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)

The clinical features of 34 Japanese patients with bronchiolitis obliterans organizing pneumonia (BOOP) are discussed. Thirty-two patients (94 percent) had symptoms of cough, fever, or dyspnea. On chest roentgenograms, bilateral patchy infiltrates were seen most frequently in 23 patients (68 percent), followed by small linear opacities in five (15 percent), both patchy infiltrates and reticulonodular opacities in four (12 percent), and reticulonodular opacities in two (6 percent). The bronchoalveolar lavage fluid (BALF) cell findings obtained from 26 patients revealed an increase in the percentage of lymphocytes in 20 patients (77 percent), neutrophils in 15 (58 percent), and eosinophils in 16 (62 percent), and a decrease in the CD4+/CD8+ ratio in 14 of 23 patients (61 percent). Corticosteroids were administered to 25 patients. Except for one patient who died, the prognosis was good in all patients. Further, in patients without corticosteroid therapy, the prognosis was good.
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PMID:Bronchiolitis obliterans organizing pneumonia. Clinical features and differential diagnosis. 151 92

Purulent bronchitis was identified in 19 of 422 patients undergoing fiberoptic bronchoscopy during a 32-month period because of suspicion of an opportunistic lung infection complicating acquired immunodeficiency syndrome or human immunodeficiency virus infection. Five patients had Pneumocystis carinii pneumonia, but other opportunistic lung infections were excluded in the remaining 14 patients. Characteristics of these 14 patients included fever (greater than 38.3 degrees C), cough, and dyspnea in 14 of 14 patients; purulence of expectorated sputum (11/14); and widened alveolar-arterial oxygen gradient (13/14). Rapid (2 +/- 1.4 days) clinical response (defervescence and resolution of pulmonary symptoms) occurred with antibiotic therapy in 10 of 14 patients. In three patients, there was no improvement, and adult respiratory distress syndrome developed. Bacterial isolates from bronchoalveolar lavage included Streptococcus viridans (n = 12), Haemophilus influenzae (n = 7), Staphylococcus aureus (n = 3). Roentgenographic features of bronchiectasis were present in seven patients. Differential cell counts revealed greater than 50% neutrophils in the bronchial washings of all patients with purulent bronchitis. Neutrophil percentages in bronchoalveolar lavage were as follows: patient with purulent bronchitis without P carinii pneumonia (n = 14), 54.53% +/- 29.18%; patients with purulent bronchitis and concomitant P carinii pneumonia (n = 5), 62% +/- 31.9%. In a control group of 17 patients with P carinii pneumonia who did not have purulent bronchitis, the neutrophil percentage was 6.8% +/- 6.17% (p = less than 0.00001, t-test). Purulent bronchitis appears to be a distinct, treatable entity in patients with HIV infection and may accompany bacterial pneumonia, bronchiectasis, and P carinii pneumonia.
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PMID:Bronchitis mimicking opportunistic lung infection in patients with human immunodeficiency virus infection/AIDS. 151 86

A rare side effect of minocycline is acute eosinophilic pneumonia. In the literature only ten cases have been reported. We report two cases of minocycline which induced (eosinophilic) alveolitis. A high fever, dry cough, dyspnoea and fatigue are the main features of the clinical picture. Peripheral blood eosinophilia and elevated total IgE content were seen in one patient. Bronchoalveolar lavage in this patient revealed eosinophilia. Transbronchial lung biopsies showed infiltration with eosinophilic granulocytes in both patients. Airway macrophages contained brown-black pigment granules. In the acute stage an important decrease in diffusion capacity was observed. The pulmonary and systemic symptoms promptly cleared up after discontinuation of minocycline. Provocation with minocycline was positive, because both patients noticed the same symptoms within one day.
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PMID:[Minocycline as a cause of acute eosinophilic pneumonia]. 153 40

Pneumocystis carinii pneumonia is often difficult to diagnose in an ambulatory care setting. Previous reports have identified elements of the clinical history, physical examination, and clinical testing that are useful predictors of P carinii pneumonia. We analyzed published data on these predictors and measured them against methodologic standards for clinical prediction rules. Variables with high negative or positive predictive value for P carinii pneumonia, low error rates, or compelling biologic credibility were then selected to develop an untested clinical prediction rule for P carinii pneumonia. We suggest that dyspnea, oral lesions, chest roentgenographic examination, and pulse oximetry may be used to select patients requiring sputum testing and/or bronchoscopy for the diagnosis of P carinii pneumonia. The role of pulse oximetry in the diagnosis of P carinii pneumonia merits further study.
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PMID:Clinical prediction of Pneumocystis pneumonia. 154 26

Pneumonia by Pneumocystis carinii (NPC) presents a high incidence in the evolution of patients infected by the human immunodeficiency virus (HIV). Common clinical signs include fever, dry cough and dyspnea, in the presence of pulmonar interstitial affection with several degrees of hypoxemia. One hundred and sixteen patients with NPC and infection by HIV were diagnosed between December 1986 and January 1990. Criteria of persistent fever was established in 10 of them (8.7%), with normal thoracic radiography at the time of hospitalization. NPC in the adquired immunodeficiency syndrome (SIDA) may develop' with persistent fever, joining the large relation of entities manifesting in this way.
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PMID:[Pneumocystis carinii pneumonia in AIDS and prolonged fever]. 157 15

Acute pneumonitis following aspiration of petroleum products is usually related to accidental poisonings in children. We describe here two cases of hydrocarbon pneumonitis in fire-eaters, caused by accidental aspiration of petroleum during the performance of fire-eating. Both patients had cough, dyspnoea, chest pain and fever. Chest X-rays showed basal lung infiltrates and, 2 weeks later, pneumatocele formations. Reversible bronchial hyperresponsiveness and restrictive ventilatory limitation were demonstrated in one of the patients. The bronchoalveolar lavage specimen showed cytoplasmic vacuolation of the macrophages and neutrophilia. After treatment with antibiotics and corticosteroids the symptoms disappeared and the lung function values returned to normal within 2-3 weeks. Radiological resolution of the pneumatoceles occurred within 2-12 months.
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PMID:Fire-eater's lung. 157 31

We examined 135 elderly patients with pneumonia to clarify the factors predicting on the outcomes of the elderly pneumonic patients. In the fatal cases respiratory symptoms such as cough and sputum, except for dyspnea were less frequent but pulmonary infiltrations on chest roentgenograms were more massive as compared with those in the survived cases. Thus, it was suggested that in the fatal cases the more advanced pneumonia had developed at the time when the diagnosis of pneumonia was made. The fatal cases showed hypoalbuminemia, hypocholesterolemia and hyponatlemia more frequently as compared with survived cases. Among these laboratory values, the decreased serum albumin concentration seemed to be most closely correlated with the fatal outcome of the elderly pneumonic patients. There were significant differences in the outcomes among three groups of the patients, those who were the prolonged bed-ridden, those with severe underlying diseases such as cancer and those treated as out-patients. The out patients showed the most favorable outcome and the prolonged bed-ridden patients the worst outcome. Approximately, 39% of the fatal cases were complicated with multiple organ failure. These results suggest that more important factors which affect the outcomes of pneumonia in the elderly may be not merely aging but the conditions of the host at onset of the disease.
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PMID:[Host factors which influence the outcome of pneumonia in the elderly]. 160 54

A 24-year-old woman had been treated with minocycline (MINO) for acute upper airway infection. Two days after the start of MINO therapy, she developed fever, cough, dyspnea, and bloody sputum. Her chest X-ray film revealed bilateral pleural effusions and butterfly shadow, and chest computed tomography revealed markedly increased density of pulmonary tissue in the central lung fields. Arterial blood gas analysis demonstrated severe hypoxemia. The characteristics of the pleural effusion were exudative. Based on the history of her illness and the chest X-ray findings, in addition to the laboratory findings of leukocytosis with eosinophilia and increased serum IgE, drug-induced pneumonia was suspected. Once the treatment with MINO was discontinued, her symptoms, laboratory data, and chest X-ray findings improved rapidly. Microscopic examination of a transbronchial lung biopsy specimen showed increased alveolar septal thickness with formation of Masson's bodies. Although the result of a lymphocyte stimulation test was negative for MINO, the skin test was positive for immediate response. Because of her clinical course, the possibility of induction by other drugs was excluded. This patient was therefore diagnosed to have MINO-induced pneumonia. To date, ten cases of MINO-induced pneumonia have been reported, but no previous case was associated with pleurisy.
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PMID:[Minocycline-induced pneumonia and pleurisy--a case report]. 160 63

A 77-year-old man underwent emergency admission for nocturnal asthmatic attack. Although his asthmatic attack improved within a few days with treatment including systemic corticosteroid, bilateral recurrent infiltrative shadows developed in his chest roentgenogram in association with a further exacerbation of dyspnea. Various antibiotic agents were given; however, the pulmonary infiltration did not improve. He was transferred to our department with the diagnosis of intractable pneumonia. C. albicans was detected in the sputum, and both IgE antibody and precipitating antibody specific for C. albicans were positive. Immediate cutaneous reactivity to C. albicans was positive even with a million-fold dilution of antigen extract C. albicans was also detected in bronchoalveolar lavage fluid. A diagnosis of allergic bronchopulmonary candidiasis was made. Chest roentgenographic findings as well as clinical symptoms improved with inhalation of 50 mg of amphotericin B.
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PMID:[A case of allergic bronchopulmonary candidiasis treated with amphotericin B inhalation]. 160 68

A 29-year-old woman presented with progressive dyspnea, fever, cough, and weight loss. A chest roentgenogram revealed bilateral peripheral infiltrates suggestive of chronic eosinophilic pneumonia. Bronchoscopic evaluation, as well as a therapeutic trial of corticosteroids, was nondiagnostic. Open lung biopsy revealed findings consistent with a diagnosis of sarcoidosis. Roentgenographically, differentiating between sarcoidosis and chronic eosinophilic pneumonia can be difficult. A diagnostic approach, as well as the differential diagnosis of bilateral peripheral pulmonary infiltrates, is discussed.
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PMID:Sarcoidosis masquerading as eosinophilic pneumonia. 161 46


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