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

Thirty-two confirmed and 24 highly probable cases of Legionnaires' disease occurred in Vermont between May 1 and Oct 15, 1977. Confirmed cases had positive results for direct fluorescent antibody testing of lung tissue or fourfold rise in antibody titer. Highly probable cases had one elevated titer (greater than or equal to 1:256) and a compatible illness. Forty-eight (86%) had underlying chronic disease, and 22 (39%) were immunocompromised. Prominent early symptoms were fever, cough, chills, and malaise. All but one patient had verified pneumonia. Courses ranged from a pneumonia not requiring hospitalization to respiratory failure necessitating support with mechanical ventilation. Seventeen patients died. Although the clinical presentation was variable, rapid development of high fever and leukocytosis together with negative cultures of lower respiratory tract secretions strongly suggested the diagnosis in an epidemic setting.
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PMID:Legionnaires' disease in Vermont, May to October 1977. 35 Dec 19

To our knowledge, this is the first reported case of primary Pseudomonas maltophilia pneumonia. Presenting symptoms were fever and chills of two days' duration and a density in the right upper lobe. Sputum culture showed normal flora, and multiple blood cultures were negative. Antibiotic therapy initially with penicillin and then with carbenicillin was unsuccessful. Selective bronchial aspiration yielded pure cultures of P maltophilia. When an appropriate antibiotic, chloramphenicol, was given, a prompt therapeutic response followed.
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PMID:Primary Pseudomonas maltophilia infection of the lung. 41 20

Clinical features of 46 patients with anaerobic bacterial pneumonitis were compared with those of patients with pneumococcal pneumonia. The presenting features in these 2 groups were comparable in terms of fever, leukocyte count, and radiographic abnormalities. In only 2 patients with anaerobic bacterial pneumonitis was putrid sputum noted on initial evaluation. None of the patients with anaerobic bacterial pneumonitis had shaking chills, although this was reported by nearly one half of those with pneumococcal pneumonia. The response to treatment with antimicrobial drugs was comparable in the 2 groups, except that 20% of patients with anaerobic bacterial pneumonitis subsequently developed pulmonary abscesses, despite the use of antimicrobial agents presumed to be active against the infecting flora. There was also a high incidence of bronchogenic neoplasms among patients who had anaerobic bacterial pneumonitis in the absence of an associated condition that would predispose to aspiration. The findings of this review suggest that anaerobic bacterial pneumonitis may be difficult to distinguish from pneumococcal pneumonia on the basis of clinical presentation.
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PMID:Anaerobic bacterial pneumonitis. 42 Apr 33

Since the initial description of Legionnaires' disease 2 years ago, a clearer picture of its clinical manifestations has emerged as a result of investigations of further epidemics and studies of laboratory-confirmed sporadic cases. Although individual clinical features are not sufficiently distinctive to distinguish Legionnaires' disease from other types of acute pneumonia, a composite can provide a sufficiently characteristic clinical profile to indicate the likelihood of this diagnosis. Such a profile includes high fever (above 39.4 degrees C); recurrent chills; relative bradycardia; early gastrointestinal symptoms (particularly diarrhea); prominent myalgias; microscopic hematuria; liver function abnormalities; toxic encephalopathy; nonproductive cough; absence of bacterial pathogens on Gram stain and culture of transtracheal aspirate; progression from patchy bronchopneumonia to lobar and multilobar consolidation; and frequently prompt and sometimes dramatic response to treatment with erythromycin.
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PMID:Clinical aspects of Legionnaires' disease. 43 24

The cases of six patients with Philadelphia Legionnaires' disease were studied during the acute phase and throughout the following year. This multisystems disease process developed abruptly with symptoms of chills, fever, myalgias, and headache. The unusual clinical association of fever with relative bradycardia was noted frequently. Pneumonia developed after the first few days and rapidly progressed to life-threatening respiratory failure despite penicillin and cephalosporin therapy. Improvement occurred within 48 hours after tetracycline or chloramphenicol was administered. No permament sequelae were noted on the one-year follow-up examination, and no secondary cases of infection occurred.
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PMID:Legionnaires' disease. Clinical findings and one-year follow-up. 68 92

For a number of years we have observed six patients whose illness began after inhaling high concentrations of mercury vapor in a single exposure. They all had symptoms of acute mercury poisoning with fever, chills, chest pain, and weakness. Three men had diffuse pulmonary infiltrates on chest x-ray suggesting chemical pneumonitis. Two of the men excreted large amounts of mercury in their urine two days after exposure following BAL therapy. Their chronic symptoms differed somewhat, but many complained of nervousness, irritability, lack of ambition, and loss of sexual desire. Chronic mercury poisoning is generally felt to follow only long periods of exposure. Although thess patients had symptoms which are not pathognomonic of chronic mercury poisoning, we feel the events described strongly suggest their relationship to a single brief exposure and represent a form of chronic mercurialism.
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PMID:Chronic mercury poisoning from a single brief exposure. 69 Jul 36

Twenty-three children with various stages and morphologic types of leukemia were treated with multiple granulocyte transfusions obtained by filtration leukapheresis when neutropenia-associated infection appeared unresponsive to antibiotics. All children meeting the above qualifications were given granulocyte transfusions during this time period. Twenty-one of 23 became afebrile during or shortly after the transfusions; one died with disseminated Herpes simplex; and one became well enough to be discharged, although he was never free of fever. Frequent mild to moderate fever and chills were noted. One child developed a severe pulmonary reaction followed by resolution of pneumonia. Filtration leukapheresis is a useful adjunct in controlling severe infections in neutropenic children.
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PMID:Granulocyte transfusions in children using filter-collected cells. 82 3

During the first week of March 1974, a hospitalized patient being evaluated for hyperproteinemia and hypertension experienced fever, chills, and myalgia and showed pulmonary signs consistent with diffuse pneumonia. Subsequently, the findings from serologic tests confirmed that the patient had viral influenza. Seven other compromised hosts on the same ward developed symptoms of pneumonic influenza, and serologic data on three of the seven confirmed influenza A2. Additionally, a previously healthy young adult admitted with acute respiratory distress died of nonbacterial complications and was shown to have community-acquired influenza. The unusual features of the epidemic were the intrahospital localization of the epidemic in compromised hosts, the high rate of pneumonic complications, the low rate of secondary bacterial infection, and the severity of the viral pneumonia in the community-acquired case.
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PMID:A nosocomial outbreak of influenza A. 85 36

From 1967-1973, a total of 54 strains of Mycoplasma pneumoniae was isolated from patients suffering from different acute respiratory diseases, with an average positive isolation rate of 4.7%. Most mycoplasmas were isolated from patients aged 40-60, and with pneumonia of primary atypical pneumonias. The highest frequency of isolation was found in sputum collected 4-8 days after onset of illness. Colony formation on PPLO medium usually occurred 7-12 days after incubation. Serological tests were methods of choice for diagnosis of mycoplasmal pneumonia. In the 6 years period, 163 patients were diagnosed: 74 were positive only by metabolic inhibition test (MIT), 55 were positive only by cold agglutination test (CAT), and 34 gave positive by both tests. Of the above 2 tests, the CAT is nonspecific, but the MIT appears to be more sensitive and specific. Of the 94 sera positive by MIT, 42 (48.2%) were also positive by CAT; of those negative by MIT, 45 of 507 (8.8%) were positive by CAT. Of 45 sera with positive mycoplasma isolation, 37 (82.2%) were also positive by MIT, but only 22 (48.9%) showed the rises of CAT titers. Clinical features of mycoplasmal pneumonia were almost similar to those described by the other investigators. The chief symptoms were fever, coughs, chills, rales, malaise, sore throat headache and chest pain. The sedimentation rate of erythrocytes was accelerated. White count was normal in most cases. Both leucocytosis and leucopenia were found in 10% of the cases. Seasonal variation in incidence of mycoplasmal pneumonia was not obvious, however the lowest incidence occurred during summer. A roentgenogram of the chest was necessary for diagnosis of mycoplasmal pneumonia, and the lung infiltration was mainly located on right side (57.1%), segmentally, and limited to one lobe, especially the lower lobe.
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PMID:Mycoplasmal pneumonia in Chinese veterans. 103 86

Infection due to Staphylococcus aureus continues to be a source of significant morbidity and mortality. However, its treatment is increasingly complicated by the rising prevalence of resistance to antibiotics. Apart from the two recognized modes of staphylococcal resistance, namely, penicillinase production and intrinsic resistance, Sabath and associates have described a third type in which resistance is manifested by susceptibility to growth inhibition but tolerance to the lethal action of bactericidal agents. The mechanism of tolerance is attributed to a deficiency of autolytic enzyme activity in the part of bacteria, possibly secondary to an inhibition of autolysins in the tolerant staphylococcal strains. These strains are found in patients with infections responding poorly to treatment with cell-wall active antibiotics including vancomycin. Because of its unique mechanism of action and pharmacokinetic properties, rifampin has been reported to be the most active among 65 antistaphylococcal agents tested and have the capacity to kill intraleukocytic staphylococci. We present 2 cases who were cured following the addition of rifampin to previously established regimens. Case 1 was a 40-year-old male who had fever, cough, dyspnea, a right elbow abscess and left leg swelling for 2 weeks prior to admission. Culture of purulent material from the elbow abscess grew staphylococcus aureus. Chest X-ray showed bilateral septic embolism and phleborheography showed partial deep vein occlusion of the left ileofemoral vein. Case 2 was 22-year-old female with fever, chills and cough for 3 weeks. Blood culture grew staphylococcus aureus, and Chest X-ray revealed bilateral septic embolism with pneumonia. Neither of them responded to standard antibiotics which were judged adequate by in vitro sensitivity tests. Clinical cure was later obtained after rifampin was added to the regimens. These results suggest that rifampin may be a useful adjunct in the therapy of staphylococcal infections.
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PMID:[The use of rifampin in the treatment of infection due to Staphylococcus aureus]. 164 82


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