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

Community acquired pneumonia in adults is an acute disease characterized by worsening in general conditions, fever, chills, cough, mucopurulent sputum and dyspnea; associated with tachycardia, tachypnea, fever and focal signs in pulmonary examination. The probability of pneumonia in a patient with acute respiratory symptoms depends on the disease prevalence in the environment where it is acquired and on clinical features. It is estimated that pneumonia prevalence is 3-5% in patients with respiratory disease seen in outpatient facilities. Clinical diagnosis of pneumonia without radiological confirmation lacks specificity because clinical presentation (history and physical examination) does not allow to differentiate pneumonia from other acute respiratory diseases (upper respiratory infections, bronchitis, influenza). Diagnosis must be based in clinical-radiological findings: clinical history and physical examination suggest the presence of pulmonary infection but accurate diagnosis is established when chest X ray confirms the existence of pulmonary infiltrates. Clinical findings and chest X ray do not permit to predict with certainty the etiology of pulmonary infection. Radiology is useful to confirm clinical suspicion, it establishes pneumonia location, its extension and severity; furthermore, it allows differentiation between pneumonia and other diseases, to detect possible complications, and may be useful in follow up of high risk patients. The resolution of radiological infiltrates often ensues several weeks or months after clinical recovery, especially in the elderly and in multilobar pneumonia cared for in intensive care units.
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PMID:[Clinical and radiological diagnosis of community-acquired pneumonia in adults]. 1616 16

A 59-year-old man was hospitalised because of dyspnoea, productive cough, fever, chills and malaise. Severe community-acquired pneumonia was diagnosed. Legionella urinary antigen testing, which can only detect serogroup 1, and the first culture ofa bronchoalveolar lavage (BAL) fluid sample were negative for Legionella. However, L. pneumophila DNA was detected by PCR in the BAL washing sample. Eventually, L. pneumophila serogroup 3 was isolated from this specimen by repeated culture. Although, in The Netherlands, legionellosis is caused by L. pneumophila serogroup 1 in more than 90% of all cases, this case demonstrates that a negative result of urinary antigen testing does not necessarily exclude this diagnosis. It is therefore advocated to expand the diagnostics to a Legionella PCR on respiratory material of patients with clinical signs of Legionella pneumonia in whom the urinary antigen test is negative.
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PMID:[A patient with Legionella pneumophila serogroup-3 pneumonia, detected by PCR]. 1617 Nov 6

Patients with community-acquired pneumonia often present with cough, fever, chills, fatigue, dyspnea, rigors, and pleuritic chest pain. When a patient presents with suspected community-acquired pneumonia, the physician should first assess the need for hospitalization using a mortality prediction tool, such as the Pneumonia Severity Index, combined with clinical judgment. Consensus guidelines from several organizations recommend empiric therapy with macrolides, fluoroquinolones, or doxycycline. Patients who are hospitalized should be switched from parenteral antibiotics to oral antibiotics after their symptoms improve, they are afebrile, and they are able to tolerate oral medications. Clinical pathways are important tools to improve care and maximize cost-effectiveness in hospitalized patients.
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PMID:Diagnosis and treatment of community-acquired pneumonia. 1711 84

A 32-year-old man presented with a 2-month history of worsening fever, chills, and cough despite therapy with oral antibiotics. Chest radiographs demonstrated migrating, peripheral upper lobe infiltrates. A CBC count demonstrated significant eosinophilia. At bronchoscopy, eosinophil-rich mucus was seen impacted throughout his bronchi. A transbronchial biopsy confirmed the diagnosis of eosinophilic pneumonia. Symptoms, eosinophilia, and radiographic abnormalities were reversed with cessation of duloxetine. This case report briefly reviews the diagnosis of drug-induced pulmonary infiltrates with eosinophilia (PIEs) and eosinophilic pneumonia. To our knowledge, this is the first reported case of PIEs due to duloxetine.
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PMID:Eosinophilic pneumonia due to duloxetine. 1735 12

Acute Q fever is a worldwide zoonosis caused by Coxiella burnetii infection. In Taiwan, cases of acute Q fever increased during 3 y of observation, especially at Kaohsiung County and City in southern Taiwan. From 15 April 2004 to 15 April 2007, a total of 67 cases of acute Q fever were identified at E-Da hospital located at Kaohsiung County. 19 (28.4%) patients had a history of travel in rural areas and only 1 had been outside southern Taiwan. 21 (31.3%) patients had a history of animal contact. 20 (30.8%) of the 65 examined patients had underlying chronic hepatitis B or hepatitis C virus infection. Fever (98.5%), chills (79.1%), headache (79.1%), relative bradycardia (44.8%), elevated aminotransferases (100%), and thrombocytopenia (74.6%) were common manifestations. 12 (19.0%) cases had abnormal findings on chest X-ray. Fatty liver (50.0%) and hepatomegaly and/or splenomegaly (41.9%) were found by abdominal image examinations. 42 (76.4%) of 55 cases had defervescence within 3 d after treatment, whereas 4 (7.3%) had spontaneous remission. Acute Q fever is an endemic infectious disease with hepatitis rather than pneumonia as the major presentation in southern Taiwan and the emergence of Q fever is due to increased alertness for the disease by physicians.
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PMID:Acute Q fever: an emerging and endemic disease in southern Taiwan. 1785 9

Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease with significant morbidity and mortality. An epidemic in 2003 affected 8,098 patients in 29 countries with 774 deaths. The aetiological agent is a new coronavirus spread by droplet transmission. Clinical and general laboratory manifestations included fever, chills, rigor, myalgia, malaise, diarrhoea, cough, dyspnoea, pneumonia, lymphopenia, neutrophilia, thrombocytopenia, and elevated serum lactate dehydrogenase (LD), alanine aminotransferase (ALT) and creatine kinase (CK) activities. Treatment has been empirical; initial potent antibiotic cover, followed by simultaneous ribavirin and corticosteroids, with or without pulse high-dose methylprednisolone, have been used. The postulated disease progression comprises (1) active viral infection, (2) hyperactive immune response, and (3) recovery or pulmonary destruction and death. We investigated serum LD isoenzymes and blood lymphocyte subsets of SARS patients, and found LD1 activity as the best biochemical prognostic indicator for death, while CD3+, CD4+, CD8+ and natural killer cell counts were promising predictors for intensive care unit (ICU) admission. Plasma cytokine and chemokine profiles showed markedly elevated Th1 cytokine interferon (IFN)-gamma, inflammatory cytokines interleukin (IL)-1beta, IL-6 and IL-12, neutrophil chemokine IL-8, monocyte chemoattractant protein-1 (MCP-1), and Th1 chemokine IFN-gamma-inducible protein-10 (IP-10) for at least two weeks after disease onset, but there was no significant elevation of inflammatory cytokine tumor necrosis factor (TNF)-alpha and anti-inflammatory cytokine IL-10. Corticosteroid reduced IL-8, MCP-1 and IP-10 concentrations from 5-8 days after treatment. Measurement of biochemical markers of bone metabolism demonstrated significant but transient increase in bone resorption from Day 28-44 after onset of fever, when pulse steroid was most frequently given. With tapering down of steroid therapy, there was a decrease in bone resorption marker together with an increase in bone formation markers round Day 50, suggesting that some of the bone loss might be reversed. Our research studies on the chemical pathology and clinical immunology of SARS should have implications for the pathophysiology and therapy of this potentially lethal infection.
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PMID:Severe acute respiratory syndrome: clinical and laboratory manifestations. 1845 12

Rituximab is a human/murine chimeric anti-CD20 monoclonal antibody used to treat CD20-positive B-cell non-Hodgkin's lymphoma (NHL). Although most of the adverse effects associated with rituximab are usually reversible and temporary infusion-related reactions, including fever, chills, flushing and skin reactions, there are several reports of pulmonary events after long-term administration of rituximab. We present a case of asymptomatic nodular organizing pneumonia occurring during rituximab-based chemotherapy in a patient with non-Hodgkin's lymphoma.
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PMID:A case of organizing pneumonia associated with rituximab. 1974 17

1. Pneumococcus vaccine was administered to 29 patients with pneumonia to determine whether a state of immunity could be induced during the course of the disease. Twenty patients received an intravenous injection of pneumococcus vaccine or pneumococcus filtrate. Nine pneumonia patients received an intradermal injection of vaccine. Eight patients with miscellaneous disease received an intravenous or intradermal injection of pneumococcus vaccine. 2. Of 23 tests in which the serum of the patient was studied for the appearance of protective substance after intravenous injection of heterologous pneumococcus vaccine, 20 or 87 per cent showed a positive response within 6 days after the administration of the antigen. The average day of onset was 4.4 days after injection. 3. Of 9 tests of the same character following the intravenous injection of pneumococcus filtrate, 8 or 89 per cent showed a positive response. The average day of onset of protective substance was 5.6 days after injection. 4. The appearance of specific protective substance following heterologous injection of pneumococcus vaccine appeared to be due to the introduction of the vaccine and not to the natural course of the disease, as was shown by negative control experiments. 5. Of 24 tests with intradermal injection of vaccine, 10 or 42 per cent developed slight protective substance of irregular degree 4.5 days after injection. 6. No immediate reactions were observed following the intravenous or intradermal injection of pneumococcus vaccine. One chill occurred after injection of pneumococcus filtrate. Of 20 cases with intravenous injection of pneumococcus vaccine or filtrate, 2 died of their disease, one a case in which homologous vaccine was used and one in which heterologous vaccine was administered. 7. Conclusions concerning the therapeutic value of the introduction of pneumococcus vaccine in pneumonia must await further investigation. These studies demonstrate that specific protective substances generally appear 4 to 5 days after intravenous injection of pneumococcus vaccine during the course of lobar or bronchopneumonia.
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PMID:FACTORS INVOLVED IN THE PRODUCTION OF IMMUNITY WITH PNEUMOCOCCUS VACCINE : II. INDUCTION OF ACTIVE IMMUNITY DURING THE COURSE OF LOBAR PNEUMONIA. 1986 65

Over 80 per cent. of school sickness, whether judged by the number of cases or by the time lost, is transmitted by "droplet" infection.The alleged increase in sickness in public schools is partly apparent, due to increased attention to minor febricula and partly real, due (1) to increased influenza prevalence, the aftermath of the great epidemic of 1918, and (2) to the increased demand for public school education leading to pressure upon accommodation, and especially to overcrowding in dormitories.The bulk of the droplet infections are accounted for by (1) influenza; (2) feverish cold, chill, or P.U.O.; (3) tonsillitis; regular infectious diseases make a comparatively small showing. The incidence and bacteriological findings and the variations in the incidence of pneumonia and otitis media are discussed. Are these complications really secondary epidemics? Tonsillitis, bacteriological findings, milk.Prophylaxis.-Efficacy of vaccines uncertain. Some evidence that they may diminish the onset of complications. If given vaccines should be administered before the danger period, i.e., not later than November.Intensive prophylaxia other than vaccines during the first half of the Lent term would probably amply repay any trouble. It should include:-(a) Special efforts to prevent boys returning to school after the Christmas holidays infected with influenza or febricula.(b) Temperature taking for three weeks.(c) Immediate isolation of all pyrexias and catarrhs.(d) No work before breakfast for at least the first six weeks of the term.(e) All hot baths and showers taken during the day or after games to be followed by cold showers.(f) Prevention of chill in watching games, etc.(g) Increased provision for drying clothes, uniforms and boots.Infection mainly takes place in sleeping quarters, and proper spacing out of beds and thorough "cross" ventilation in dormitories is of paramount importance; instances of cross infection due to proximity of beds; illustrated by bed charts and bacteriological findings; standards of wall space, floor space and cubic space, laid down by the Royal Commission, Board of Education.No school authority has done its duty to its pupils unless it has provided dormitory accommodation allowing at least 3 ft. of clear space between the edges of beds, and thorough and through ventilation. Until these essential wants are met, the provision of properly sited, amply spaced and "cross" ventilated dormitories should take precedence of all other building requirements.Milk should be pasteurized.
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PMID:Some Observations on Naso-pharyngeal Epidemics in Public Schools. 1998 81

Among 1,017 influenza A cases identified from July 20 (week 30) to August 30 (week 35), 2009, at Naha Municipal Hospital, most subjects were under the age of 20, and ranged from 1 month to 79 years (median: 17 years). Of these, 714 (73%) came to the hospital within 12 to 24 hours of symptom onset. Of those under 4-years-old, 88% had had contact with these ill with influenza, in so history taking may aid in correct diagnosis. The most frequent symptoms were fever such as 38 degrees (87%), cough (86.3%), headache (73%), arthralgia (69%), sore throat (65%), chills (61%), myalgia (50%), and nausea, vomiting and diarrhea (18%). In 606 (60%) were prescribed oseltamivir, 78 (8%) zanamivir, 175 (17%) maoto, and 333 (33%) no antiviral medication. The percentage of oseltamivir prescription among teenagers was 30%. Of the 1,017, 12 (1.2%) were hospitalized; 6 (50%) with pneumonia and 4 (33%) with asthma. Among the 12, 6 were over 60-years-old and 2 under 1-year-old. All adult admissions had underlying conditions, and 10 (83%) not prescribed antiviral medication and positive in rapid influenza diagnostic testing at a second hospital visit, all were admitted to treat complications, indicating that antiviral medication is a key in treating those with influenza-like illness in a high risk group.
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PMID:[Clinical review of 1,017 influenza A cases between weeks 30 and 35 weeks in 2009]. 2042 Jan 58


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