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

We report a patient with pathologic evidence of anterograde spread of varicella zoster virus (VZV) through the visual system. A 29-year-old homosexual man developed the acquired immunodeficiency syndrome (AIDS) 2 months before the onset of left herpes zoster ophthalmicus. During the next 11 months, the zoster infection progressed to involve the left eye, with resultant keratitis, iritis, retinitis, and eventual blindness. Later, the patient developed bilateral blindness, left hemiparesis, and fatal pneumonia. At autopsy, the brain revealed destruction of the visual system and adjacent structures, with sparing of the remainder of the brain. Glial cells near the areas of necrosis showed Cowdry type A intranuclear inclusions. In situ hybridization with probes to VZV nucleic acid sequences were positive in the necrotic brain and retinal areas. Hybridization with probes to cytomegalovirus, herpes simplex virus type II, human immunodeficiency virus, and Epstein-Barr virus were negative. Electron microscopy revealed characteristic herpes group nucleocapsids. This case provides insight into the mechanisms of virus dissemination and the production of encephalitis.
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PMID:Transsynaptic spread of varicella zoster virus through the visual system: a mechanism of viral dissemination in the central nervous system. 253 32

Viral pneumonitides are among the known pulmonary complications of human immunodeficiency virus (HIV) infection. Cytomegalovirus (CMV) pneumonitis is the most frequently recognized viral infection involving the lung. Although CMV may occasionally be the sole pathogen found to be responsible for severe pneumonitis in patients with the acquired immunodeficiency syndrome (AIDS), in most cases, its role in causing pulmonary disease is less clear, primarily because of the propensity to infect with a variety of other copathogens. CMV pneumonitis has been difficult to diagnose during life, although techniques utilizing in situ DNA hybridization or monoclonal antibodies for detection of the virus may improve the diagnostic yield of less invasive procedures such as bronchoalveolar lavage. Pneumonitis due to herpes simplex virus, varicella-zoster, and respiratory syncytial virus have occasionally been reported in AIDS patients, and are of practical importance because of the availability of effective treatment. The role of influenza and adenoviruses in causing HIV-related pulmonary complications is unknown, but could be of importance during outbreaks of these infections. Finally, data from several studies now suggest that Epstein-Barr virus or HIV itself or both have a role in the pneumonitis. Further study in this area could provide information leading to more effective management of this common complication of childhood AIDS.
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PMID:Pulmonary infection in human immunodeficiency disease: viral pulmonary infections. 254 36

Adult patients suffering from infection with the HIV-virus acquire pneumocystis carinii pneumonia in nearly 80 per cent and in the half of all patients the basic disease AIDS has been detected by this lung infection. In childhood the patients with AIDS show most frequently interstitial lung diseases due to pneumocystis carinii or to lymphoid interstitial pneumonia. Also recurrent bacterial pneumonia may frequently occur, likewise infections with the cytomegalovirus or the Epstein-Barr-virus causing atypical pneumonia. The identification of the aetiology of these lung diseases is more difficult in children than in adults. In future it should be necessary to include more often AIDS as the basic disease into the differential diagnostic considerations in cases of such lung infections.
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PMID:[Pulmonary complications in AIDS]. 268 58

Heart-lung transplantation is a surgical alternative for patients with end-stage lung disease with associated right heart failure. While the procedure is very promising, the morbidity and mortality remain high. The current understanding of the proper selection of candidates, procurement and preservation of donor organs, operative procedure and postoperative care continues to evolve. At the University of Pittsburgh, 70 heart-lung transplantations have been performed since 1982. Early infection and chronic rejection are the major factors influencing survival. Early (less than 2 weeks) intrathoracic infection occurred in 43% of heart-lung transplant recipients, with pneumonia being the most frequent infection. The incidence of pneumonia in heart-lung transplant recipients is twice that in a comparable group of heart recipients. Subclinical pneumonitis in the donor lung, abnormal muco-ciliary clearance and altered allogenic response in the transplanted lung are significant factors associated with the increased incidence of early infections. Chronic rejection, manifested as bronchiolitis obliterans, has occurred in 54% of heart-lung transplantation recipients. Infection caused by cytomegalovirus, Epstein-Barr virus and Pneumocystis carinii have been shown to increase the incidence of bronchiolitis obliterans, as have episodes of acute rejection. Recent reports of a 61% 2-year survival rate represent a substantial improvement over earlier trials. With a better understanding of the pathogenesis of infection in the transplanted lung as well as improved immunosuppressive agents, further improvements in survival can be expected.
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PMID:[New trends in combined transplantation of the heart and lungs]. 269 75

Diarrhea, pneumonia, and malnutrition account for most of mortality and morbidity in children in developing countries. The Expanded Program of Immunization (EPI) is making progress with more than 50% of children under the age of 1 year receiving vaccination against the 6 EPI-listed diseases. The eradication of poliomyelitis by 2000 is realistic, so that the world could be smallpox- and polio-free by the 21st century. In July-August 1988 a cholera epidemic erupted in Delhi, India in which several hundreds died. The combined whole cell and toxin-B subunit oral vaccine against cholera has shown a decrease in protection from around 75-80% at the end of 6 months to around 60% at the end of 2 years. Typhoid fever affecting close to 8 million people in Asia has been treated with the improved formulation of TY21A vaccine and with the Vi polysaccharide capsular surface antigen in encouraging trials in Nepal. Co-trimoxazole has reduced child mortality caused by acute lower respiratory tract infections at the community level. 3 oral antirabies vaccines have been found safe, and oral baits have been effective. Chloroquine-resistant Plasmodium falciparum malaria is a major problem in may Asian countries involving sulfadoxine-pyrimethamine combinations as well. Lymphatic filariasis is expressed clinically as elephantiasis. More than 90 million people are believed to be infected. Ivermectin in a single dose as low as 25 mcg/kg of body weight was shown to be microfilaricidal in lymphatic filariasis. Allopurinol riboside is effective against visceral leishmaniasis or kala-azar. Leprosy and tuberculosis continue to be major health problems in Asia. There have been encouraging advances in immunization against cancers of the tropics, such as hepatitis B and primary carcinoma of the liver, the human papilloma virus and cancer of the uterine cervix, the Epstein-Barr virus and Burkitt's lymphoma, and nasopharyngeal carcinoma.
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PMID:Perspectives on research and diseases of the Tropics: an Asian view. 269 93

In a retrospective study chest radiographs of 87 bone marrow transplant recipients were analysed. 36 patients had pulmonary complications with lung opacifications. Interstitial changes were more frequent than airspace pneumonias. The latter were caused by bacteria and fungi only. The most common cause of pulmonary complications was cytomegalovirus pneumonia. It was characterised uniformly by a bilateral diffuse interstitial pattern. Idiopathic interstitial pneumonias were indistinguishable from CMV infection. Pneumonias caused by Epstein-Barr virus and protozoa, diffuse radiation pneumonitis and leukaemic infiltrates were rare and also associated with interstitial changes.
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PMID:[Pulmonary complications following bone marrow transplantation as seen on the x-ray]. 282

Fatal T-cell lymphomas developed in three patients with a chronic illness manifested by fever, pneumonia, dysgammaglobulinemia, hematologic abnormalities, and extraordinarily high titers of antibody to the Epstein-Barr virus (EBV) capsid antigen (greater than 10,000) and early antigen (greater than 640) but low titers to the EBV nuclear antigen (less than or equal to 40). To understand the pathogenesis of these tumors better, we determined the immunophenotype of the tumor cells and analyzed tumor-cell DNA for EBV genomes and for lymphoid-cell gene rearrangements. More than 80 percent of the cells in tumors had an activated helper T-cell phenotype (T4, T11, la positive). The EBV genome was found by in situ hybridization in tumor tissue from each patient. Southern blot assay of DNA digests from one patient showed the same pattern as that of the EBV-infected marmoset line, B95-8. DNA digests from two patients showed a monoclonal proliferation of T cells determined on the basis of uniform T-cell-receptor gene rearrangements and a single band for the joined termini of the EBV genome. We conclude that EBV may infect T cells and contribute to lymphomas in selected patients with severe EBV infections.
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PMID:T-cell lymphomas containing Epstein-Barr viral DNA in patients with chronic Epstein-Barr virus infections. 283 53

Between 1976 and 1982, 113 children aged 6 months to 16 years with documented Epstein-Barr virus-induced infectious mononucleosis were studied prospectively, and in most instances serially. An unexpected finding was the large number of young children, less than 4 years old, with this disease. Children with infectious mononucleosis, in particular the very young, tended to have more rashes, significant neutropenia, abdominal pain (older children only), and possible hepatosplenomegaly than have been reported in adult patients. The intensity of the characteristic relative atypical lymphocytosis found in peripheral blood was age-related; it was less in the very young. Findings of failure to thrive, otitis media, and episodes of recurrent tonsillopharyngitis appeared to be unique or more closely associated with childhood disease. Complications such as thrombocytopenia with hemorrhagic manifestations, significant airway obstruction, and neurologic problems occurred more frequently whereas jaundice occurred less frequently than noted in adult patients. Six children, all less than 4 years old, developed pneumonia during the disease course. The increased availability of Epstein-Barr virus-specific testing should continue to expand our knowledge of this disease in children of all ages.
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PMID:Epstein-Barr virus infectious mononucleosis in children. I. Clinical and general laboratory findings. 298 84

Forty-four heart and five heart-lung transplant recipients with cytomegalovirus (CMV) infection were investigated for risk factors associated with symptomatic CMV infection (17 patients) and CMV pneumonia (eight patients). Symptomatic infection was associated with primary rather than reactivated infection (P less than .005), younger age (P less than .005), heart-lung transplantation (P less than .001), and significant rises in titer of antibody to the early antigen of Epstein-Barr virus (P less than .001). Among recipients of heart transplants, patients with cardiomyopathy more often had symptomatic disease due to CMV (P less than .05). CMV pneumonia was associated with heart-lung transplantation and, in patients with primary CMV infection, earlier positive cultures for CMV after transplantation (P less than .02). CMV viremia was found in all patients with symptomatic infection, including the eight patients with CMV pneumonia, and the frequency of positive buffy coat cultures for CMV was significantly higher in patients with symptoms than in patients without symptoms (P less than .001). Neither symptomatic CMV infection nor CMV pneumonia was significantly associated with the use of antithymocyte globulin, restricted to therapy for rejection, and the use of high doses of acyclovir in 11 patients had no demonstrable impact on CMV culture positivity.
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PMID:Morbidity of cytomegalovirus infection in recipients of heart or heart-lung transplants who received cyclosporine. 299 55

Three cases of cholesterol interstitial pneumonia in patients 3, 9 and 10 years of age respectively are reported. All three were born in Island of Reunion. Two were sisters. All had failure to thrive, dyspnea on rest and clubbing. Respiratory symptoms had appeared early in infancy. Open pulmonary biopsy was diagnostic. Prognosis was poor the boy dying at 4 years of age and severe respiratory insufficiency at 9 or 10 years in the two girls. Current etiological investigations were non contributory. However a profile of chronic infection with Epstein Barr virus (EBV) was found in each case while serological profiles ruled out infection with a virus of the herpes group virus (cytomegalovirus, herpes simplex). The possible role of EBV as an etiological agent of cholesterol pneumonia is discussed and genetic or environmental factors as well.
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PMID:[Cholesterol pneumopathy in children. Apropos of 3 cases. Possible role of chronic Epstein-Barr virus infection]. 300 Mar 13


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