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

In Ethiopia, a social anthropologist, a pediatrician, and a nurse project supervisor interviewed 15 mothers living in Butajira district to learn about their current perceptions and practices in the care of children with acute respiratory infections (ARIs) in order to plan effective intervention programs for the Butajira Rural Health Project. All the mothers were familiar with measles and identified fever and rash as its major symptoms. Since they tended to believe that modern medication keeps the rash from appearing, which they thought necessary for recovery, many mothers thought that a child with measles should not go to a health facility. Mothers considered lentil and a cereal soup as necessary to bring out the rash. The only white-colored food allowed during measles is breast milk. Mothers would not allow a child with measles to be taken out of his or her house. All the mothers were familiar with whooping cough and its key feature--a chronic cough. None of the mothers knew that vaccination would prevent whooping cough. An acceptable treatment for whooping cough was use of leaves of Lippia adoensis and garlic or milk of a black donkey. The mothers considered infection of the uvula and/or the tonsils to be natural since all children develop these throat infections. Treatment consists of a traditional healer cutting the uvula with a wire or scratching the tonsils with the fingers. Herbs are applied to the resultant wounds. Only two mothers knew about pneumonia. They had taken their children to a health center, where they were told that their children had it. Even after the interviewers had thoroughly explained the symptoms of pneumonia, 10 mothers did not recognize it as an illness entity. Mothers did not know about the symptoms of fast breathing or chest indrawing. Only a few mothers would take their child with these symptoms to a health center. Traditional treatments would be used (e.g., massaging the chest with butter). Regardless of ARI, most mothers would take their child to the health center only as a last resort. Any interventions developed based on these findings should at least target harmful practices (e.g., cutting the uvula with nonsterile instruments).
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PMID:The Butajira Rural Health Project in Ethiopia: mothers' perceptions and practices in the care of children with acute respiratory infections. 1232 Mar 83

A 62-year-old woman was admitted because of chronic cough and bilateral infiltrates on chest roentgenogram. Additional history revealed that the patient had been taken diclofenac emulgel during the previous 10 years for arthrosis. Diagnostic bronchoscopy showed eosinophilic alveolitis. After ruling out infectious, parasitic or systemic diseases drug-induced eosinophilic pneumonia was diagnosed due to topical diclofenac therapy and subsequent percutaneous drug absorption. No previous case of eosinophilic pneumonia to topical diclofenac was discovered in our review of the literature. The diclofenac therapy was discontinued. Oral corticosteroid therapy cleared bilateral infiltrates on CT scan within seven days. Drug reactions are the most common cause of pulmonary infiltrates with blood eosinophilia and/or eosinophilic alveolitis and should be considered as a differential diagnosis.
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PMID:[Pulmonary infiltrates with blood eosinophilia in a 62-year-old patient]. 1467 18

Patients with congenital diaphragmatic hernia usually present in the immediate neonatal period with respiratory distress. However, presentation beyond the neonatal period has sporadically been reported. We report a case of a 4-year-old girl who presented with a 1 month history of chronic cough and low-grade fever, with no response to multiple antibiotics. Initially, both clinical and radiological findings suggested inflammatory chest disease. Fortunately, after performing ultrasound, suspicion was raised and she was later diagnosed to have left congenital diaphragmatic hernia of Bochdalek type. Although rare, this entity should form one of the differential diagnoses of unresolving pneumonia in children.
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PMID:Congenital diaphragmatic hernia masquerading as pneumonia. 1523 34

The medical and social impact of cough is substantial. Current antitussive agents at effective doses have adverse events such as drowsiness, nausea and constipation that limit their use. There is also recent evidence that standard antitussive agents, such as codeine, may not reduce cough during upper respiratory infections. Therefore, there is a need for more effective and better-tolerated agents. The efficacy of levocloperastine, a novel antitussive, which acts both centrally on the cough center and on peripheral receptors in the tracheobronchial tree in treating chronic cough, was compared with that of other standard antitussive agents (codeine, levodropropizine and DL-cloperastine) in six open clinical trials. The studies enrolled patients of all ages with cough associated with various respiratory disorders including bronchitis, asthma, pneumonia and chronic obstructive pulmonary disease. Levocloperastine significantly improved cough symptoms (intensity and frequency of cough) in all trials, and improvements were observed after the first day of treatment. In children, levocloperastine reduced nighttime awakenings and irritability, and in adults it was effective in treating cough induced by angiotensin-converting enzyme inhibitors. When compared with other antitussive agents, levocloperastine had improved or comparable efficacy, with a more rapid onset of action. Importantly, no evidence of central adverse events was recorded with levocloperastine, whereas drowsiness was reported by a significant number of patients receiving codeine. Levocloperastine is an effective antitussive agent for the treatment of cough in patients of all ages. It has a more rapid onset of action than standard agents with an improved tolerability profile.
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PMID:Levocloperastine in the treatment of chronic nonproductive cough: comparative efficacy versus standard antitussive agents. 1555 59

Aspiration of foreign bodies is extremely rare in adults, but it may occur during the course of dental treatment and become a serious problem for the patient. A case of a 77-year old man with chronic cough after dental treatment and unrecognised aspiration of an implant is presented. The implant remained unidentified for three years as an endobronchial foreign body of the lower lobe bronchus. A bronchoscopic removal failed and surgery was indicated for lobectomy of the right lower lobe because of chronic pneumonia. A review of prevention, signs and symptoms, management and documentation of the complications is presented.
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PMID:[Aspiration of dental implant -- reasons, management and prevention]. 1575 30

The diagnosis of tracheobronchial foreign body (FB) aspiration in children is often delayed or overlooked. The aim of this study is to examine the causes of delay (>1 month) in the diagnosis and to study the complications of late presentation and their management. During the period between July 1993 and August 2002, 128 patients with suspected FB aspiration were admitted to KKUH, Riyadh, Saudi Arabia. Twenty-eight patients out of 128 patients presented late (>1 month). The medical records of those 28 patients were reviewed in respect to: history of FB aspiration, physical signs of symptoms, reason for delayed presentation, radiological investigation, complications and their management, and follow-up. There were 16 males and 12 females; the average age was 3.28 years (range 1--11 years). All of them experienced chronic cough at presentation. Thirteen (48 per cent) children had a history suggestive of FB aspiration. Seventeen (63 per cent) children presented with complications that included pneumonia (n=13), bronchiectasis (n=3), and bronchoesophageal fistula (n=1). The diagnostic delay was attributed to physician misdiagnosis (n=9), failure by parents to seek early medical advice (n=4), patients left against medical advice (n=1), and the cause of delay was unknown in the remaining 14 children. Rigid bronchoscopy was performed in all patients. FB was found in all cases except four. Complications were treated as follows: pneumonia with intravenous antibiotics, bronchiectasis conservatively and bronchoesophageal fistula repaired surgically. Follow-up ranged from 6 to 48 months. Diagnostic delay of tracheobronchial FB aspiration has significant morbidity in children. A high index of suspicion and early referral are essential in preventing such complications.
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PMID:Late presentation of tracheobronchial foreign body aspiration in children. 1583 67

Sub-Saharan Africa, which has just over 10% of the world's population, is home to more than 25 million people living with HIV/AIDS-two thirds of the global total. Opportunistic pulmonary infections are major causes of morbidity and mortality among HIV-infected adults in the subcontinent. Of these diseases, tuberculosis (TB) is by far the most prevalent and serious, and in some countries it causes one third or more of all AIDS-related deaths. Because it is so frequent and a major public health problem, TB tops the list of differential diagnoses of people-with or without coexisting HIV infection-who present to the health care system with chronic cough and other pulmonary symptoms. As HIV-induced immunosuppression worsens, the clinical and radiographic manifestations of TB become increasingly atypical. Second among HIV/AIDS-associated pulmonary complications is community-acquired pneumonia, most commonly caused by Streptococcus pneumoniae, which usually responds to standard beta-lactam antimicrobial agents. The prevalence of Pneumocystis jirovecii pneumonia is increasing, due to both improved recognition of its characteristic clinical and radiographic features and aggressive diagnostic interventions. Treatment outcome in most countries, however, has been poor. Combined infections, usually including TB, are common. Pulmonary nocardiosis, cryptococcosis, Kaposi's sarcoma, and (possibly) histoplasmosis appear to be infrequent, but probably underdiagnosed. Improved diagnosis, treatment, and prevention of all these diseases are urgently needed, but a greatly expanded antiretroviral treatment program will help most of all.
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PMID:Pulmonary complications of HIV-1 infection among adults living in Sub-Saharan Africa. 1610 26

The constellation of chronic cough, dyspnea, and hemoptysis can include a broad range of differential diagnoses. Although uncommon, exogenous lipoid pneumonia (ELP) should be considered when patients present with this symptom complex. We report a case of a 72-year-old female who presented with hemoptysis, cough, and dyspnea. The admission computed tomography scan of the chest revealed progressive interstitial infiltrates. Bronchoscopy revealed diffuse erythema without bleeding. Culture and cytology of lavage fluid were negative. Open-lung biopsy revealed numerous lipid-laden macrophages and multinucleated foreign-body giant cells. On further questioning, the patient admitted to the daily use of mineral oil for constipation. The diagnosis of ELP was made. The literature review revealed that many cases typically present with chronic cough with or without dyspnea. Our case illustrates an unusual presenting symptom of hemoptysis and the need to identify patients who can be at risk of developing this rare condition.
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PMID:Not your typical pneumonia: a case of exogenous lipoid pneumonia. 1784 47

Brucellosis remains a world-wide public health problem especially in developing brucellosis remains a world-wide public health problem especially in developing countries. Although involvement of the respiratory system in brucellosis is an acknowledged but rare event, its clinical manifestations and focal complications are often troublesome in making a diagnosis. Herein, we report a pneumonia case which proved due to Brucella melitensis in a 57-year-old man who presented with chronic cough, sputum, hemoptysis and fever.
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PMID:[A rare agent of pneumonia: Brucella melitensis]. 1912 82

A one-year-old boy with two months' chronic cough and dysphonia, unresponsive to therapy for pneumonia, had a radiopaque, wedge-shaped tracheal foreign body noted on anteroposterior, but not lateral radiographs, and he eventually became aphonic. Laryngoscopy yielded a subglottic embryonated duck eggshell. Foreign body aspiration should be considered in the presence of chronic cough. Radiopaque airway foreign bodies may be metallic or calcific. The patient was fond of sucking soup from a partially-shelled embryonated duck egg. The last occasion occurred immediately before the onset of cough. The hard egg white of the same delicacy is a commonly-ingested oesophageal foreign body in the Philippines, but the preceding slurping of the amniotic fluid predisposes one to unusual eggshell aspiration. With the continuing global migration of overseas workers and their families, healthcare providers with Asian and Southeast Asian clients should consider such cultural practices in assessing symptoms suggestive of aerodigestive foreign bodies.
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PMID:Embryonated duck ("balut") eggshell aspiration in a one-year-old boy. 1949


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