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

The Centers for Disease Control conducted a case-control study to investigate an outbreak of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men. The occurrence of these diseases was found to be associated with certain aspects of lifestyle, including a greater number of male sex partners per year, exposure to feces during sex, history of syphilis and non-B hepatitis, treatment for enteric parasites, and use of various illicit substances. Laboratory studies reflected both this lifestyle and the probable underlying cause of the Kaposi's sarcoma and P. carinii pneumonia--cellular immune deficiency. Patients were found to have lymphopenia, specifically a deficiency of the T-helper subpopulation, resulting in a reversal of the T-helper to T-suppressor ratio. Levels of IgG and IgA were increased. When compared with controls, patients were also found to have significantly higher titers of antibody to Epstein-Barr virus and cytomegalovirus, a higher prevalence of antibody to hepatitis A virus and Treponema pallidum, a lower prevalence of antibody to varicella zoster virus, and a higher frequency of isolation of cytomegalovirus.
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PMID:National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 2. Laboratory results. 630 49

Cloned fragments of the Epstein-Barr virus (EBV) genome were used to examine tissues from 145 patients for the presence of EBV DNA by two techniques: (1) nucleic acid hybridization of cell spots from which the DNA had been extracted in situ and (2) hybridization of DNA that had been transferred to nitrocellulose by Southern blotting. EBV DNA was found in tissues from four adults and five children with American Burkitt's lymphoma, infectious mononucleosis, lymphoma following bone marrow transplant, central nervous system lymphoma, nasopharyngeal carcinoma, and fatal polyclonal B-cell lymphoma following mononucleosis; two patients also had chronic pneumonitis, failure to thrive, and abnormal immune function. Six of the nine patients whose tissues contained EBV DNA had a demonstrable or presumed associated immunologic disorder. EBV DNA was not found in normal tissues or in a variety of hematologic neoplasms and other disorders. Nucleic acid hybridization methods can be used for the routine examination of the association of EBV with lymphomas and other lymphoproliferative syndromes occurring in immunodeficient individuals.
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PMID:Use of cloned probes to detect Epstein-Barr viral DNA in tissues of patients with neoplastic and lymphoproliferative diseases. 631 74

We report a case involving a young adult who had life-threatening bilateral pneumonitis in the course of an acute Epstein-Barr virus (EBV) infection. Because of severe hypoxemia, the patient required mechanical ventilation and additional oxygenation by an intravascular oxygenator. The patient was treated with corticosteroids and survived without sequelae. Severe pulmonary involvement associated with EBV infection is a rare but potentially fatal complication of infectious mononucleosis. Similar cases reported in the literature are reviewed, and the therapeutic options for this particular complication are discussed.
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PMID:Severe respiratory insufficiency complicating Epstein-Barr virus infection: case report and review. 757 34

Epstein-Barr virus-induced lymphoproliferative syndrome (EBV-LPS) is associated with OKT3 therapy in transplant patients. Response to chemotherapy or radiation is generally poor, while polyclonal EBV-LPS has had favorable responses to therapy with CD21 and CD24 monoclonal antibodies. Oligoclonal disease has not been previously reported to respond to therapy with CD21 and CD24. We report a 27-y old woman who developed a monoclonal EBV-LPS (confirmed by southern analysis of tumour for EBV DNA) after 180 mg of OKT3 for a multivisceral transplant. The patient achieved clinical remission for more than 2 months, but later died from cytomegalovirus pneumonia. Levels of CD21 and CD24 were > 2000 ng/ml during therapy and no human anti-mouse antibodies were formed. Peripheral blood B cells were cleared during therapy. We conclude that CD21 and CD24 monoclonal antibodies may be of value in the therapy of oigoclonal EBV-LPS, and merit further study.
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PMID:Anti-B cell antibodies for the treatment of monoclonal Epstein-Barr virus-induced lymphoproliferative syndrome after multivisceral transplantation. 789 25

During a 2-year period, 49 patients underwent heart transplantation at Rigshospitalet, Copenhagen. Nine (18%) were females and the mean age for all patients was 44 years (range 14-56 years). Immunosuppressive therapy included cyclosporin, azathioprine and steroids in all patients. 43 patients received in addition short-term (approx. 4 days) induction treatment with antithymocyte immunoglobulin (ATG). 17 patients received ATG Fresenius, 2.5 mg/kg/day or ATGAM, 12.5 mg/kg/day, whereas the remaining 26 patients received ATG Merieux, 2.5 mg/kg/day. Prophylactic antimicrobial chemotherapy included ceftriaxone, acyclovir (1 g daily), nystatin, and pyrimethamine in toxoplasmosis mismatch patients. Serological assays for cytomegalovirus (CMV), Epstein-Barr virus, varicella-zoster virus, herpes simplex virus, legionella and toxoplasmosis as well as CMV and bacterial culturing were carried out before transplantation, at regular intervals and when clinically indicated. Five patients developed septicaemia. Nine had pulmonary bacterial infections, including 2 cases of legionella pneumonia. Two had Clostridium difficile diarrhoea. Three patients had Pneumocystis carinii pneumonitis. 24 patients (49%) had evidence of CMV infection/reactivation. Seven out of 10 CMV mismatch (pos donor/neg recipient) patients and 3 out of 12 CMV match (pos donor/pos recipient) patients developed clinical CMV disease. The rate of CMV infection/reactivation was significantly higher among patients who had CMV-positive donors (p < 0.01) and among patients receiving ATG Merieux induction treatment (p < 0.0001). Logistic regression analysis showed that both positive CMV donor status and ATG Merieux induction treatment were significant independent predictors of CMV infection. Six patients (12%) died. Two out of 4 infection related deaths could be ascribed to CMV disease.
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PMID:Cytomegalovirus infection rate among heart transplant patients in relation to anti-thymocyte immunoglobulin induction therapy. Copenhagen Heart Transplant Group. 793 22

We report 11 cases of gastric lymphoma that harbor the Epstein-Barr virus (EBV) encoded small messenger RNA, EBER-1, detected by in situ hybridization. The cases represented 18% of 61 consecutive gastric lymphomas from three institutions in Hong Kong between 1988 and 1993. The mean age of patients was 62 years (range, 33 to 87). The male to female ratio was 5:6. Nine of the 11 (81.8%) EBER-1+ gastric lymphomas were diffuse large cell lymphomas of B-cell type without low grade components. Macroscopically these lymphomas appeared either as large noncleaved cell (centroblastic) or immunoblastic type. From the available follow-up data, five of the nine patients with B-cell lymphoma were alive and well 48, 40, 14, 13, and 12 months, respectively, after gastrectomy and chemotherapy. One patient died of postoperative pneumonia and one died of a second malignancy (esophageal squamous carcinoma) 40 months after gastrectomy. None of the EBER-1+ B-cell gastric lymphomas showed histological features characteristic of low grade lymphoma of the mucosa-associated lymphoid tissue (MALT) type reported to be common in some Western countries. Of the two patients with T-cell lymphoma, one had a pleomorphic T-cell lymphoma and the other had an angiocentric lymphoma. The former was lost to follow-up after the biopsy and the latter presented with gastric perforation and died 1.5 months after gastrectomy. It is concluded that a significant proportion of gastric lymphomas in Hong Kong Chinese are EBV-related and that they show histological features more akin to conventional node-based lymphomas than to MALT-type lymphomas.
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PMID:Epstein-Barr virus-associated gastric lymphoma in Hong Kong Chinese. 808 72

Thirty-nine paraffin-embedded transbronchial biopsies from ten lung transplant recipients were evaluated by the polymerase chain reaction for the presence of Epstein-Barr virus (EBV). Six of these patients had positive EBV serology. Nine biopsies from nine non-transplant patients with nonspecific interstitial pneumonitis were studied as a control group. Eight biopsies from four of the ten transplant patients (40%) were positive for EBV by polymerase chain reaction, utilizing 40 cycles and two sets of primers (501/502) complementary to sequences within the Bam H1 W region of the viral genome. Five of these eight positive biopsies had been diagnosed as mild acute cellular rejection based on clinicopathologic criteria. Three of the four EBV-positive patients showed clinical improvement with antiviral agents prescribed for concomitant cytomegalovirus infection. Our data demonstrate the potential of polymerase chain reaction to detect small quantities of EBV in transbronchial biopsies from lung transplant recipients. Such findings should be interpreted cautiously in the evaluation of lung transplant recipients, since EBV can be detected in the absence of a lymphoproliferative disorder or an active pneumonitis caused by this virus.
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PMID:Detection of Epstein-Barr virus by polymerase chain reaction in transbronchial biopsies of lung transplant recipients: evidence of infection? 824 11

From 108 cases of new daily persistent headaches, clinical or laboratory evidence was found suggesting extracranial or systemic infections in: 28 cases (25.9%) of gastrointestinal mainly Salmonella, 28 (25.9%) urinary Coli, 16 (14.8%) Streptococcal, 4 (3.7%) each of Epstein Barr virus or Toxoplasma, and 1 (0.9%) each of Herpes Zoster or pneumonia. A group of 26 (24.1%) showed high Proteus OX titer or clinical adenoviral involvement. All had normal neurological examinations plus selective negative neuroimaging or spinal taps. The mean headache duration was 13.8 days, and mean age 28.8 years. Prominent symptoms were fever in 37 (34.2%) cases, nausea/vomiting in 30 (27%) and vertigo in 17 (15.7%). Diarrhea, dysuria, and abdominal discomfort were rare. Headache was a solitary symptom in 36 (33.3%). The predominant sign was painful cervical lymphadenopathy in 61 (56.5%). These cases represent 1.2% of our 9060 neurology patients.
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PMID:Headache and painful lymphadenopathy in extracranial or systemic infection: etiology of new daily persistent headaches. 828 28

The purpose of this study was to determine the occurrence and histologic correlates of viral infections in immunocompromised patients with pneumonia. Of the 44 immunocompromised patients studied, 37 had AIDS. Lung tissue from these patients, including 34 with pneumocystis pneumonia, was evaluated by in situ hybridization for the presence of cytomegalovirus (CMV), adenovirus, Epstein-Barr virus, and herpes simplex virus. Fifteen of the 44 patients were positive for at least one virus (34%); CMV (13 cases) was the most common. In an additional seven cases, CMV DNA was detected using the polymerase chain reaction (PCR), for an overall viral detection rate of 22 of 44 (50%). Histologic features were diagnostic of a viral infection in nine of 15 cases (60%) of the in situ positive cases and in nine of 22 (41%) of the tissues where viral DNA was detected by PCR. Mortality rate was significantly correlated with viral detection: 77% for the viral-positive cases and 27% for the viral-negative cases (p < 0.05). We concluded that in immunocompromised patients with pneumonitis, the detection of viral DNA is strongly correlated with survival and that histologic features of the inflamed lung tissue are a specific but insensitive means of diagnosing viral presence.
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PMID:Correlation of viral infection, histology, and mortality in immunocompromised patients with pneumonia. Analysis by in situ hybridization and the polymerase chain reaction. 828 33

An adenovirus culture-positive lymphoblastoid cell line was derived from a bone marrow transplant recipient with fatal B-cell lymphoproliferative disease and adenovirus pneumonia. At autopsy, focal areas of the lymphoma infiltrating the patient's lung were positive for adenovirus proteins by immunohistochemical staining. The Epstein-Barr virus-transformed B-cell line Mk, established from pleural fluid cells, contained adenovirus virions in both the nucleus and the cytoplasm by electron microscopy. The majority of Mk cells expressed adenovirus proteins and produced a high level of infectious adenovirus by plaque assay analysis. However, in contrast to the rapid cell death induced by adenovirus in other permissive cell lines, Mk was maintained stably in tissue culture for 6 months. These data indicate that adenoviral replication is not sufficient for cell lysis and confirm that adenovirus can cause persistent infection in human lymphoid cells in vivo.
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PMID:Spontaneous, persistent infection of a B-cell lymphoma with adenovirus. 880 Dec 88


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