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)

A study of 34 hospitalized patients with suspected neuroleptic malignant syndrome (NMS) found that 24 had NMS and the other 10 had acute, usually serious, medical problems. There were no demographic, psychopathologic, or treatment-related differences between the groups. NMS patients had more dehydration, cogwheeling, diaphoresis, disorientation, drooling, dysphagia, and rigidity and higher diastolic blood pressure. The groups had similar fevers, heart rates, creatine kinase levels, and white blood cell counts. Three non-NMS patients died during their acute illnesses. Results suggest that considering NMS as a diagnosis and ruling out other acute illnesses such as pneumonia are equally important when a patient on neuroleptic medication becomes medically ill.
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PMID:Distinguishing neuroleptic malignant syndrome (NMS) from NMS-like acute medical illnesses: a study of 34 cases. 135 2

One of the disabilities in patients with cerebral palsy (CP) is dysphagia. To establish the prevalence of dysphagia in a population of children with CP, and to determine if any factors are related to dysphagia, we studied 56 CP patients, 5-21 years, enrolled in a primary school for the disabled. Fifteen patients (27%) had either radiographic or clinical evidence of dysphagia. These 15 patients were compared to the remaining 41 patients without dysphagia. Using data obtained from chart review and interviews with speech pathologists, several factors that contributed to dysphagia were found. These included: bite reflexes, slowness of oral intake, poor trunk control, inability to feed independently, anticonvulsant medication, coughing with meals, choking, and pneumonia. We also noted trends in the following factors: presence of tongue thrusting, presence of drooling, severity of CP, poor head control, severity of mental retardation, seizures, and speech disorders. Factors not related to the presence of dysphagia include: subject age, cause of CP, and type of CP. Early, aggressive work-up and identification in CP patients with the risk factors outlined above can reduce the associated pulmonary complications.
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PMID:Swallowing disorders in a population of children with cerebral palsy. 139 5

An eleven month old girl was admitted to a county hospital because of persistent low grade fever, cough, vomitus and food and oral fluids rejection. A small radiopaque, button sized, round object was seen impacted in the upper esophageal third on X ray examination and later extracted by endoscopy, corresponding to an electric cell, from a father's handwatch, which had been ingested by the baby without knowledge of parents about 30 h before. After 12 h fasting, oral feedings were resumed being apparently well tolerated, but in the following day fever and respiratory distress reappeared, together with drooling, cianosis, abdominal distention and pale skin. Patient was transferred to a regional hospital where extensive bilateral pneumonia and anemia were documented. Gastric drainage via nasogastric tube, antibiotic treatment, blood transfusion and oxygen therapy were given from admission, but she died within a few hours. At necropsy a 3 per 2.5 cm diameter orifice of sharp borders was seen in the upper third of the esophagus, communicating to tracheal lumen through its upper six cartilages. Extensive, severe, bilateral pneumonia was confirmed. When this kind of electric cells become impacted into the esophagus, wall necrosis may occur within 4 h and perforation within 8 to 12 h and can be prevented by immediate endoscopic extraction. Otherwise fistulae should be suspected and patients managed accordingly. Emergency room medical staff must always be aware of this potentially lethal condition and its proper management. Infants should not be permitted to play with such apparently innocent objects as battery operated handwatches.
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PMID:[Tracheoesophageal fistula secondary to ingestion of a button battery]. 184 45

Four cases of pharyngeal trauma in cattle due to improper administration of oral medications are discussed. These cases presented for suspected gastro-intestinal disorders and anorexia. Physical findings included copious drooling of saliva, pharyngeal pain, extended head and neck, forestomach stasis, fever, dysphagia, and pneumonia. Diagnosis was made by manual examination of the oral cavity or endoscopy. Ancillary diagnostic aids included clinical pathology and radiography. Hemograms were consistent with infection, serum electrolytes were normal. Radiographs in 3 of 4 did reveal significant evidence of retropharyngeal cellulitis. The signs of dysphagia and forestomach dysfunction were explained by either a pain induced inhibition of swallowing and eructation or direct involvement of the vagus nerve itself in the retropharyngeal region. An additional consequence of laryngeal motor dysfunction was aspiration pneumonia. Response to treatment with broad spectrum antibiotics, analgesics and symptomatic supportive care over a 7 to 14 day period was good.
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PMID:Pharyngeal trauma in cattle. 722 42

Fifteen incidents of infectious bovine rhinotracheitis (IBR) were studied in herds distributed widely throughout northern Britain. Fattening beef animals (10 outbreaks), dairy cattle (four outbreaks) and suckler beef cows (one outbreak) were affected and all bar one incident occurred in housed cattle during the winter. The first signs of illness noticed were a reduced appetite, dullness, coughing and oculonasal discharge. In 13 of the incidents they were observed in cattle purchased from a market within the previous four weeks. In every outbreak, affected animals developed a serous nasal discharge which became purulent in severe cases. In the early stages the nasal mucosa was congested but later yellow-brown diphtheritic plaques developed. In such animals halitosis was always detected. Soft coughing was frequently heard but pneumonia was rarely confirmed ante mortem. Conjunctivitis and ocular discharge were a major finding in 13 incidents and, in severely affected cases, conjunctival oedema was seen. The drooling of saliva was noticed in 14 incidents but congestion of the oral mucous membranes was the only abnormality found on examination of the oral cavity. Diarrhoea was a consistent feature in one outbreak. As a result of contracting this disease beef cattle failed to put on weight for a period of one to eight weeks and the milk yield of lactating dairy cattle decreased markedly. The morbidity rate was high, being more than 90 per cent in 10 incidents. The mortality rate varied considerably but 7 to 8 per cent of the animals died, or were culled, in three outbreaks. The clinical signs were most severe on intensive units with a high turnover of cattle.
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PMID:Clinical and epidemiological features of 15 incidents of severe infectious bovine rhinotracheitis. 745 95

Drooling is rarely seen in the normal child after the age of 6 months, but an estimated 10% of children with neurological impairment suffer significant interference with everyday living due to excessive drooling. Submandibular duct relocation is a procedure that involves the dissection and re-routing of the submandibular ducts to the posterior tonsilar pillar. This procedure has been carried out on 53 patients over the past 15 years at the Childrens Hospital, Dublin. All patients have been followed up with a detailed questionnaire to determine symptomatic improvement, parent satisfaction and complications. Parental satisfaction regarding this procedure is high, with 94% of parents stating that their child had benefited from the operation and over half the parents reported complete cessation of all drooling within 3 months of the operation. The major complication of post-operative pneumonia presumed secondary to salivary aspiration occurred in three children. These patients all made a full recovery. Early minor complications occurred in two children, involving post-operative submandibular gland swelling, and the late complication of a ranula was seen in four patients. We believe this is a safe and highly successful procedure that can significantly improve the quality of life of these children.
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PMID:The surgical management of drooling--a 15 year follow-up. 922 38

Patients with developmental disorders, including adolescents, comprise a large and heterogeneous group of individuals who vary in underlying diagnosis and degree of disability. The largest numbers of patients are those with cerebral palsy and with traumatic brain injury. While these conditions themselves do not directly cause airway or parenchymal lung dysfunction, consequences of neuromuscular dysfunction, especially aspiration and ineffective cough, may lead to lung damage. Poor nutritional status, impairment of airway clearance by muscular weakness or incoordination and poor pulmonary reserve (due to chest wall or spine deformity) increase the risk of significant morbidity and mortality from respiratory infections. Individuals who were premature infants or who had prolonged neonatal courses may also have residual chronic lung disease (bronchopulmonary dysplasia) contributing to their pulmonary problems. This review discusses conditions that have adverse effects on the airway and lung (drooling, feeding problems, gastroesophageal reflux, aspiration, spasticity, scoliosis) and some of the consequences of these insults (disordered airway clearance, pneumonia, sleep apnea). Also discussed are issues important to the prevention or amelioration of respiratory difficulties, including preventive care, the effects of exercise, dental hygiene, and surgical intervention.
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PMID:Respiratory problems in the adolescent with developmental delay. 1106 May 58

A previously neurodevelopmentally intact 5-year-old male was admitted to hospital with a right lower lobe pneumonia with pleural effusion, subsequently confirmed to be a Mycoplasma pneumoniae infection. On the seventh day of the illness he had a prolonged generalized tonic or tonic-clonic convulsion, requiring intubation and ventilation. He was slow to regain consciousness (Child's Glasgow Coma Score 7-10 over 6 days) and brain imaging with CT and then MRI demonstrated bilateral thalamic lesions with oedema and central haemorrhage suggestive of acute bilateral thalamic necrosis, without striatal or white-matter involvement. He was treated with a 2-week course of erythromycin, and as an autoimmune process was considered possible, 5 days of intravenous methylprednisolone (20 mg/kg/day) followed by a 4-week oral prednisolone taper. He made a slow recovery over the next few weeks with almost complete neurological recovery by 2 months but with significant dysarthria, drooling, and a mild left hemiparesis. At 9 months, significant dystonia continued to affect his speech and, together with tremor, his upper-limb fine motor function bilaterally. His gait, personality, and higher cognitive functions appeared to have recovered fully. Although acute striatal necrosis, acute disseminated encephalomyelitis, and encephalitis have been reported with Mycoplasma pneumoniae and a similar picture of acute bilateral thalamic necrosis with influenza-A ('acute necrotizing encephalopathy'), this is the first reported case of Mycoplasma pneumoniae-associated isolated acute bilateral thalamic necrosis.
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PMID:Acute bilateral thalamic necrosis in a child with Mycoplasma pneumoniae. 1499 91

The aim of this study was to determine whether the incidence of pneumonia in patients taking clozapine was more frequent compared with those taking risperidone or no atypical antipsychotics at all before admission to a tertiary care medical center. This was a retrospective, case-matched study of 465 general medicine patients over a 25 month period from 1 July 2010 to 31 July 2012. Detailed electronic medical records were analyzed to explore the association between the use of two atypical antipsychotics and incidence of pneumonia. Of the 155 patients in the clozapine group, 54 (34.8%) had documented pneumonia compared with 22 (14.2%) in the risperidone group and 18 (11.6%) in the general population group. Clozapine, when compared with the untreated general population, was associated with an increased risk of pneumonia (odds ratio=4.07; 95% confidence interval=2.25-7.36). There was, however, no significant increase in the risk of pneumonia associated with the use of risperidone (odds ratio=1.26; 95% confidence interval=0.65-2.45). Clozapine use is associated with increased risk of pneumonia that may be related to immunologic factors or side effects of sedation and drooling that make aspiration more likely, although causative mechanisms require further investigation. These findings suggest that providers should use added caution in choosing candidates for clozapine therapy.
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PMID:Clozapine usage increases the incidence of pneumonia compared with risperidone and the general population: a retrospective comparison of clozapine, risperidone, and the general population in a single hospital over 25 months. 2805 28

BACKGROUND Mendelson's syndrome consists of pulmonary aspiration of acidic gastric contents that results in acute lung injury (chemical pneumonitis). CASE REPORT We present the case of a 15-year-old girl who was admitted to the Emergency Department 1 h after ingestion of an organophosphate pesticide. The patient had abundant emesis of aqueous, transparent content, accompanied by drowsiness and moderate sialorrhea. We observed drooling and foaming at the mouth and tachycardia, and her oxygen saturation dropped to 75%, requiring immediate invasive ventilation. Computed tomography (CT) revealed opacities in both lung bases, while bronchoscopy evidenced burn lesions along the airway. A bronchoalveolar lavage (BAL) was performed and microbiological results were negative. Following the BAL, the patient showed a satisfactory evolution and full recovery. CONCLUSIONS This case report describes chemical pneumonitis due to pulmonary aspiration of sterile gastric contents following ingestion of a pesticide. We discuss the importance of timely diagnosis, the characteristic burn lesions found in bronchoscopy, and the role of bronchoalveolar lavage, which most likely allowed for a rapid recovery with favorable results.
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PMID:Mendelson's Syndrome: Chemical Pneumonitis After Pesticide Intake. 3282 30


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