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)

A 75-year-old male presented with paraparesis and pain in the thighs, which progressed rapidly. Five days later, he was unable to stand or to void urine. A lung cancer was found in the right upper lobe. A spinal cord metastasis from the lung cancer was suspected from the neurologic and pulmonary findings. After 2 weeks, motor dysfunction and a total sensory deficit were observed below the lumbar region, and the patient developed pneumonia, which resulted in death. Autopsy showed an extensive intramedullary metastasis at the third lumbar segment of the spinal cord. Histology revealed poorly differentiated adenocarcinoma of the lung.
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PMID:Intramedullary spinal cord metastasis from lung cancer presenting with paraparesis: an autopsied case. 141 59

We report the first known case of daunorubicin administered directly into the human central nervous system. A 3 1/2-year-old female with pneumonia and otitis media was diagnosed with acute lymphoblastic leukemia and was admitted for antibiotics and chemotherapy. On the first day she inadvertently received a 17 mg intrathecal (IT) injection of daunorubicin. When the error was recognized about 1 hour later, her cerebrospinal fluid (CSF) was exchanged with sterile saline by barbotage, IT hydrocortisone was given, a subarachnoid catheter was inserted, and the CSF was allowed to drain for 36 hours. Only 5.6 mg (33%) of the dose was recovered from CSF, 2.7 mg as daunorubicin and 2.9 mg as the metabolite, daunorubicinol. Initially she was asymptomatic and induction therapy continued with vincristine, 1-asparaginase, prednisone, and IT methotrexate. One week after the daunorubicin injection she developed headache and irritability; CSF protein was 3.2 gm/dl. On the 12th day, she developed fungal sepsis and worsening pneumonia. On the 15th day, she became comatose with a flacid paraparesis, areflexia, and an ascending progressive bulbar palsy. A series of computerized tomography scans over 6 weeks showed increasing diffuse cerebral atrophy. Nerve conduction velocity studies were consistent with an axonal neuropathy. Despite her multiple concurrent medical problems, the timing and characteristics of neurologic damage suggest that IT daunorubicin caused progressive destruction of the nervous system.
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PMID:Inadvertent intrathecal injection of daunorubicin with fatal outcome. 157 39

A male with an atypical adrenomyeloneuropathy is described, who developed spastic paraparesis at the age of 37. Because his gait deteriorated further and he had a bladder dysfunction, he was admitted to National Sanatorium Hyogo Central Hospital at the age of 51. A diagnosis of adrenomyeloneuropathy was supported by increased level of very long chain fatty acids in plasma. He became demented and suffered from grand mal seizures during the last one year of his life. CT scan showed symmetrical hypodense lesions in the centrum semiovale. He died of pneumonia and renal failure at the age of 53. Autopsy revealed symmetrical degeneration throughout the corticospinal tracts from cerebral white matter to lumbar spinal cord. Degeneration of the optic radiation, posterior half of the corpus callosum, thalamus, cerebellar white matter, and gracile tract in high cervical segments were also observed. In these area, there was a loss of myelin and axon with marked gliosis and foamy macrophages, as well as mild perivascular cuffing. In our case, symmetrical and well-defined lesion in cerebral white matter is atypical for adrenomyeloneuropathy, while destruction of the gracile tracts is not a feature of adrenoleukodystrophy. In addition, well-demarcated "pseudosystemic" type of fiber tract degeneration appears to be different from a feature of primary demyelination which has been considered to be an essential alteration of adrenoleukomyeloneuropathy-complex. We propose another hypothesis, therefore, that neurons are primarily altered, thereby leading to the degeneration of myelins in this disease.
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PMID:[A case of adrenomyeloneuropathy with localized cerebral white matter degeneration]. 261 1

Primary intracranial yolk sac tumor (Endodermal sinus tumor, YST) is quite rare, and most usually involves the pineal gland. This report concerns a rare case of unknown origin of yolk sac tumor with intracranial and spinal metastases. The 6-year-old boy initially manifested symptoms of acute urinary retension and paraparesis. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an intrathecal tumor spreading below the third lumbar segment, and tumors also appeared in the left temporal area and right cerebellar hemisphere. The pineal region was free of neoplastic involvement and the gonads were normal. The patients underwent operation to remove intracranial and spinal tumors, and postoperative radiotherapy was administered. The histological findings showed metastatic yolk sac tumor. Multiple intracranial and spinal seeding were noticed postoperatively. The patient died of recurrent YST and pneumonia three months after operation. The origin of secondary YST can always be found in specific midline sites. This is a rare case since the primary lesion is unknown.
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PMID:Yolk sac tumor of unknown origin with intracranial and spinal metastases. 749 Jul 97

Nine of 74 American alligators (Alligator mississippiensis) from a captive Florida herd of 3-4-m-long, 200-350-kg, adult males greater than 30 yr of age died within a 10-day period during 1995. Nonspecific clinical signs included anorexia, lethargy, muscle weakness, paraparesis, bilateral white ocular discharge, and various degrees of periocular, facial, cervical, and limb edema. Pneumonia, pericarditis, and arthritis were found on postmortem evaluation of the spontaneously dead and euthanatized alligators. Rapidly growing mycoplasmas were identified by culture, and mycoplasma nucleotide sequences were identified by polymerase chain reaction testing of fresh lung and synovial fluid from an affected alligator. Culture of banked frozen lung from necropsy specimens and fresh lung and fresh synovial fluid from newly affected alligators confirmed the presence of a new mycoplasma species in seven of eight individuals. Oxytetracycline was administered, but related deaths continued for 6 mo until only 14 of the initial alligators remained. An enzyme-linked immunosorbent assay to detect antibody was developed, and the organism was transmitted experimentally to naive juvenile alligators, although the source of the organism, Mycoplasma sp. (ATCC 700619), has not been identified. The alligator isolate is a novel species in the mycoplasma family because its nucleotide sequence does not match those of over 75 characterized mycoplasma species. Such factors as population density, animal age, and mycoplasmal virulence likely contributed to the course of disease.
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PMID:Morbidity and mortality associated with a new mycoplasma species from captive American alligators (Alligator mississippiensis). 1123 36

A previously healthy 69-year-old man developed a progressive neurological illness with bulbar signs and ataxic paraparesis. Repeated MRI examinations revealed a large space occupying lesion in the lower brain stem with patchy contrast enhancement. MRI angiography was unremarkable and CSF had normal cell count but raised protein content. A brainstem tumor was suspected and a course of intravenous glucocorticosteroids was started. No improvement occurred and the patient died of pneumonia 11 weeks after onset. Neuropathology revealed confluent areas of complete or incomplete necrosis with marked edema in the lower brainstem. Predominantly venous meningeal vessels of the brainstem showed extensive fibromuscular thickening of all layers with luminal narrowing. In addition, intramural mononuclear infiltration was found. With the exception of localisation, this case exhibits all pathologic features of subacute diencephalic angioencephalopathy (SDAE), a rare fatal disease of unknown aetiology. In addition, the clinical features of typical age, male sex, disease duration and raised CSF proteins are shared. A common disease entity is suggested and the pathogenetic relevance of inflammation and venous outflow obstruction is discussed.
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PMID:Subacute brainstem angioencephalopathy: a case report and review of the literature. 1263 32

A 23-year-old woman with mild psychomotor retardation presented with fever, coughing, reduced consciousness and a stiff neck. A chest X-ray revealed an infiltrate in the left lower lobe; the cerebrospinal fluid was cloudy with a mild pleocytosis. Ceftriaxone was prescribed and the fever subsided. On the second day of admission she had a seizure, and a paraparesis emerged. Despite changes in the antibiotic regimen, her clinical condition hardly improved. On the fifth day, antibodies against Mycoplasma pneumoniae were found to be strongly positive and the diagnosis was M. pneumoniae infection. This accounted for the pneumonia together with meningoencephalitis and a transverse myelitis. The antibiotics were switched to doxycycline and the clinical condition improved dramatically. Six weeks after discharge, the patient had made a complete recovery. In patients suffering from meningitis with an atypical presentation, uncommon causes of infection should be considered. Together with a pneumonia, M. pneumoniae, Chlamydia pneumoniae, Legionella pneumophila and Listeria monocytogenes should be high on the list of potential causes for bacterial meningitis.
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PMID:[Clinical reasoning and decision-making in practice. A young woman with fever, shortness of breath, and reduced consciousness]. 1289 64

Human T-lymphotropic virus type II (HTLV-II) is a human retrovirus which is endemic in Amerindian and pygmy tribes. Molecular subtypes show geographic segregation consistent with an ancient origin of this virus within humans in Africa or South America. More recently, injection drug users in the United States and Europe have become infected with HTLV-II, and secondary sexual transmission has introduced the virus at low levels into the general population and blood donors. HTLV-II has been linked with a spastic paraparesis called HTLV-associated myelopathy / tropical spastic paraparesis (HAM/TSP), and perhaps with other neurological syndromes. It is also associated with an increased incidence of pneumonia and bronchitis, inflammatory conditions such as arthritis, and perhaps with increased mortality. Except for a few cases of cutaneous lymphoma in patients coinfected with HIV, there is no evidence that HTLV-II causes lymphoproliferative disease. HTLV-II and HIV coinfection has not been proven to alter the course of HIV disease, but such patients may have altered levels of CD4+ and CD8+ lymphocytes, and antiretroviral therapy may paradoxically increase HTLV-II proviral load.
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PMID:The epidemiology and disease outcomes of human T-lymphotropic virus type II. 1559 31

Leukemic meningitis is a rare manifestation of chronic lymphocytic leukemia (CLL) and typically occurs in advanced stages. We report the case of a 71-year-old male in whom Binet A, Rai 1 stage CLL was diagnosed in June 2002. The stage called for a "watch and wait" strategy. Six months later the patient presented with paraparesis. Magnetic resonance imaging of the lumbar spine revealed no abnormalities. Lumbar puncture disclosed xanthochromic cerebrospinal fluid (CSF) with 1003 cells/microl, 95% atypical lymphocytes. Flow cytometry confirmed typical features of CLL. Intrathecal injections of methotrexate, cytosine arabinoside and corticosteroids did not substantially reduce the CSF cell count and failed to improve the neurological symptoms. Two weeks later the patient developed a pulmonary embolism complicated by fatal secondary pneumonia. Leukemic meningitis is a rare manifestation of CLL, especially in early stages. Selective spinal paraparesis as the first symptom of meningitis in CLL is even rarer and has been reported only once.
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PMID:Spinal paraparesis due to leukemic meningitis in early-stage chronic lymphocytic leukemia. 1601 94

Hepatocellular carcinoma (HCC) is usually diagnosed at an advanced stage, when little remedy could be offered. There is a need for relatively affordable, available and non-invasive tests for diagnosis, staging and detection of metastasis among individuals at risk. A clinical, chest radiographic (CXR) and abdominal ultrasonographic examination was carried out to detect and evaluate the pattern of metastasis among 53 untreated patients. One patient had clinical paraparesis with no outward evidence of metastasis. CXR revealed lung metastasis in 11 (20.8%), with multifocal deposits and bilateral involvement in 10 (18.8%), and unilateral single deposit in one. Two (3.8%) patients had perihilar lymphadenopathy and consolidation, respectively, while 18 (34%) patients had elevated right hemidiaphragm and four 17.5%) had pleural effusion. One had right basal pneumonitis, multiple cavitatory lesions in the lung fields and soft-tissue wasting. No abnormality was seen in 17 (32.1%) cases. Abdominal ultrasonograph showed probe tenderness in 22 (41.5%), hepatomegaly in 49 (92.5%), with 33 (62.3%) of these having nodularities of varying sizes. The spleen was enlarged in 10 (18.9%) cases, with four (7.5%) showing irregular outline. There were eight (15.1%) cases with para-aortic lymphadenopathy. Portal hepatic lymphadenopathy was demonstrated in two (3.8%) cases, while pleural effusion was detected in seven (13.2%). Metastasis is common in HCC at presentation, the lung is the commonest site of spread. Clinically visible metastasis appears uncommon in HCC.
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PMID:Clinicoradiologic and sonographic patterns of metastasis in hepatocellular carcinoma. 1705 52


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