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

Sarcoidal (non-caseating) or tuberculoid granulomas are cutaneous manifestations of common variable immunodeficiency (CVID). In this case report, we describe a patient with CVID but with non-sarcoidal, non-tuberculoid granuloma. The 29-year-old Egyptian male patient presented with a vitiliginous patch on the chin of 1 year duration and multiple recurrent warts on the hands and feet of 8 years duration. He is a known case of CVID with chronic diarrhea, recurrent otitis media, pneumonia, purulent conjunctivitis, septic arthritis, hepato-splenomegaly, and generalized lymphadenopathy. In addition, he had evidence of multiple non-tender subcutaneous nodules predominantly juxta-articular and recurrent rheumatoid-like arthritis. The skin overlying the nodules was either normal or slightly erythematous. Laboratory findings revealed markedly reduced serum immunoglobulins (IgG 3.4, n = 7.2-16.9 g/l; IgA 0.1, n = 0.69-3.82 g/l and IgM 0.1, n = 0.63-2.77 g/l) and deficient T cell function. Histopathologic examination of a skin nodule showed well demarcated areas of fibrinoid degeneration of collagen that stain homogeneously and are surrounded by histiocytes in a palisading arrangement, suggestive of granuloma annulare. No microorganisms could be detected. Serology for rheumatoid factor and HIV infection has been persistently negative. Although most infections, including common warts responded well to intravenous immunoglobulin replacement therapy (12 g/i.v., every 2 weeks) and oral broad spectrum antibiotic therapy, the subcutaneous nodules persisted. The vitiliginous patch responded favorably and disappeared within 24 local PUVA sessions. Since skin nodules are asymptomatic, no further treatment was given.
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PMID:Non-sarcoidal, non-tuberculoid granuloma in common variable immunodeficiency. 1667 8

From July 1999 to November 2001, Mycoplasma sp. was cultured from lesions in 16 California sea lions (Zalophus californianus) undergoing rehabilitation. The Mycoplasma sp. was the likely cause of death of four animals in which it was associated with either pneumonia or polyarthritis. The most common lesion associated with this bacterium was subdermal abscessation, found in 12 animals. Other lesions included intramuscular abscesses, septic arthritis, and lymphadenopathy. Infection was associated with a leukocytosis and left shift in 12 animals. Animals with abscesses improved clinically after surgical lancing, irrigation, and systemic antibiotic therapy. The mycoplasma isolates had a consistent 16S rRNA sequence dissimilar from other Mycoplasma spp. and represent a novel species, Mycoplasma zalophi proposed sp. nov.
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PMID:Lesions associated with a novel Mycoplasma sp. in California sea lions (Zalophus californianus) undergoing rehabilitation. 1669 47

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the gene for Bruton tyrosine kinase (BTK) that result in the deficient development of B lymphocytes and hypogammaglobulinemia. Because the disorder is uncommon, no single institution has had sufficient numbers of patients to develop a comprehensive clinical picture of the disorder. Accordingly, a national registry of United States residents with XLA was established in 1999 to provide an updated clinical view of the disorder in a large cohort of patients. A total of 201 patients were registered by 66 physicians. The estimated birth rate for the 10-year period of 1988-1997 was 1/379,000. Infection was the most common initial clinical presentation (85%), followed by a positive family history (41%) and neutropenia (11%). Although the average age of diagnosis was younger in patients with a positive family history (mean, 2.59 yr) than in patients with a negative family history (mean, 5.37 yr) (p < 0.001), only 34.5% of patients with a positive family history at the time of their birth were diagnosed before clinical symptoms developed-that is, based on family history alone. Seventy percent of patients had at least 1 episode of otitis, 62% at least 1 episode of pneumonia, 60% at least 1 episode of sinusitis, 23% at least 1 episode of chronic/recurrent diarrhea, 21% at least 1 episode of conjunctivitis, 18% at least 1 episode of pyoderma and/or cellulitis, 11% at least 1 episode of meningitis/encephalitis, 10% at least 1 episode of sepsis, 8% at least 1 episode of septic arthritis, 6% at least 1 episode of hepatitis, and 3% at least 1 episode of osteomyelitis. Fourteen of 201 (6.9%) patients were dead at the time they were entered in the Registry. However, in a prospective 4 /4-year follow-up of living patients, only 3/80 (3.75%) patients died. Causes of death included disseminated enterovirus infection (n = 6), pulmonary insufficiency (n = 5), adenovirus infection (n = 1), sepsis (n = 1), acquired immunodeficiency disease syndrome (AIDS) (n = 1), myocarditis (n = 1), hepatitis (n = 2), and stem cell transplantation (n = 1).
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PMID:X-linked agammaglobulinemia: report on a United States registry of 201 patients. 1686 44

In order to determine the clinical and laboratory findings of Iranian patients with presumed hyper-immunoglobulin E syndrome (HIES), the medical records of 22 patients from 21 unrelated families, who had been registered in the Iranian Primary Immunodeficiency Registry, were observed. The median age of patients at the time of first symptom and at the time of diagnosis was 1 month and 52.5 months, respectively, with a median diagnosis delay of 70 months. 13 families had consanguineous marriages. IgE level was higher than 2000 IU/ml in all patients, ranging from >2000 to 80,000 IU/ml. The most commonly occurring manifestations were: eczema and dermatitis, pneumonia, upper respiratory tract infections, cutaneous abscesses, diarrhoea, deep abscesses, and otitis media. Other less frequent manifestations were: mucocutaneous candidiasis, sinusitis, cutaneous ulcers, Molluscum contagiosum, herpetic keratitis, onychomycosis, conjunctivitis, septic arthritis, and meningitis. Five patients were complicated by bronchiectasis due to recurrent pneumonia and 5 patients died because of severe infections and malignancy. The HIES is a multisystem disorder that affects especially cutaneous, respiratory, skeletal and the immune system. Although HIES is a rare condition, the recurrent infections should always raise a suspicion, which deserves further evaluation for detecting the syndrome.
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PMID:The clinical and laboratory survey of Iranian patients with hyper-IgE syndrome. 1700 35

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It occurs predominantly in tropical regions. The manifestations are protean which include pneumonia, visceral abscesses, septic arthritis, osteomyelitis, acute suppurative and chronic granulomatous lesions with involvement of almost all organ systems. Fulminant sepsis is much more common and is associated with high mortality. Hence prompt recognition and early treatment is warranted. We report unusual presentations of urinary tract melioidosis in two diabetic men.
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PMID:Melioidosis presenting as genitourinary infection in two men with diabetes. 1749 76

Lactobacillus is a Gram positive bacteria found in the mouth, gastrointestinal and female genital tract. Serious infections due to Lactobacillus are becoming increasingly common. We present a 49-year-old diabetic patient with Lactobacillus septic arthritis. To our knowledge, this is the first reported case. Usually, Lactobacillus is implicated with bacteremia, endocarditis and more rarely pneumonia, meningitis and endovascular infection, and half of the cases are reported in immunocompromised patients. As in our patient, diabetes mellitus is a comorbid condition which has been clearly noted. Our finding suggests that further studies are necessary to establish the significance of Lactobacillus as an etiologic agent of septic arthritis.
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PMID:Lactobacillus septic arthritis. 1753 95

Staphylococcus aureus is the most common cause of joint infections. It also contributes to several other diseases such as pneumonia, osteomyelitis, endocarditis, and sepsis. Bearing in mind that S. aureus becomes rapidly resistant to new antibiotics, many studies survey the virulence factors, with the aim to find alternative prophylaxis/treatment regimens. One potential virulence factor is the bacterial ability to survive at different oxygen tensions. S. aureus expresses ribonucleotide reductases (RNRs), which help it to grow under both aerobic and anaerobic conditions, by reducing ribonucleotides to deoxyribonucleotides. In this study, we investigated the role of RNR class III, which is required for anaerobic growth, as a virulence determinant in the pathogenesis of staphylococcal arthritis. The wild-type S. aureus strain and its isogenic mutant nrdDG mutant were inoculated intravenously into mice. Mice inoculated with the wild-type strain displayed significantly more severe arthritis, with significantly more synovitis and destruction of the bone and cartilage versus mutant strain inoculated mice. Further, the persistence of bacteria in the kidneys was significantly more pronounced in the group inoculated with the wild-type strain. Together these results indicate that RNR class III is an important virulence factor for the establishment of septic arthritis.
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PMID:Ribonucleotide reductase class III, an essential enzyme for the anaerobic growth of Staphylococcus aureus, is a virulence determinant in septic arthritis. 1760 58

A 42-year-old patient presented acutely with bacteremic pneumococcal pneumonia along with metastatic pneumococcal infection of the hip joint. Diagnostic evaluation revealed evidence of a pre-existing bilateral hip osteonecrosis. The osteonecrotic changes were attributed to chronic alcohol abuse and/or an old motor vehicle accident. Appropriate therapy was promptly instituted and the septic arthritis responded well, necessitating hip aspiration only once. A few months later, the patient had no permanent sequelae of the infection.
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PMID:Streptococcus pneumoniae septic arthritis complicating hip osteonecrosis in adults: case report and review of the literature. 1763 52

Invasive Haemophilus influenzae type b (Hib) diseases are major causes of childhood morbidity and mortality. For the period from 1994 to 2003, we retrospectively identified 53 children with invasive Hib disease including 31 with meningitis, 14 with pneumonia, 2 with septic arthritis, 2 with epiglottitis, 1 with neutropenic sepsis, and 3 who were bacteraemic without a focus. Two children died and 22 had serious sequelae; significantly, survivors with sequelae had presented with meningitis (P-value<0.001) or sepsis (P-value=0.001). During the 11-year period, the annual incidence of invasive Hib disease was estimated to be 4.4/100,000 children <5 years old. With rising affluence, decreasing costs of vaccines, and increased costs in caring for survivors, universal infant immunization with Hib vaccine may need to be reconsidered in Singapore.
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PMID:Epidemiology of invasive Haemophilus influenzae type b disease in Singapore children, 1994-2003. 1765 71

We observed a number of cases of sepsis from bacteremia in children from community-associated methicillin-resistant Staphylococcus aureus (MRSA), which led us to study its patterns of infection and outcome. A retrospective review identifying children admitted to our institution with blood culture-proven community-associated MRSA sepsis over a 2-year period was performed. The inclusion criteria were younger than 19 years old, two or more blood cultures for MRSA within 48 hours of admission, evidence of systemic inflammatory response syndrome, and no prior hospital admissions within 6 months. Eight patients were included; seven required mechanical ventilation. Vasopressors were required in seven patients. Four patients required extracorporeal membrane oxygenation. Four patients had culture-proven septic arthritis or thrombophlebitis and three of these patients developed bilateral necrotizing pneumonia. Bilateral necrotizing pneumonia was identified in the other four patients, but the primary source of infection was never identified. The overall intact neurologic survival was 50 per cent. Children with severe community-associated MRSA sepsis can rapidly progress to cardiorespiratory failure. Mortality appears to be high, and children may benefit from a search of their soft tissues and joints to identify the source of infection to prevent embolic dissemination.
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PMID:Severe sepsis attributable to community-associated methicillin-resistant Staphylococcus aureus: an emerging fatal problem. 1767 41


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