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

Broncholithiasis, a disease that is probably much more common than has been reported, is most often associated with pulmonary infections, for example, tuberculosis and histoplasmosis. Stones originate from calcified peribronchial lymph nodes that erode into the tracheobronchial tree, but lithoptysis occurs infrequently. The most common symptoms are persistent cough and hemoptysis, sometimes followed by findings of obstructive pneumonia (fever, chills, and purulent sputum). Physical findings are nonspecific, and radiologic findings are varied. Complications include formation of a fistula between the respiratory tract and the esophagus or aorta and obstructive pulmonary symptoms. Treatment ranges from conservative management (simple observation) to thoracotomy for patients in whom complications from stone erosion develop. The prognosis of patients with broncholithiasis is generally excellent.
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PMID:Coughing up a stone. What to do about broncholithiasis. 334 60

279 patients with 285 episodes of bacteremic pneumococcal pneumonia (Pnb), treated at the 2 departments for infectious diseases in Stockholm, Sweden, were reviewed retrospectively. Almost half of all episodes were caused by serotypes 3, 9 and 4 (in that order). The overall mortality rate was 7% and as low as 5% if patients with extrapulmonary complications were excluded. As in other studies male sex, alcoholism and absence of leukocytosis on admission to hospital were all associated with a higher mortality rate. However, the prognosis for old patients was much better than in most other studies. This was true also when the infecting strain was of serotype 3. For 89 consecutive patients out of the 279 ones with Pnb the clinical, laboratory and chest X-ray data were compared with those of 44 patients with non-bacteremic pneumococcal pneumonia (Pn) and 27 patients with Mycoplasma pneumoniae pneumonia (MP). Within the pneumococcal group almost all non-bacteremic patients had respiratory tract symptoms compared to less than half of the patients with bacteremic disease. High age, alcoholism, chills, pleuritic chest pain, a leukocyte count of greater than 15 x 10(9)l and an elevated CRP were factors significantly more common among those with pneumococcal pneumonia than among the MP patients. On chest X-ray an alveolar pattern was seen in all but 2 of the totally 133 patients with a pneumococcal pneumonia, but also in half the patients with MP.
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PMID:Bacteremic pneumococcal pneumonia in Sweden: clinical course and outcome and comparison with non-bacteremic pneumococcal and mycoplasmal pneumonias. 339 36

Patients usually provisionally diagnosed as having typhoid fever or pneumonia are regularly admitted to the Rietfontein Fever Hospital suffering from psittacosis. The main symptoms are intense headache, chills and fever and an irritating non-productive cough. Later most patients develop signs of pneumonitis most clearly seen on radiographic examination. An important clue to the diagnosis is a history of contact with birds, most often budgerigars and more recently cockatiels. The diagnosis may be confirmed by the isolation of Chlamydia psittaci, the causative organism, but more usually reliance is placed on the results of serological tests revealing the development of chlamydial antibodies. None of the patients in this series developed serious complications, but if not treated psittacosis sufferers may develop severe pneumonitis, hepatitis and gastro-enteritis; the mortality rate is up to 20%. A rare but fatal complication is chlamydial endocarditis, presenting with the signs and symptoms of subacute bacterial endocarditis, but giving repeated negative blood cultures. The illness responds specifically to treatment with tetracycline antibiotics within 48 hours. Chlamydial infections are widespread among avian species. In the RSA most cases of psittacosis have resulted from contact with budgerigars and cockatiels, but outbreaks have been associated with imported batches of birds including South American parrots and Australian finches, emphasizing the need for vigilance at seaports.
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PMID:Psittacosis in the RSA. 370 61

A case of a 69-year-old man admitted with procarbazine pneumonitis and a review of the literature are presented. The patient completed a second course of MOPP chemotherapy for Hodgkin's disease three days before admission. He presented with a recent onset of fever, chills, anorexia, and malaise. Chest radiography indicated diffuse bilateral interstitial pneumonitis, and pulmonary function studies revealed restrictive lung disease. Attempts to identify an infectious etiology, including open lung biopsy, were negative, and empirical antibiotic therapy was ineffective. The diagnosis was drug-induced hypersensitivity reaction, most likely due to procarbazine. Corticosteroid therapy was instituted with gradual improvement. Six other cases of pneumonitis associated with procarbazine therapy are briefly reviewed, and the use of pulmonary function tests to identify the type and degree of injury and monitor therapy is discussed.
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PMID:Acute pneumonitis associated with MOPP chemotherapy of Hodgkin's disease. 610 Dec 51

In the absence of recognized pneumonitis, psittacosis is unlikely to be considered as a cause of infection in patients with febrile illnesses. To identify findings useful in the diagnosis of psittacosis, the clinical and roentgenographic characteristics of 46 cases that occurred in two outbreaks among workers in turkey processing plants were reviewed. Headache (96% of patients), chills (93% of patients), and fever (89% of patients) were the most common symptoms; a nonproductive cough occurred in 65% of patients. Rales or rhonchi were detected in only six (18%) of 33 patients examined, but 21 (72%) of 29 patients receiving a chest film had roentgenographic evidence of pneumonia. We conclude that few diagnostically useful symptoms or signs occur in patients with psittacosis but that roentgenographically confirmed pneumonitis may occur commonly in patients with little clinical evidence of pneumonitis. A history of exposure to birds, in an individual with a flu-like illness, appears to be the single best clue to the diagnosis of psittacosis.
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PMID:Psittacosis. A diagnostic challenge. 649 78

Chemotherapy-related pneumonitis developed in eight patients during treatment for breast cancer. Six were receiving adjuvant therapy and two were being treated for metastatic disease. Fever, chills, dyspnea, and dry cough were the initial symptoms. Observations from chest roentgenograms varied from normal to bilateral interstitial-alveolar infiltrates. Results of pulmonary function tests were markedly abnormal, with a decreased diffusing capacity being the most characteristic abnormality. The pneumonitis developed in six patients while receiving 20 mg or less per day of prednisone and appeared temporarily related to tapering of steroid therapy in four patients. All patients recovered clinically, although prednisone therapy of 60 mg/day or its equivalent was required in three cases. Mild pulmonary function abnormalities persisted. Drug-induced pneumonitis should be considered in the differential diagnoses of patients with breast cancer in whom unexplained fever, dyspnea, or infiltrates develop during multidrug chemotherapy.
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PMID:Chemotherapy-associated pulmonary toxic reactions during treatment for breast cancer. 660 32

M. pneumoniae is a common cause of pneumonia. The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell count is normal or only slightly elevated, and the Gram stain of the sputum (if any can be obtained) reveals polymorphonuclear leukocytes and few bacteria. The diagnosis is more difficult when the patient presents with symptoms not suggestive of pneumonia including lethargy, dyspnea, and a 1- to 4-week history of shortness of breath without cough or fever in association with diffuse reticulonodular or interstitial pulmonary infiltrates. The disease in the previously healthy host is usually benign and self-limiting. However, the course is shortened by the administration of tetracycline derivatives or erythromycin. M. pneumoniae pneumonia can occur in association with other diseases including sickle cell anemia, sarcoidosis, systemic lupus erythematosus, Hodgkin's disease, and various other immunodeficiency states. In these patients mycoplasma pneumonia can be very serious. Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients.
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PMID:Mycoplasma pneumonia. 676 79

Sixty-five cases of nosocomially acquired Legionnaires' disease are reported and the world literature is reviewed. The etiologic agent, Legionnella pneumophila, has been isolated from several environmental sources at outbreak sites. Legionnaires' disease appears to be acquired by inhalation and is primarily manifested by severe, potentially fatal, pneumonia. Characteristic clinical disease consists of high fever with relative bradycardia, dry cough, chills, diarrhea, and pleuritic pain. Although no single feature is pathognomonic, the clinical presentation is usually sufficiently characteristic to suggest the diagnosis. The diagnosis of Legionnaires' disease during acute illness may be established by culture of Legionella pneumophila, or by demonstration of the bacterium using special stains. However, in most instances, the physician must make a presumptive diagnosis based on the clinical presentation in order to institute appropriate antimicrobial therapy. Retrospective confirmation of the diagnosis may be made by serologic studies in most instances. Erythromycin is, at this time, the drug of choice for the treatment of Legionnaires' disease. A prompt salutory response following institution of erythromycin therapy is typical.
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PMID:Legionnaires' disease: report of sixty-five nosocomially acquired cases of review of the literature. 699 73

Eight patients with Legionnaires' disease were seen at one hospital in the summer of 1979. They presented in the same 12-day period with an illness of rapid onset characterized by fever, chills, malaise, profuse sweating and neurologic symptoms. Neutrophilia, a high erythrocyte sedimentation rate, proteinuria, hypoalbuminemia, hyponatremia, hypochloremia and abnormal liver enzyme levels in the serum were usually noted. The roentgenographic findings in the lungs ranged from segmental interstitial infiltration to panlobar pneumonia. Seven patients responded to erythromycin treatment, though one died suddenly, presumably of unrelated cardiac disease. The other patient died of a combination of renal and respiratory failure, with pulmonary edema.
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PMID:Eight cases of Legionnaires' disease. 700 76

In 1978 and 1979, eight sporadic cases of Legionella pneumonia were observed in the Berne and Ticino areas of Switzerland. In all cases the diagnosis was established serologically using indirect immunofluorescence. Seroconversion was observed in five patients. In three cases initially high antibody titers decreased progressively. The clinical picture was characterized by acute onset with high fever, frequent chills, and dry cough. Occasional concomitant symptoms included muscular pains, headache, thoracic pain, dyspnea, hemoptysis, and gastrointestinal and central nervous symptoms. Laboratory findings showed markedly increased BSR as well as slightly increased WBC with a pronounced shift to the left. In all cases, X-ray examinations demonstrated extended, mainly unilateral and often remarkedly peripheral infiltrations of the lung. On the basis of the clinical course, two groups could be distinguished: (a) non-complicated cases of pneumonia with rapid improvement within 2-3 weeks; and (b) cases with a protracted sometimes severe course with persistence of the infiltrations up to 4 months and more. All patients with a protracted course suffered from concomitant symptoms. Whereas none of the patients died of legionellosis, two patients died six months later from their underlying disease. Most patients were treated with several antibiotics. In three patients definite improvement occurred only after therapy had been changed to doxycycline. Erythromycin, currently recommended as the drug of choice, was used in none of these cases.
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PMID:[Clinical data on Legionnaires' disease. Report on 8 sporadic cases of Legionella pneumonia]. 720 64


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