Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Legionella infections can take the clinical course of a relatively harmless respiratory infection. However, serious, atypical pneumonia is a more frequent manifestation of infection with these pathogens. As yet, six different Legionella species can be identified; Legionella pneumophila appears to be the most common. Legionnaires' pneumonia is being found with increasing regularity during summer and autumn in elderly male patients with previous illnesses. The clinical picture is characterised by viral "prodrome", high fever, a dry cough, breast pain, confusion, diarrhoea, haematuria, moderate leukocytosis with lymphopenia, low concentrations of sodium in the serum and negative results from microbiological analysis of the sputum and pleural exudate. Diagnosis is confirmed culturally, microscopically and serologically; the indirect immunofluorescence test is of particular value for this purpose. Erythromycin alone or in combination with rifampicin is the treatment of choice.
 ...
PMID:[Clinical picture of Legionnaires' disease (author's transl)]. 710 21

Clinical effect of acetylspiramycin, one of macrolide antibiotics, primary atypical pneumonia and serologically proven Mycoplasma pneumonia in children was studied. Twenty-four cases of these pneumonia (PAP 11, MP 13) in children were selected and acetylspiramycin was given in dose of approximately 30 mg/kg/day orally. Clinical response was evaluated in terms of improvement in fever, cough and chest X-ray. Clinical response was excellent in 4, good in 5, fair in 14 cases and none in 1 case. No definite adverse effect was observed, however 3 cases showed skin rashes. Two cases showed evanescent small erythematopapulous rash and 1 case developed urticaria on the 2nd to 4th day after this drug was given. These skin rash seemed one of the manifestation of Mycoplasma infections, rather than adverse side effect. One case showed elevated transaminase activity before acetylspiramycin was given and improved on the 2nd week, although this drug was continued. No other side effect was observed. We were able to use acetylspiramycin only in the form of 200 mg tablet and difficulty of the administration was encountered in children under 5 years of age. Other form (dry syrup, etc.) of this drug should be considered for the clinical use in children. In conclusion, acetylspiramycin was effective and safe for the treatment of primary atypical pneumonia and Mycoplasma pneumonia.
 ...
PMID:[Clinical effect of acetylspiramycin on primary atypical pneumonia in children (author's transl)]. 732 Nov 87

Adhesins and adhesin-related accessory proteins of pathogenic mycoplasmas are required for cytadherence and the subsequent development of disease pathology. The classic example has been Mycoplasma pneumoniae, which causes primary atypical pneumonia in humans. Mutants of M. pneumoniae defective in adhesins (P1 and P30) or in adherence-accessory proteins (HMW1 through HMW4) are unable to colonize host tissues and are avirulent. Mycoplasma genitalium, implicated in nongonococcal, nonchlamydial urethritis, pneumonia, arthritis, and AIDS progression, was found to encode a 140-kDa adhesin that shared both DNA and protein sequence similarities with P1, a major adhesin of M. pneumoniae. In this report, we show that M. genitalium possesses additional homolog sequences to well-characterized adherence-related genes and proteins of M. pneumoniae. The M. genitalium homologs are designated P32 and P69 and correspond to P30 and HMW3 of M. pneumoniae, respectively (J. B. Baseman, p. 243-259, in S. Rottem and I. Kahane, ed., Subcellular biochemistry, vol. 20. Mycoplasma cell membranes, 1993, and D. C. Krause, D. K. Leith, R. M. Wilson, and J. B. Baseman, Infect. Immun. 35:809-817, 1982). Interestingly, the operon-like organizations of P32 and P69 in the M. genitalium genome are similar to the organizations of P30 and HMW3 genes of M. pneumoniae, suggesting that the conservation of these adherence-related genes and proteins might have occurred through horizontal gene transfer events originating from an ancestral gene family.
 ...
PMID:Molecular cloning and characterization of an adherence-related operon of Mycoplasma genitalium. 759 48

The major agents responsible for atypical pneumonia in children include a wide variety of organisms, one Mycoplasma species, two Chlamydia species, a rickettsia, and one fastidious bacterium. Mycoplasma pneumoniae and C. pneumoniae together may be responsible for over 40% of these infections. Recognition of the role that these agents play in pneumonia is important since many of the diagnostic methods used to detect these organisms are not available in most hospital microbiology laboratories. If you don't look, you won't find. Epidemiologic factors can provide valuable clues, especially with the less frequently encountered infections, since it is almost impossible to make a clinical diagnosis on which to base treatment. A reliable history of avian exposure should suggest psittacosis, exposure to sheep or pregnant cats suggests Q fever, and children with underlying malignancy or immunodeficiency or those receiving systemic steroids may have legionnaires' disease. None of these organisms are susceptible to beta-lactam antibiotics. Sometimes the diagnosis is not considered until after the child has failed to respond to a penicillin or a cephalosporin and routine bacteriology is negative. In view of the role played by M. pneumoniae and C. pneumoniae, a macrolide may be the first-line antibiotic for atypical pneumonia in children.
 ...
PMID:Atypical pneumonias in children. 771 3

Mycobacterium avium is a common pathogen in barnyards, where it infects poultry and pigs. In human beings M. avium is most often found to cause disease in immunocompromised individuals, although it is also described fairly often as affecting patients with tuberculosis or chronic obstructive pulmonary disease; in recent years lung infections by M. avium have even been reported in elderly women with no underlying disease. Respiratory infection by this mycobacterium is unusual, however, in healthy children. We describe the case of a previously healthy 2-year-old boy with pneumonia whose course was complicated. After 6 months of treatment with various broad spectrum antibiotics there was no clinically or radiologically observable improvement. Other underlying diseases were ruled out, including infection by germs that cause atypical pneumonia. When all tests were negative, we investigated the possibility of primary infection by an atypical mycobacterium. A skin test was positive for M. avium. Acid-alcohol resistant bacilli were isolated from lung biopsy samples and the presence of tuberculoid granulomas were confirmed. Our patient then responded favorably after tuberculostatic treatment with 3 drugs (isoniazid, rifampicin and pyrazinamide).
 ...
PMID:[Primary Mycobacterium avium respiratory infection in nonimmunocompromised children]. 778 87

The traditional classification of community-acquired pneumonia into typical and atypical pneumonia to facilitate successful empirical treatment is no longer optimal. An accurate prediction of cause and adequate empirical therapy cannot be provided with this approach in severely ill patients. There is an increasing spectrum of recognized treatable pathogens presenting as community-acquired pneumonia including Legionella species, Chlamydia pneumoniae, and Pneumocystis carinii in addition to the traditional community pathogens. The variability of presentation in severely ill or compromised hosts makes clinical prediction of cause inadequate. A more rational approach may involve the classification of patients by the severity of illness and underlying disease with little or no microbiological workup in mild illness unless the results will contribute to the epidemiological surveillance of resistance because these investigations have not been shown to affect outcome in this setting. Etiologic diagnosis should be more aggressively sought and the microbiology laboratory can be best used by providing the efficient and rapid diagnosis of this expanded range of pathogens in more severely ill patients. The mounting antimicrobial resistance of common pathogens such as Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus will require not only a critical review of empirical therapy, but an increased emphasis on epidemiological monitoring of resistance by laboratories and effective communication with clinicians.
 ...
PMID:Community-acquired pneumonia: the future of the microbiology laboratory: focused diagnosis or syndromic management? 783 39

The characteristics of lung lesions of slaughtered lambs and the presence of microorganisms in the lesions were investigated. Pneumonia was detected in 500 (3.6%) of 13,588 lambs. Macroscopical lesions were of atypical pneumonia and were often seen in the pars cranialis of lobus cranialis dexter. Histologically, proliferative pneumonia was detected in most cases and was often accompanied by exudative characteristics. Pasteurella haemolytica was isolated from 258 (51.6%) and Mycoplasma ovipneumoniae from 215 (43.0%) of 500 pneumonic lungs. In 131 (26.2%) cases both organisms were isolated from same samples. A close relationship was found between P. haemolytica and exudative inflammation (p < 0.05).
 ...
PMID:Studies of the pathology and microbiology of pneumonic lungs of lambs. 789 25

This recently recognised member of the genus Chlamydia is one of the most widespread pathogens of man, though up to 90% of infected people have few or no symptoms. Several studies have estimated the population prevalence of antibodies to C. pneumoniae at 40-55% in the northern hemisphere, and over 60% in under-developed countries. The incidence of infections follows a cyclical pattern, with peaks at regular intervals of 2-10 years, but no apparent seasonal periodicity. Nosocomial transmission may be mediated by environmental surfaces as well as aerosols, and immunosuppression, for example by the human immunodeficiency virus, predisposes to infection. Chlamydia pneumoniae causes predominantly atypical pneumonia, often severe in adults, especially the elderly; including 5-10% of community-acquired pneumonia in Scandinavian countries. Serological evidence indicates associations with asthma, bronchitis, exacerbations of chronic airflow obstruction, otitis media and bronchiolitis. Several studies, using both serological and morbid anatomical techniques, also indicate associations with vascular atheroma and ischaemic heart disease, and with acute myocardial infarction. Chronic, latent and recurrent infections have been documented, and it is postulated that, like chronic or recurrent C. trachomatis infections, these may produce disease as a consequence of the host's immunological hypersensitivity. Several techniques are available for serological diagnosis: the technique of choice is micro-immunofluorescence, using fixed whole elementary or reticulate bodies as antigen, but antibody responses are highly variable. Traditional alternatives, antigen detection (by direct immunofluorescence or enzyme immunoassay) and cell culture, have major disadvantages. Polymerase chain reactions have not yet been widely applied to the clinical setting. tetracycline antibiotics, erythromycin and quinolones are not very efficacious in the treatment of C. pneumoniae infection. The azalide antibiotic, azithromycin, and the macrolide, clarithromycin, are active in vitro against C. pneumoniae, and may become treatments of choice. The development of anti-chlamydial vaccines remains an important research goal.
 ...
PMID:Clinical aspects of Chlamydia pneumoniae infection. 789 84

The macrolides are still widely used in general practice and the new 14- or 15 membered-ring compounds-roxithromycin, clarithromycin, dirithromycin, azithromycin -may offer a new development. Their antibacterial activity is similar to erythromycin but azithromycin is more active against Gram negative strams. Roxythromycin exhibits high serum concentrations; azithromycin and dirithromycin present low serum concentrations but prolonged half-lives allowing a reduction of the duration of treatment particularly for pharyngitis (azithromycin). Macrolides are less useful for otitis and sinusitis treatment since their activity against H. influenzae and S. pneumoniae are weak. The activity against atypical bacteria justify their choice as first line treatment for benign atypical pneumonia of healthy young adults and for sexually transmitted diseases. In AIDS, these compounds are indicated in mycobacteriosis (clarithromycin), bacillary angiomatosis and excavated pneumonia due to Rhodococcus equi. Clinical tolerance is very good, particularly the gastro-intestinal one. The reported drug interactions are those of this class of antibiotics.
 ...
PMID:[New macrolides]. 793 38

In pneumonias, the short diagnostic results of non-invasive procedures lead frequently to use invasive techniques, among which we find pulmonary puncture aspiration (PPA). In this study, the profitability of PPA in the diagnosis of pneumonias is evaluated. One hundred and thirteen PPA were performed on 107 patients diagnosed of pneumonia. The PPA was performed with a 22-25 G needle without radioscopic control. Hemocultures were gathered in 104 cases, serological tests for productive agents of atypical pneumonia were applied in 50 cases, sputum test in 95 cases, and bronchofibroscopy with occluded telescopic brush in 25. The PPA had a specificity of 98 percent and a sensibility of 54% which rose to 73% in patients without antibiotic treatment prior to the puncture. Only 10 patients had complications with pneumothorax (9 percent) and four (3 percent) presented hemoptysic sputum. In the 53 patients with a positive PPA, knowledge of an etiological agent allowed the antibiotic treatment to be switched in 32 cases (60 percent). In addition, a decrease in the number of days of hospitalization was confirmed in the group of patients who received an etiological diagnosis while alive (p < 0.03). In conclusion, the PPA is a technique with excellent specificity, acceptable sensitivity, and a short rate of complications which allowed the treatment to be changed in 60 percent of the cases and reduced the number of days of hospitalization for patients who received a diagnosis. Thus, it constitutes a very useful technique in the etiological diagnosis of severe pulmonary infections.
 ...
PMID:[Pulmonary aspiration puncture in the etiological diagnosis of pneumonias]. 802 88


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>