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

A randomized prospective study of the relative effectiveness of broad-spectrum versus specific antistaphylococcal antibiotic prophylaxis in open-heart surgery was done between May 1972 and June 1973. All patients undergoing open-heart surgery were assigned randomly (by hospital number) to receive either methicillin (M) or cephalothin (C) beginning the night before operation. There were 132 patients in the C group and 129 in the M group. There were no statistically significant differences in age or duration of hospitalization, cardiopulmonary bypass, urinary tract drainage, or postoperative fever. There was a significant difference in the ratio of male to total patients (0.67 C, 0.52 M, P less than .02) and duration of operation in hours (4.27 C, 3.87 M, P less than .02). A statistically significant higher rate of urinary tract infection (3 C, 22 M, P less than .05), pneumonia (0 C, 9 M, P less than .01), and episodes of sepsis and prosthetic endo carditis (0 C, 11 M, P less than .001) was found in the methicillin group. The incidence of wound infections and positive cultures from blood obtained immediately after termination of cardiopulmonary bypass was not significantly different. Cephalothin replaced methicillin as the routine antibiotic prophylaxis for open-heart surgery at our institution.
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PMID:Open-heart surgery. 33 7

Kawasaki disease (KD) often presents as an acute multisystem febrile illness which is most often self-limiting. During an 11-year period, 39 patients with KD, aged 11 weeks to 15 years (mean 2.5 years), were admitted to the Queen Elizabeth Hospital, Barbados. Eighty-seven per cent of children were less than 4 years of age. There were 26 males (67%) and 13 females (33%) with a sex ratio of 2:1. A peak occurrence was observed in 1985 and the mean hospital stay of cases was 12.7 days. Treatment regimens included antibiotics in 36 patients (93%), aspirin in 32 (82%) and steroids in 3 (7%). Major complications were observed in 11 patients (26%), with these being gastrointestinal bleeding in 1, broncho-pneumonia in 3 and cardiac abnormalities in 7 (18%). Among the latter were abnormal proximal coronary arteries in 5 patients (2 with dilatation and 3 with aneurysms) and carditis in 2. Other complications included croup (1), hydrops of the gallbladder (2), paralytic ileus (1), and abnormal focal neurological signs in two patients. There were no deaths. Follow-up ranged between one month and four years. Although KD often presents as a benign self-limiting illness, it is extremely important to make a diagnosis early in the course of the illness, institute appropriate therapy and be on the alert for possible fatal complications.
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PMID:Outcome of Kawasaki disease in Barbados. 152 36

Bone marrow transplantation is the treatment of choice of many haematological disorders but its success is limited by two major complications, graft-versus-host disease (GVHD) and pulmonary disorders. Of the first 31 patients transplanted at St. James's Hospital (1984-1986) 16 (52%) had a successful outcome. Of the 15 patients who died, two died of GVHD and one of recurrent leukaemia. All others had severe pulmonary disease either causing death directly (9 cases) or contributing to death from toxic encephalopathy, carditis or recurrent leukaemia (1 case each). The principal forms of pulmonary disease were cytomegalovirus pneumonitis (4 cases), acute haemorrhagic pulmonary oedema (4 cases) and pneumocystis carinii pneumonia (2 cases). There were single cases of staphylococcal pneumonia and idiopathic pulmonary fibrosis. Aspergillus was a second pathogen in two cases. Pulmonary damage due to conditioning chemoradiotherapy and to GVHD probably underlies this high incidence of pulmonary disease. T-cell depletion to limit the incidence of GVHD together with increased prophylaxis against CMV and pneumocystis carinii will probably substantially reduce these complications in the near future.
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PMID:Pulmonary disease following allogeneic bone marrow transplantation. 266 67

Skin rash, fever, and eosinophilia developed in a previously healthy 35-year-old woman three weeks after starting carbamazepine. Fulminant respiratory and renal failure ensued. Autopsy showed pneumonitis, nephritis, serositis, pancreatitis, hepatitis, and carditis, characterized by an infiltrate of eosinophils and lymphocytes. The severity, duration, and extensive organ involvement of the reaction make this case unique.
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PMID:Carbamazepine-induced severe systemic hypersensitivity reaction with eosinophilia. 322 45

Pulmonary involvement in acute rheumatic fever is rare. Clinical and laboratory findings in rheumatic pneumonia are non-specific. Most of the cases of rheumatic pneumonia described in recent years have had a fulminant course often resulting in death. Autopsy findings are suggestive of but not specific for rheumatic pneumonia. In this article a case of pneumonia associated with acute rheumatic fever is described. Pneumonia and carditis occurred simultaneously in a 10-year-old boy treated without steroids, which resulted in recovery. The clinical spectrum of rheumatic pneumonia can range from mild to fulminant.
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PMID:Pneumonia associated with acute rheumatic fever. 382 66

The frequency of human infections caused by Campylobacter (C.) jejuni is thought to be at present as significant as that of the gastroenteric salmonelloses. The clinical symptoms are mostly like enteritis, enterocolitis, acute abdomen or ileitis terminalis. Post-infection reactions are possible not only as arthritis or septicemia but also as meningitis, conjunctivitis, carditis, pneumonia, cholecystitis, peritonitis, urinary tract infection and abortion. Only cultural examinations confirm the diagnosis of an infection with C. jejuni. If chemotherapy is required, erythromycin is the remedy of choice. Animals are an important reservoir for C. jejuni, but the epidemiology of human infections with this microorganism is not well understood.
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PMID:[Campylobacter jejuni--a "recent" pathogen worthy of study. Present knowledge on its clinical aspects, diagnosis, therapy and epidemiology]. 675 59

From the patients of the Cardiologic Department of the Medical Clinic of Leipzig University 34 adult patients aged 21 to 62 years with the diagnosis of Eisenmenger's syndrome confirmed by heart catheterization were established. The cases in question were 20 ventricular septum defects, 8 atrial septum defects and 6 open arterial ducts. In 26 of the 34 patients first symptoms appeared already during the preschool period, in 4 patients with atrial septum defect in the 12th year as well as between the 35th and 46th year of age, in 4 patients with ventricular septum defect twice in the 8th or 26th and 50th year of age, respectively. The average time of diagnostics from the beginning of the complaints to the heart catheterization was with 15 years and 3 months very long. The average survival time after diagnosis of shunt reversal by means of the heart catheter was 9.7 years in the ventricular septum defect, 5.6 years in the atrial septum defect and 3.8 years in the open arterial ducts. Since 19 of the 34 patients with Eisenmenger's syndrome are still alive and the moment of the shunt reversal does not correspond to the moment of the diagnostics, the average life expectancy is greater. It is higher than the values given in literature, which vary between 2 and 10 years after the beginning of the shunt reversal. The progressing of the clinical picture could be objectified by annual increases of various parameters, such as hemoglobin, hematocrit, angle alpha QRS, Sokolov's index for right hypertrophy and radiologically established sizes of surface and diameter of the heart and the pulmonary vessels. Correlations of abrupt enlargements and acute diseases were found only for the prominence of the pulmonary segment and the basal diameter of the heart. The examinations showed that in the course of Eisenmenger's syndrome the pulmonary hypertension, the polyglobulia, the right heart hypertrophy, the size of the heart and last not least the complaints increase continuously or in dependence of complications (heart insufficiency, carditis, pneumonia, embolism a.o.).
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PMID:[Evolution and prognosis of the adult Eisenmenger syndrome]. 734 7

The clinical diagnosis of acute rheumatic fever (ARF) may be challenging; however, a constellation of signs including new valvular insufficiency, cardiomegaly, and heart failure should readily prompt consideration of the diagnosis of rheumatic carditis. In addition, pulmonary findings are compatible with ARF, as associated pulmonary involvement may represent rheumatic pneumonia. We report the case of a young man with ARF and rheumatic pneumonia, a previously described but rare complication of ARF.
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PMID:Rheumatic pneumonia: reappearance of a previously recognized complication of acute rheumatic fever. 864 92

Twenty-six persons from five families comprising 34 members residing in different areas of Saptari district of the eastern region of Nepal developed symptoms of epidemic dropsy over 6-8 weeks. Seventeen patients were studied during July-August 1996. The age of affected individuals varied from 3 to 75 years. Members who had not consumed food cooked in mustard oil or who were not residing with the family were spared. Mustard oil, which was used for cooking, was found to be contaminated with oil of Argemone mexicana seeds. Sanguinarine was detected in all mustard oil samples collected from the homes of affected families. Gastrointestinal symptoms were present in 82 per cent of cases a week or so prior to the onset of pedal oedema. Pitting oedema of the lower limbs, fever, and darkening of the skin were the most consistent features, found in all cases. Other prominent features such as local erythema (82 per cent) and tenderness (88 per cent) of the lower limbs were present in most cases. Two striking features not previously noted were perianal itching (100 per cent) and severe carditis (35 per cent) with congestive cardiac failure (29 per cent). Other unique features noted were 'sarcoid' skin changes (18 per cent), bilateral pleural effusion, and Roth's spots and subhyloid haemorrhages in the fundus in one patient. Other important findings were anaemia (88 per cent), hepatomegaly (41 per cent), pneumonia (35 per cent) and ascites (12 per cent). There were no deaths due to epidemic dropsy. In the majority of cases, oedema, cutaneous changes, and carditis showed a marked improvement in 2-3 weeks and patients were well after 6-8 weeks of follow-up.
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PMID:Epidemic dropsy in the eastern region of Nepal. 1019 86

Legionella infection can manifest itself in many clinical forms, most commonly as pneumonia, but rarely in the form of myocardial involvement. Legionella with myocardial involvement independent of pneumonia is almost never seen in the adult population and therefore is cited only a handful of times in the medical literature. When reported, Legionella carditis itself typically occurs as an isolated pericarditis with effusion. Cases of isolated Legionella with myocardial involvement, but without associated pneumonia, have been reported among children. To our knowledge, there are no reported cases of Legionella myocarditis and pericarditis presenting concurrently with or without pneumonia, in either an adult or a pediatric population. Herein, we report a rare manifestation of Legionella pneumophila-induced perimyocarditis (strongly suspected, if not incontrovertibly proved) in an adult, in the absence of pneumonia.
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PMID:Suspected Legionella-induced perimyocarditis in an adult in the absence of pneumonia: a rare clinical entity. 2006 90


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