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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 radiological characteristics of 217 consecutive episodes of gram-negative bacillary pneumonia occurring in 189 adult cancer patients between November 1968 and December 1974 were analyzed. The majority of patients had acute leukemia (54%). Fever larger than or equal to 101 degrees F was the single most common symptom and sign of the presence of infection (90%). Next in frequency were crepitant rales (65%), cough (41%), dyspnea (19%) and chest pain (18%). Radiographic evidence of pneumonia was found in 83% of cases and it consisted mainly of alveolar infiltrates involving both lung fields and predominantly the bases. Up to one-third of the patients had normal chestx-ray examinations at the onset of infection, though they subsequently became abnormal in 42% of them. The majority of patients (81%) whose initial chest x-rays did not reveal the presence of pneumonia were neutropenic (less than 1000 circumlating neutrophils/mm3). Klebsiella sp. and Pseudomonas sp. were the most common infecting organisms. The overall cure rate was 61%; 70% for Klebsiella sp. infections and 64% for Pseudomonas sp. infections. Pulmonary abscesses occurred in 14% of the cases. Cures were related to the antibiotic sensitivity of the infecting organisms and to the number of circulating neutrophils during the period of infection. Best results were obtained with the administration of gentamicin, the newer aminoglycoside antibiotic sisomicin, tobramycin and amikacin, or the combination of gentamicin with carbenicillin or with cephalosporins. Early and vigorous therapy of gram-negative bacillary pneumonia with appropriate antibiotics has improved the prognosis of this infection at our institution.
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PMID:Gram-negative bacillary pneumonia in the compromised host. 32 40

A 40-year-old woman who had recently undergone kidney transplantation was succesfully treated for diffuse influenza virus pneumonia. The illness was acute, with rapid onset, high fever, nonproductive cough, dyspnea, cyanosis, crepitations and rales over both lung bases, and associated arterial hypoxemia, leukopenia, and thrombocytopenia. Prophylactic use of antibiotics to prevent superimposed bacterial infection and reduction of immunosuppressive therapy to minimal dosage during the critical phase of the respiratory infection contributed to the patient's survival. An episode of graft rejection was reversed by resumption of immunosuppressive therapy at standard dosage levels.
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PMID:Influenza virus pneumonia after renal transplant. 32 48

75 out of 77 children surviving IRDS with the aid of intermittent positive pressure ventilation have been followed up by age 2.6-7.6 years together with 68 matched controls. The morbidity of lower respiratory tract illnesses was significantly higher in IRDS survivors than in controls affecting a total of 48%, half whom were admitted to hospital on at least on occasion. Only 3 IRDS survivors had pneumonias beyound their third year, however. One child suffered from a moderate stridor due to a partial laryngeal stenosis and one from some dyspnoea at function caused by broncho-pulmonary dysplasia. Thoracic X-ray changes were found significantly more often and more marked in IRDS survivors but on the whole the changes were discrete. Neither the occurrence of pneumonia nor X-ray changes in the IRDS survivors were statistically relatable to a number of neonatal or therapeutical characteristics. Measurements of heart volume, respiratory frequency, oxygen saturation and acid-base values did not differ between the groups. Ventilated IRDS survivors, even with some degree of radiographic demonstrable residua, thus seem to have a good long-term prognosis with regard to lung function, irrespective of a preliminary high morbidity of lower respiratory tract illnesses.
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PMID:Long term prognosis of infants with severe idiopathic respiratory distress syndrome. II. Cardio-pulmonary outcome. 34 87

A review of the medical records of 123 persons with Legionnaires' disease hospitalized in the 1976 Philadelphia epidemic showed that the manifestations of infection ranged from mild grippe to a severe pneumonia that also involved other organ systems. Early in the illness, constitutional symptoms predominated. Fever, malaise, myalgia, rigors, confusion, headache, and diarrhea were usually followed by nonproductive cough and dyspnea. Physical examination showed few abnormalities other than rales. Moderate leukocytosis with left shift, elevated erythrocyte sedimentation rate, elevation of serum levels of liver enzymes, and hematuria and proteinuria were characteristic. Chest radiograph showed patchy, often nodular, areas of consolidation. Progression of pneumonia led to respiratory failure and the need for mechanical ventilatory assistance for 19 patients; renal failure, primarily after shock, occurred in 18 persons. Twenty-six patients died. Treatment with erythromycin or tetracycline resulted in the lowest case-fatality ratios, but the associations were not statistically significant.
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PMID:Legionnaires' disease: clinical features of the epidemic in Philadelphia. 43 27

Aspiration pneumonitis is an important cause of many anesthetic and non-surgical deaths and complication. One hundred and eight cases from 1964 to 1974 were reviewed to study the factors associated with aspiration pneumonia. Forty surgical and 68 non-surgical patients were evaluated and compared. Predisposing factors included impaired consciousness, esophageal and neurological disorders, cardiac resuscitation, debilitation, presence of a nasogastric tube or tracheostomy. The most common findings in both groups were dyspnea, cough, cyanosis, fever, tachycardia, rhonchi, rales and wheezes. Sputa of 64 patients failed to reveal the precise etiologic agent. High mortality (30%) and morbidity were found in both groups even with optimum treatment. The causes of morbidity in both groups of patients were pneumonia, lung abscess, myocardial infarction, gastrointestinal hemorrhage, and pulmonary embolus. Prevention, with particular attention to high-risk patients and to factors influencing aspiration in groups of surgical and non-surgical patients, is the solution to the problem.
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PMID:Aspiration pneumonia: a ten-year review. 45 16

Acute massive right-sided hydrothorax is a relatively rare but serious complication of peritoneal dialysis and may be responsible for the development of dyspnea during peritoneal dialysis. The pleural fluid appears to arise from the peritoneal dialyzate based on the time of its appearance and its chemical composition. It should be included in the differential diagnosis when a patient becomes dyspneic during peritoneal dialysis along with exaccerbation of congestive heart failure, pneumonia, atelectasis, and purulent bronchitis. Its occurrence is an indication to stop the peritoneal dialysis and contraindicates further use of this form of dialysis. Treatment may be conservative or aggressive (thoracentesis) depending on the clinical condition of the patient. Etiology is poorly understood. In some cases, there may be traumatic diaphragmatic fenestrations, but the majority of cases appear to be due to less well defined communications between the peritoneal and pleural spaces.
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PMID:Acute massive hydrothorax complicating peritoneal dialysis, report of 2 cases and a review of the literature. 47 54

Report on a 17 months old boy with the minor form of asphyxiating thoracic dystrophy. The clinical picture is characterized by a rigid, narrow, and extended thorax and by dyspnea and tendency to develop pneumonitis during early infancy. Later on there is gradual improvement by increase of the thoracic volume. At the age of 17 months there are no more radiographic pelvic deformities which the infant had initially. Up to now the boy shows no skeletal changes of the hands, and no symptoms of renal involvement frequently developing in this disease. Since the a. th. d. is inherited by an autosoma recessive gene, the recognition also of the minor forme is important for genetic counseling. The differentiation between the a. th. d. and the chondroektodermal dysplasia Ellis-van Crefeld is discussed.
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PMID:[Asphyxiating thoracic dystrophy (author's transl)]. 55 76

A 29-year-old woman with systemic lupus erythematosus (SLE) developed dyspnea, hemoptysis, pleuropericarditis, and azotemia shortly after an episode of arthritis and progressive hair loss. She had a high titer of radioimmune anti-DNA Antibodies, positive fluorescent anti-smooth muscle antibodies, and depressed C3 levels in her serum. Antiglomerular basement membrane antibodies were negative, and the titer of antibodies against extractable nuclear antigen was within normal limits. Cryoglobulins and lupus erythematosus cell preparations were negative. Despite steroid therapy and other supportive measures, including dialysis, she died ten days after admission. Percutaneous renal and pulmonary biopsies were performed postmortem at bedside and were processed for immunohistology. Identical granular deposits of C3 and IgG were found in both the lungs and the kidneys. This finding suggests that a common pathogenetic mechanism is operating in the development of pneumonitis and nephritis in SLE, and is in agreement with the currently held views on immune-complex diseases.
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PMID:Immunohistologic findings in the lung in systemic lupus erythematosus. 57 88

A follow-up study of eight Mayo Clinic patients with chronic eosinophilic pneumonia (also called Carrington's eosinophilic pneumonitis) was done in order to ascertain, if possible, the long-term prognosis of this entity, since it has not been delineated clearly in the literature. Chronic eosinophilic pneumonia is a subacute-to-chronic pulmonary disorder occurring most commonly in nonatopic women with cough, fever, dyspnea, weight loss, and night sweats. The typical chest roentgenogram shows peripheral non-migratory infiltrates, and the characteristic pulmonary histologic finding is eosinophilic infiltration of the interstitium and alveolar spaces. Peripheral eosinophilia is seen in most cases but not all. At the time of follow-up, two of eight patients were continuing to take corticosteroids after 5 1/2 and 8 years. Five patients have been able to discontinue corticosteroid treatment after an average of 4 years, and one patient never required corticosteroids. Chronic eosinophilic pneumonia is added to previous classifications of pulmonary infiltrate with eosinophilia.
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PMID:Chronic eosinophilic pneumonia (Carrington's): a follow-up study. 62 61

An 18-year-old woman with stage IIIB Hodgkin's disease presented with minimal shortness of breath and progressed to fatal pulmonary insufficiency in five days. Biopsy and necropsy lung tissue specimens established the diagnosis of acute radiation pneumonitis. The diagnosis of radiation pneumonitis should be considered in the presence of a nonproductive cough, dyspnea, mixed interstitial and alveolar infiltrates on chest roentgenogram, negative cultures, and the characteristic findings on lung biopsy of macrophage accumulation and alveolar fibrin deposition in the face of minimal cellular infiltrate. A trial of steroid treatment may be warranted.
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PMID:Acute febrile illness associated with bilateral pulmonary infiltrates after irradiation in a patient with Hodgkin's disease. 84 87


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