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

A 77-year-old lady with malaise, cough, weight loss, an elevated ESR and bilateral patchy infiltrates on the chest X-ray is described. The symptoms progressed inspite of antibiotic treatment. On the basis of clinical findings, transbronchial biopsy, bronchoalveolar lavage and lung function tests the diagnosis of a bronchiolitis obliterans, organizing pneumonia (BOOP) was established. The clinicopathological entity of BOOP, its differential diagnosis and treatment are discussed.
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PMID:[Antibiotic-resistant pneumonia]. 821 Aug 73

A 64-year-old male consulted our hospital with a 6-day history of malaise, body temperature to 38 degrees C, anorexia, and light headedness. The chest radiograph showed consolidation in the left lower lung area. Chest CT and ultrasonography revealed left pleural fluid. The pleural fluid was exudative (yellowish in color, protein 3.0 g/dl, Rivalta reaction positive, adenosine deaminase 19.4 U/L), and had a total cell count of 4.7 x 10(6)/ml with 45% lymphocytes, 40% histiocytes, and 15% polymorphonuclear leukocytes. He had kept a budgerigar, but we could not isolate Chlamydia from the pleural fluid or the pet bird. Transbronchial lung biopsy from left S10 revealed an increase of mononuclear leukocytes within the interstitial spaces, and the alveolar spaces contained polymorphonuclear leukocytes, fibrin, and organized alveolar exudate. Bronchoalveolar lavage cellular constituents were 50% lymphocytes, 27% neutrophils, and 23% macrophages. Serologic studies demonstrated C. trachomatis specific IgM antibody titers at 1:20 in a serum sample and at 1:10 in pleural fluid. We report a case of community-acquired pneumonia caused by C. trachomatis diagnosed by serologic studies.
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PMID:[A case report of pneumonia due to Chlamydia trachomatis with pleural effusion]. 831 7

We report on an HIV positive patient with a disseminated Penicillium marneffei infection. A 35-year-old Swiss homosexual male with HIV-associated immunodeficiency with a CD4 cell count of 90/mm3 presented with a two-month history of malaise, intermittent fever, loss of weight, unproductive cough and widespread molluscum contagiosum-like skin lesions, mainly on the face. The patient had travelled extensively and had last visited Thailand 19 months before admission. The chest X-ray showed bilateral diffuse reticulonodular markings. The diagnosis was suspected in bronchoalveolar lavage, which showed round-to-oval intracellular yeast cells but also elongated sausage-shaped extracellular forms. The diagnosis was confirmed on culture. Penicillium marneffei was further isolated from the following specimens: blood cultures, bone marrow, stool, skin and tracheal mucosa biopsy. Intravenous amphotericin B therapy led to a complete subsidence of all symptoms and the skin lesions healed without leaving a scar. The infection, with its clinical presentation, epidemiology, diagnostic problems and therapy is reviewed. We stress that since Penicillium marneffei is an increasingly important pathogen in HIV positive patients in Southeast Asia, this fungus can also be imported to Europe by travellers. If immunocompromised patients have molluscum contagiosum-like skin lesions, pneumonitis and a history of travelling in Southeast Asia, disseminated Penicillium marneffei infection should be considered in differential diagnosis.
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PMID:[HIV-associated Penicillium marneffei infection]. 845 67

Over the past 4 years, 7.4% of deaths caused by strangulation in Peoria County, Ill., involved children under 18 years of age. Clinical review of a consecutive series of 13 children treated from 1985 through 1994 revealed an incidence of 32 of 10,000 intensive care unit admissions with a 5.5:1 male bias. Accidental causes were seen in six children, with suicide or autoerotic causes prevalent in older children and adolescents. Five children had behavioral disorders before injury. The initial Glasgow Coma Scale score was 8 or below in seven children. Cervical roentgenograms in all patients and computed tomographic examinations performed in seven children were interpreted as normal. Seven children required ventilatory assistance, and four had pneumonia or acute lung injury. Intracranial pressure monitoring in three children failed to reveal sustained elevations of pressure. Serial changes in electroencephalograms in five patients paralleled improvements in their clinical examinations. Ten children were normal on follow-up; one adolescent reported mild neurologic sequelae and one adolescent showed severe disability. One adolescent died 2 days after injury. Comparison of this series with previous reports of 26 children indicated that the extent of the initial injury and effectiveness of resuscitation were major determinates for outcome. Pulmonary complications were common, whereas the development of elevated intracranial pressure indicated a poor prognosis and suggested the use of telemetry in children, with clinical evidence of severe injury. Continued awareness of preventative measures for accidental strangulation in infants and intentional hanging in children with behavioral disorders may reduce the incidence of these injuries.
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PMID:Strangulation injuries in children. Part 1. Clinical analysis. 867 18

A 30-year-female with chronic myelogenous leukemia received allogeneic bone marrow transplantation (BMT). On day 104, low-grade fever, cough, and general malaise developed, resulting in hospitalization 10 days later. Chest X ray revealed diffuse infitrates, suggesting cytomegalovirus interstitial pneumonia. Ganciclovir (DHPG) was given daily and all symptoms disappeared three days later. However, a very few vesicular lesions appeared on her trunk and her two children had chickenpox at that time. Chest CT was taken and disclosed diffuse nodular shadows. Clinical course and chest CT suggested varicella pneumonia. DHPG administration was stopped and acyclovir PO started to be given. She was discharged in excellent condition. In this report, we show a rare case of varicella pneumonia after allogeneic BMT and efficacy of DHPG for the treatment of varicella pneumonia.
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PMID:[Varicella pneumonia with multiple nodular shadows after allogeneic bone marrow transplantation in chronic myeloid leukemia]. 869 67

Influenza is an epidemic respiratory illness caused by one of three viral subtypes: A, B, or C. Influenza A causes higher mortality than influenza B and C and is often responsible for pandemics and yearly epidemics of this common, infectious disease. Clinically, patients with influenza present with an abrupt onset of fever, malaise, headache, and a dry, hoarse cough. These symptoms usually last three to five days. Amantadine and rimantadine may be used to prevent and to treat influenza A infection, but not B or C. Ribavirin, however, may be effective treatment for severe influenza pneumonia caused by either A or B subtype, although it is not FDA approved for this application. Annual influenza vaccination should be administered between mid-October and mid-November to any person at increased risk for complications. Health-care workers, those in close contact with high-risk individuals, and personnel vital to community function should also be immunized.
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PMID:Influenza. More than mom and chicken soup. 884 75

Acute respiratory infections (ARI) are among the principal causes of mortality of children under 5 years of age. Most deaths are due to pneumonia, which, when timely identified and properly treated, could be avoided. An effective case management scheme, based on early recognition of pneumonia and prompt antibiotic treatment, relies on early recognition of alarm signs by mothers and community health workers. For mothers to understand and act on advice from health workers, language and concepts commonly used by mothers should be utilized. The present study was carried out to compare the relative effectiveness of two different methods to elicit local terms used by mothers to refer to ARI symptoms/signs/treatments. A comparison was made among the terms elicited by a free listing of common terms mentioned by mothers in relation to ARI, and the terms they recognized when looking at a video that showed children with different ARI signs. The video was shown in a community and a clinical setting, in order to identify strengths and weaknesses of showing it in these settings. The video elicited more signs dealing with serious illness, respiratory distress and general malaise, but missed non-visual signs, such as fever, lack of appetite or pain. Also, mothers tended to be distracted by trivial signs, such as skin color. Free listing was easier to administer and elicited more non-life-threatening symptoms/signs, but mothers were more prone to drift away and mention terms not related to respiratory illness. Showing the video in the clinic elicited more medical-related terms, and was easier to show than in the community. In conclusion, choice of either of the two methods depends on the researcher's purpose. Using both methods produced a larger list of terms associated with ARI.
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PMID:Methodological issues for eliciting local signs/symptoms/illness terms associated with acute respiratory illnesses. 885 96

Progressive disseminated histoplasmosis (PDH), a recognized defining illness of AIDS, is an opportunistic fungal infection caused by Histoplasma capsulatum. The authors report a case of PDH in a HIV-infected African child from a Histoplasma capsulatum non-endemic area. An 8-year-old girl from Kwazulu/Natal, South Africa, was admitted to King Edward VIII hospital with pyrexia and respiratory distress. Pale with generalized lymphadenopathy, she had been sick with general malaise and fever for 3 weeks. A punched-out painless ulcer was present on the child's lower left leg and she had ulcerative lesions on the tip of her tongue and the angle of her mouth. There was a tender hepatomegaly and clinical signs of pneumonia, while a chest roentgenogram showed right upper lobe consolidation with early cavitation. The purified protein derivative tuberculin skin test was negative and no acid-fast bacilli were detected on three sputum samples taken on different days. A Western blot test conducted for antibodies to HIV was positive. Additional laboratory tests were conducted. The patient was treated with parenteral acyclovir for herpesvirus infection, ceftriaxone for severe community-acquired pneumonia, and trimethoprim-sulfamethoxazole because Pneumocystis carinii infection was part of the clinical differential diagnosis. Bone marrow aspirate and trephine biopsy revealed yeast forms of H. capsulatum. The girl died on the second day of hospital admission, before antifungal therapy could be commenced.
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PMID:Disseminated histoplasmosis in a human immunodeficiency virus-infected African child. 910 50

Influenza virus infection is a serious problem in the elderly because of the high pneumonia complication rate and a significant increase in mortality. Influenza vaccine is a method for controlling influenza epidemics in the elderly. The vaccinated elderly showed lower influenza infection rate and had fewer incidences of febrile episodes than did non-vaccinees during epidemics. Significantly, decreased rates of mortality subsequent to influenza epidemics among vaccinated elderly inpatients were also found. The antibody response to influenza vaccine in the elderly is quite comparable to that of younger adults. Adverse reactions to influenza vaccination, including local reaction such as soreness, systemic reactions such as malaise and fever, and allergic reactions, are less frequent in the elderly than in children and younger adults. The currently used inactivated influenza virus vaccine is as safe or safer than other vaccines. Serious adverse effects are unknown in the elderly. The influenza vaccination rate is quite low in Japan when compared with that of other developed countries. To prevent influenza epidemics among the elderly, especially among those who have been institutionalized, influenza vaccine should be promoted more actively.
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PMID:[Efficacy and adverse reactions of influenza vaccine in the elderly]. 936 Apr 2

In a number of patients, radiotherapy following surgery for breast carcinoma may induce radiation injury to the lungs. This has classically been divided into an early radiation pneumonitis and a late fibrosis, both confined to the irradiated lung volume. However we observed a female patient who similarly to other recent reports in the literature developed a recurring pneumonitis migrating from one lung to the other after radiotherapy for breast carcinoma. This migratory BOOP (bronchiolitis obliterans organizing pneumonia) was characterized by a lymphocytic alveolitis and responded well to corticosteroids. Clinicians should be aware of the possibility of a lymphocytic pneumonitis in both lungs after unilateral thoracic irradiation and recognize the distinctive features of fever, cough, dyspnoea and malaise in order to start an effective treatment with corticosteroids. They should also be aware of the high tendency for recurrence when tapering off.
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PMID:Chronic lymphocytic alveolitis with migrating pulmonary infiltrates after localized chest wall irradiation. 956 4


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