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

The clinical and autopsy records of 65 patients with either polymyositis (24) or dermatomyositis (41) and pulmonary disease were reviewed. Pulmonary symptoms were recorded in 43 of the cases and included dyspnoea in 31, cough in 23, and chest pain in six. Interstitial lung disease was noted at autopsy in 27 patients; almost half of these had arthritis. Bronchopneumonia was found in 35 patients, 31 of these had received prednisone. Dysphagia was present in a similar proportion of patients with and without pneumonia. Pulmonary vasculitis was seen in five patients; pulmonary symptoms, arthritis, and raised erythrocyte sedimentation rate were present in four of these cases and all five had associated interstitial lung disease. Other pulmonary manifestations included pulmonary oedema, primary pulmonary malignancy, diffuse alveolar damage, fibrinous pleuritis, pulmonary emboli, and diaphragmatic atrophy. The mean survival after disease onset was 29 months but was much less for those with interstitial lung disease and pulmonary vasculitis.
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PMID:Pulmonary disease in polymyositis/dermatomyositis: a clinicopathological analysis of 65 autopsy cases. 381 71

The authors report a case of pleuro-pulmonary fibrosis after 9 months of high dose bromocriptine therapy for the treatment of Parkinson's disease. When the drug was stopped there was a significant improvement of the clinical state with complete regression of chest pain and dyspnea of effort. The major inflammatory biological syndrome disappeared completely. Chest X-rays showed partial improvement with signs of pleural pneumonitis. The results of ventilatory and respiratory function tests stabilised. After one year follow-up, the causal relationship of this iatrogenic pathology has therefore been established. The initial diagnostic problems are stressed, particularly with respect to malignant disease (mesothelioma) when there has been exposure to asbestos, as in our case. The early stages must be carefully looked for so as to prevent fibrosing complications. The presence of immune complexes in our case could indicate immuno-allergic mechanism.
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PMID:[Bromocriptine in Parkinson's disease: pleuropulmonary toxicity]. 406 41

Children with foregut cysts of the mediastinum can present at any age with nonspecific respiratory symptoms or dysphagia. Chest radiograph and barium esophagram are recommended for initial evaluation, but they fail to identify some lesions. In other cases, an obvious mass may be confused with a solid neoplasm. We have operated upon 34 infants and children with mediastinal bronchogenic cysts and esophageal duplications from 1968 through 1985. This review of their clinical course and radiographic imaging studies emphasizes some of the diagnostic pitfalls that lead to operative delay. Twelve (35%) of these patients were asymptomatic. The correct diagnosis was delayed longer than 3 months from the onset of symptoms in 14 of the 22 symptomatic children. Fifteen of these presented with pneumonia or symptoms or airway obstruction. In 11, the cyst was in a perihilar or subcarinal location, areas in which a lesion can be "hidden" behind the cardiac silhouette. Five children with esophageal duplication had severe neonatal respiratory failure, chest pain, hematemesis or dysphagia. The immediate preop chest radiograph revealed a mass in 29 of 34 cases. However, the lesion was initially missed or never seen in eight of those who were symptomatic. Esophagram, performed in 23, was diagnostic in only six and was normal in four. Prior to 1979 when CT scanning became available at this institution, 11 of 19 children (57%) underwent extensive work-up, but the preop diagnosis was correct in only 50%. Since 1979, only 4 of 15 (26%) have required similar evaluation, and the preop diagnosis has been correct in all.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnostic dilemmas of mediastinal cysts. 408 7

Four adults had varicella pneumonitis. All developed respiratory symptoms within a week of the exanthem. Cough and/or dyspnea, cyanosis and chest pain were common. Radiological signs of disease were more marked than physical signs. A slight polymorphonuclear leukocytosis and normal sputum culture were usual. One man with mild symptoms recovered. Two women, one pregnant, had severe symptoms and died. A second man succumbed to secondary bacterial pneumonia. The lungs in fatal cases showed interstitial pneumonitis with mononuclear cell infiltrate, focal areas of necrosis, and acidophilic inclusion bodies in two cases. Patients received oxygen, antibiotics and, in one instance, corticosteroid therapy. The value of antibiotics and corticosteroid treatment is questionable. Use of gamma globulin in preventing varicella pneumonitis is mentioned and residual pulmonary changes are discussed.
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PMID:Varicella pneumonitis. 601 59

A prospective study of cytomegalovirus (CMV) infections has been carried out in 28 renal graft recipients. The protocol called for frequent blood and urine sampling during the first year after transplantation, but death or graft loss caused earlier termination in nearly half the patients. In this material 5/7 (71%) susceptible patients developed primary infections and 20/21 experienced a secondary infection (95%). Viruria was detected in 79% and viremia in 43%. The type of blood cell responsible for the viremic phase was studied by separating the blood cells on a density gradient. The polymorphonuclear cell fraction was the most common source of virus but virus could also be recovered from the mononuclear cell fraction. As some samples that were freeze-thawed repeatedly never yielded virus, it would appear that viable cells are needed for virus isolation. In both primary and secondary infections isolation of CMV from blood cells often preceded the isolation of CMV from urine. Among variables tested for a possible relationship to the occurrence of CMV viremia the only one to display such an association was the time at which rejection episodes occurred. In 19/28 such episodes recorded in 19 patients there was a temporal relationship to viremia (p less than 0.03). Seven of the patients experienced clinical symptoms suggestive of CMV infection as fever, cough, myalgia, arthralgia, chest pain and pneumonia. Laboratory signs included elevated amino acid transferase levels, leukopenia and thrombocytopenia and a specific anti-CMV antibody response.
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PMID:Studies of cytomegalovirus infection in renal allograft recipients. 628 51

Classically, the middle lobe syndrome has been described as being caused by a central obstruction. Clinical records and radiologic findings were reviewed in 129 patients examined between 1955-1981 who had chronic disease in the right middle lobe and/or lingula. Fifty-eight patients (45%) had no evidence of a central obstructive lesion. The majority were middle-aged women with histories of chronic cough and chest pain. Bronchoscopic and radiologic evaluation served to exclude central lesions. Surgical confirmation was available in 38 patients. Pathologic study showed varying degrees of chronic inflammation, pneumonia, and bronchiectasis. Surgical results were excellent in isolated disease. Chronic atelectasis and pneumonitis of the right middle lobe and/or lingula do not always imply central obstruction. A lack of collateral ventilation is a plausible theory to explain the pathophysiology in such patients.
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PMID:Peripheral middle lobe syndrome. 661 25

This 9-year-old white male suffered mild trauma to the left side of the chest on two occasions in April 1981, and then developed a low-grade fever. A chest x-ray film showed pneumonia. He was then given oral ampicillin for 2 weeks, and the fever and left chest pain resolved. Repeat chest radiograph one month later showed a persistent density, and a bone scan revealed increased uptake in the left fifth rib. Osteomyelitis was diagnosed, and intravenous antibiotics were administered. In June 1981, the density had become larger on radiographic examinations, and a left chest wall mass was noted for the first time. He was referred to the Children's Hospital of Philadelphia, with the suspected diagnosis of Ewing's sarcoma of the left fifth rib. On arrival at the Children's Hospital of Philadelphia on June 13, 1981, the physical examination was unremarkable except for a 1 X 2-cm mass overlying the fifth rib anterolaterally. Dr Hugh Watts of the Division of Orthopedic Surgery reviewed the radiographs and bone scan and felt that the appearance was not consistent with primary Ewing's sarcoma of the rib. The boy was then taken to surgery by Dr. Moritz Ziegler on June 23, 1981, at which time biopsy of the lesion was accomplished. The tumor had by then grown to a size of 3 X 5 cm.
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PMID:Localized sarcoma of the chest wall. 670 May 46

A retrospective analysis of the postoperative ophthalmic surgical mortality during the 20-year period ending in 1974 at the Jules Stein Eye Institute was performed. Eleven of 17,632 patients died following ophthalmic surgery (0.062%). Frequently, the cause of death was related to pulmonary embolism, myocardial infarction, congestive heart failure, or pneumonia. The postoperative complications were often heralded by complaints referable to the chest, and misdiagnosis was common. A simplified approach to postoperative chest pain based on location is presented.
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PMID:Chest pain in the postoperative ophthalmic patient. 726 18

In 12 years 627 patients presented to Wentworth Hospital, Natal with chronic destructive pneumonia (CDP). Common symptoms were haemoptysis, the production of foul-smelling sputum, and chest pain. The disease pursued a chronic course with acute exacerbations which may be lethal. The majority of patients were African men aged between 20 and 50 years who were free from other significant disease apart from dental infection. Radiographically and pathologically CDP had the characteristics of a necrotising pneumonia, and microbiological investigation showed mixed aerobic and anaerobic flora in the lower respiratory tract. Gram-positive aerobic cocci and Bacteroides species were the predominant organisms. In 120 patients treatment regimens were based on chloramphenicol, in 429 cephalosporins, and in 78 on combination therapy with cephalosporins, penicillin, and metronidazole. One hundred and seventy patients also required operative management in an attempt to control progress of the disease. The overall inpatient mortality rate from CDP was 7.8%. In the group of patients treated with combination therapy the mortality rate was 1.3%.
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PMID:Characteristics and management of chronic destructive pneumonia. 743 83

A 62-year-old male was admitted to our hospital after an abnormal shadow was pointed out by Chest X-ray in June, 1994, even though he was asymptomatic otherwise (first episode). The serum IgG antibody against Chlamydia pneumoniae was elevated up to 512-fold in the acute phase and decreased to 32-fold in the convalescent phase using the micro-immunofluorescence (MIF) test, indicating a C. pneumoniae acute infection. In fact, no other micro-organisms were detected. The patient recovered from the pneumonia without any treatment. He was admitted to our hospital again after having right chest pain in December, 1994 (second episode). An X-ray examination revealed a slight infiltration of the right lower lung field and pleural effusion. In this episode, he received therapy with carbapenem anti-bacterial agent and he recovered from the pneumonia 9 days after the administration of the antibiotic. The serum IgG titer against C. pneumoniae was elevated up to 1024-fold on admission, indicating mixed infection with bacteria and C. pneumoniae. It was concluded that both of these episodes indicated a spontaneous cure of the pneumonia which had developed from C. pneumoniae.
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PMID:[Spontaneous cure of pneumonia caused by Chlamydia pneumoniae]. 759 89


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