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

The purpose of this study was to demonstrate the high incidence of atelectasis or pneumonia (A/P) in the left lung of acute spinal cord injured (SCI) patients. The study group consisted of 46 consecutive motor complete (Frankel A or B) SCI patients admitted within 48 hours of injury. The ages of the patients ranged from 15 to 72 years. Neurologic levels ranged from C3 to T11. There were 19 high-level quadriplegic patients (HLQ; C3-C5), 11 low-level quadriplegic patients (LLQ; C6-C8), and 16 paraplegic patients (Para; T1-T11). The patients were followed during the first 30 days postinjury for radiographic evidence of A/P lasting more than three days. The time of onset, duration, and location of A/P was determined. Fifty percent (23 of 46) of the patients developed A/P in the first 30 days after their spinal cord injury. The incidence was higher in the HLQ than in the LLQ and Para (74% vs 33%; p less than 0.02 using the Fischer exact test). There was a preponderance (4:1 ratio) of left-sided involvement for A/P in this population (p = 0.01 using the two-tailed binomial test). Sixteen patients had left-sided A/P, four patients had right-sided A/P, and three patients had bilateral findings. There was no relationship between level of injury and side of involvement. The high incidence of left-sided pulmonary involvement in the acute SCI patient may be due to the tendency to retain secretions in this period combined with the increased difficulty of clearing secretions from the left lung.
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PMID:Atelectasis and pneumonia in acute spinal cord injury. 231 37

Fatal T-cell lymphomas developed in three patients with a chronic illness manifested by fever, pneumonia, dysgammaglobulinemia, hematologic abnormalities, and extraordinarily high titers of antibody to the Epstein-Barr virus (EBV) capsid antigen (greater than 10,000) and early antigen (greater than 640) but low titers to the EBV nuclear antigen (less than or equal to 40). To understand the pathogenesis of these tumors better, we determined the immunophenotype of the tumor cells and analyzed tumor-cell DNA for EBV genomes and for lymphoid-cell gene rearrangements. More than 80 percent of the cells in tumors had an activated helper T-cell phenotype (T4, T11, la positive). The EBV genome was found by in situ hybridization in tumor tissue from each patient. Southern blot assay of DNA digests from one patient showed the same pattern as that of the EBV-infected marmoset line, B95-8. DNA digests from two patients showed a monoclonal proliferation of T cells determined on the basis of uniform T-cell-receptor gene rearrangements and a single band for the joined termini of the EBV genome. We conclude that EBV may infect T cells and contribute to lymphomas in selected patients with severe EBV infections.
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PMID:T-cell lymphomas containing Epstein-Barr viral DNA in patients with chronic Epstein-Barr virus infections. 283 53

A case of streptococcal toxic shock-like syndrome in a previously healthy, 57 year old Japanese female has been reported. Initially, she had a sore throat and low grade fever for 5 days. Because of sudden severe pain on the extremities and erythema on bilateral forearms, she was hospitalized. On admission, her conciousness was clear. Although profound hypotension, anuria and prolonged blood coagulation were observed. Antibiotics, fluid therapy and dopamine were given. Four hours after admission, she died in spite of resuscitation efforts, by sudden cardiac arrest. Streptococcus pyogenes was isolated in her blood. At the same time as when she died, three of the five people of the patient's family living with her, had pharingitis or pneumonia. From the pharynxs of the three people with pharingitis, Streptococcus pyogenes was also isolated. The serotype of all organisms was T11, and they produced exotoxintype B in vitro. This case suggests that infection of Streptococcus pyogenes is not essential for the development of toxic shock-like syndrome.
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PMID:[A case report of toxic shock-like syndrome associated with prevalence of streptococcal pharingitis in the family]. 796 2

All of the 88 episodes of beta-haemolytic streptococcal bacteremia (2.9% of all bacteremias) in adult patients during the years 1987-94 in a university hospital were reviewed. 38 bacteremias (43%) were caused by group A, 24 (27%) by group B, 3 (4%) by group C, and 23 (26%) by group G beta-haemolytic streptococcal. There was a statistically significant increase in group A and decrease in group C and G bacteremias (p < 0.02) compared to an earlier 8-year period in the same hospital, although the total number of streptococcal bacteremias remained the same. The most common T types of group A streptococcal strains were T11 (26%), T28 (14%), T6 and T1 (11% each), and T12 (8%). Cardiovascular disease, skin lesions, malignancy, and alcohol abuse were the most common underlying conditions. The most usual types of infection were skin (47%) and respiratory tract infections (23%). The overall mortality was 16%. It was highest in group A (24%) and lowest in group C (0%), 38% of patients with pneumonia died. All streptococcal strains were sensitive to penicillin, vancomycin, and cephalosporins. 11% of group A and 12% of all the strains had decreased sensitivity to erythromycin, 14 and 38% to tetracycline, and 0 and 2% to clindamycin, respectively.
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PMID:A clinical study of beta-haemolytic groups A, B, C and G streptococcal bacteremia in adults over an 8-year period. 925 81

We describe a previously independent T11 paraplegic patient who had delayed-onset hand weakness and recurrent pneumonia caused by myotonic dystrophy. A man in his late thirties suffered a thoracic spinal cord injury (SCI) from a gunshot wound at the age of 17 years, with resultant T11 American Spinal Injury Association class A paraplegia. He lived independently until the age of 36 years when he was hospitalized multiple times for pneumonia. During a rehabilitation stay after one of the acute hospitalizations, the patient's hand weakness and diffuse muscular atrophy were noted. Electrodiagnostic testing was performed, which showed myotonic discharges. Genetic testing was consistent with myotonic dystrophy. This case shows the importance of considering causes of weakness that affect the population as a whole when evaluating a patient with SCI who presents with delayed-onset weakness.
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PMID:Myotonic dystrophy presenting as new-onset hand weakness and recurrent pneumonia in a patient with paraplegia: a case report. 1552 Sep 88