helper/T-suppressor cell ratio. Biologic markers included elevated alpha-1 thymosin and beta-2 microglobulin levels, elevated immune complexes, and the presence of acid-labile interferon. Of interest were differences in the clinical expression of AIDS between this series and cases in the US. The Haitian data suggest a higher incidencs of female cases,a predominance of gastrointestinal symptoms rather than respiratory symptoms and lymphadenopathy, a frequent association with tuberculosis, and a relatively low incidence of Kaposi's sarcoma or P. carinii pneumonia compared to the situation in the US. As in the US, where most AIDS cases are concentrated in New York and California, most AIDS cases in Haiti are found in residents of Port-au-Prince and Carrefour, which are centers for male and female prostitution.
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PMID:Acquired immune deficiency syndrome: specific aspects of the disease in Haiti. 639 48


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