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)

During a 16-month period children presenting to a pediatric outpatient facility from an area with a high tuberculosis incidence (> 400/100,000) and suspected of having respiratory tuberculosis (TB) were evaluated for close contact with adult pulmonary tuberculosis, weight loss, symptom duration, respiratory signs, lymphadenopathy and hepatosplenomegaly and by chest radiography and tuberculin testing (Mantoux or tine). Probable tuberculosis was diagnosed in 258 children and was confirmed in 109 (42%) patients with a mean age of 31 months by culture of Mycobacterium tuberculosis from gastric aspirate or another source. Eleven children with confirmed TB had a normal chest radiograph. After review of special investigations, clinical course and follow-up of the remaining 149 children, 86 children (58%) with a mean age of 32.4 months were considered to have probable TB and 63 (42%) with a mean age of 27 months not to have TB. Significantly fewer children in the "not TB" group than in the confirmed and probable TB groups had a close adult pulmonary tuberculosis contact (13 (21%) and 95 (49%), respectively; P < 0.01). There was no difference between the "not TB" group and the confirmed and probable TB groups in the proportion presenting with weight loss, cough or other respiratory symptoms, a symptom duration > 2 weeks, the presence of bronchial breathing, wheeze, hepatomegaly or splenomegaly or peripheral lymphadenopathy. Final diagnoses in the "not TB" group included bacterial or viral pneumonia or bronchopneumonia in 37, asthma often accompanied by segmental collapse in 9 and cavitating pneumonia in 3 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Respiratory tuberculosis in childhood: the diagnostic value of clinical features and special investigations. 776 Nov 83

Tracheomalacia describes a generalized or localized weakness of the trachea that results in excessive narrowing of the tracheal lumen during expiration or whenever intrathoracic pressure increases. Severe forms of tracheomalacia are characterized by life-threatening apneic spells, inability to extubate the airways, and episodic pneumonia. Aortopexy has proved to be an effective method of treatment for most of these conditions when seen in children. When aortopexy fails to prevent tracheal obstruction, a support applied to the external circumference of the trachea can be useful to prevent airway collapse.
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PMID:Tracheomalacia. 785 Mar 65

New histological lesions have been reported in the lungs of preterm neonates treated with surfactant for respiratory distress syndrome (RDS). Globular deposits of hyaline maternal in parenchymal air spaces, absence of hyaline membranes, and increased interstitial cellularity and edema without associated fibrosis have been described. Fifteen histological findings were assessed in the lung pathology of 76 infants with RDS from three study groups. Group I (24 infants) died in the presurfactant era (before 1982), group II (26 infants) died despite having surfactant treatment, and group III (26 infants) were either untreated controls or did not receive surfactant for other reasons. The three groups were comparable in respect of sex and survival time. All infants were 34 weeks of gestation or less. Infants with a significant congenital abnormality or pulmonary hypoplasia were excluded. The 76 cases were assessed independently and "blindly" by two pathologists. The histological findings assessed were alveolar collapse; epithelial necrosis, proliferation, and metaplasia; hyaline membranes; dilated lymphatics; pulmonary interstitial emphysema; interstitial edema, inflammation, and fibrosis; arteriolar muscular hyperplasia; interstitial and intra alveolar hemorrhage; massive pulmonary hemorrhage; and pneumonia. No significant differences were found in any of the histological findings between the three groups. The hyaline membranes seen in the surfactant-treated infants were identical to those in the untreated lungs and were of the characteristic linear type. Interstitial fibrosis, inflammation, and edema were present in all three groups. It has also been suggested that surfactant therapy protects preterm infants from interstitial hemorrhage but predisposes them to intra-alveolar hemorrhage. No significant difference in the incidence of intra-alveolar and interstitial hemorrhage in the three groups was identified.
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PMID:Surfactant replacement therapy in preterm neonates: a comparison of postmortem pulmonary histology in treated and untreated infants. 785 14

This study was aimed at assessing the role of high resolution Computed Tomography (HRCT) in the asthmatic patient, during disease worsening. Chest radiography plays a major role in the assessment of the most common complications of asthma, such as pneumothorax, pneumomediastinum, or lobar collapse. Conventional CT and HRCT are sometimes used when a complication is suspected, particularly chronic eosinophilic pneumonia and allergic bronchopulmonary aspergillosis. We prospectively examined 31 asthmatic patients with clinical and functional worsening submitting them to chest radiographs and HRCT scans. In 5 of them, radiographic findings were suggestive of a complication: 3 patients presented allergic bronchopulmonary aspergillosis and 2 chronic eosinophilic pneumonia; in these cases HRCT confirmed the diagnosis and yielded other useful pieces of information, but did not change the prognosis or the therapeutic approach. In the remaining 26 patients, HRCT findings were abnormal in 61% of cases, while chest films were abnormal in 26% of cases only. An outstanding diagnostic contribution came from HRCT which demonstrated a high incidence of small airway disease and, above all, cylindrical bronchiectasis (53.8%), especially in the upper lobes. HRCT also demonstrated that asthma does not usually cause emphysematous destruction in the patients that never smoked. Even though our study enrolled only a small number of patients, the results suggest that asthma is a more destructive disease than previously believed and that HRCT could be a useful examination to perform even when chest film findings are normal.
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PMID:[Use of computerized tomography in asthmatic patients]. 787 33

A 56-year-old diabetic man presented with left upper lobe collapse and postobstructive pneumonitis. Fiberoptic bronchoscopy revealed an endobronchial mass obstructing the left mainstem bronchus. The lesion resembled a bronchial adenoma; however, cytologic and histologic examination revealed invasive mucormycosis. The patient was treated with intravenous amphotericin B followed by endoscopic laser surgery that relieved the obstruction.
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PMID:Pulmonary mucormycosis presenting as an endobronchial lesion. 798 19

We present the case of a patient with a history of asthma who developed cough and hemoptysis that were unresponsive to antituberculous therapy. Chest roentgenography demonstrated right-sided collapse with consolidation and a pleural effusion. Bronchial biopsy revealed fungal hyphae, and cultures later yielded Bipolaris spicifera. In addition, weight loss and intractable hypotension in association with hyponatremia and elevated potassium levels suggested addisonian crisis, which was confirmed by measurement of serum ACTH and cortisol levels. Computed tomography of the abdomen revealed bilateral adrenal involvement. Tissue obtained on biopsy of the adrenal glands yielded B. spicifera. The patient responded to treatment with 2 g of iv amphotericin B; the adrenal masses and pneumonia resolved, and he remained well until last seen in July 1992. However, he requires replacement therapy with prednisone and fludrocortisone. On review of the available literature, we were unable to find a previously reported case.
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PMID:Disseminated bipolaris infection in an asthmatic patient: case report. 839 76

We reviewed the radiographic features of 42 patients with Mycobacterium avium complex (MAC) infection. Six cases were definite "primary", 20 were "secondary", and 15 were indeterminate (probably "primary"). In the definite and probable "primary" cases, and some of the "secondary" cases, pulmonary lesions slowly progressed following a common and characteristic sequence from a cluster of small nodules or fibro-productive nodules to those with subpleural thickening, or with thickening of the draining bronchi, or with both subpleural and bronchial thickening, and to cystic bronchiectatic changes associated with collapse of the segment or the lobe, in the final stage. Cases of airspace pneumonia appeared rarely. In these cases, neither apical-subapical region prevalence, pleural effusion, nor mediastinal lymphadenopathy were found. On the contrary, in five cases of "secondary" infection, MAC lesions located at the same place with the predisposing lung disease and did not progress during more than five years of observation. In the progressive cases of "secondary" infection, however, the appearance of new lesions and the progressions thereafter showed the same pattern as in "primary" infection. These features would suggest that MAC infection would occur and progress slowly among patients who had unknown pathogenetical factor, whether they had underlying predisposing lung conditions or not.
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PMID:[Clinical features of the patients with "secondary infection" of Mycobacterium avium complex--Radiographic pattern of progressions in the patients with and without underlying pulmonary conditions]. 843 26

Age-related changes, for example reduced elasticity and earlier airways collapse, predispose the elderly to respiratory infection. Other factors such as a lifetime of smoking, the use of hypnotics, or the development of stroke also predispose. Pneumonia becomes increasingly common with advancing age, and both morbidity and mortality increase with associated disease burden. Diagnosis of pneumonia may be more difficult in the aged because of physiological changes. However, careful physical examination with accurate, regular recording of body temperature will usually reveal the characteristic features of pneumonia, which should be confirmed by chest radiograph. In the frail elderly, the onset of impaired function, such as confusion, immobility, falling or incontinence, should raise suspicion of infection. Pneumonia is classified as community-acquired, nursing home-acquired or nosocomial, which helps in the empirical choice of antibiotics. Streptococcus pneumoniae is the most common organism in the community, then Haemophilus influenzae and Branhamella catarrhalis. Gram-negative organisms like Klebsiella and Escherichia coli are more common in nosocomial infections. Nursing home patients with pneumonia tend to be more frail than those in the community. Treatment is directed at eradication of the organism with the appropriate antibiotic, maintaining hydration and oxygenation, as well as managing impaired mobility, faecal loading, urinary incontinence and confusion. Influenza vaccination is strongly recommended for the frail elderly. Tuberculosis remains an important diagnosis in the frail elderly and should always be considered, especially in patients with respiratory infection who fail to respond to conventional therapy.
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PMID:Treatment recommendations for respiratory tract infections associated with aging. 845 84

The pulmonary radiological manifestations of lipoid pneumonia following a cultural practice of forced feeding of rendered animal fat (ghee) in 24 Saudi children are described. The age range is 15 days to 11 years with 68% of cases being in infancy. The chest radiographic appearances encountered could be grouped into four broad patterns, viz, bilateral multilobar consolidations (BMLC) in 50% (12 cases), bilateral perihilar infiltrates (BPHI) with or without associated lobar consolidation in 21% (five cases), right perihilar infiltrates (RPHI) in 21% (five cases) and unilateral right multilobar consolidation (RMLC) 8% (two cases). The pneumoniae were non-resolving acute or chronic lung consolidations despite the usual antimicrobial chemotherapy. Associated nodular dense opacities (granulomas) were seen in the lower lobes of four of the 12 cases in the first group. Complications, seen also in this first group, included chronic collapse consolidation, fibrosis and death in three cases. In communities where the traditional practice of infant feeding with ghee exists, these pulmonary radiological patterns, although in some cases indistinguishable from those of bacterial pneumoniae, should raise the suspicion of ghee administration with consequent early diagnosis and energetic management to avert prolonged morbidity and potential death.
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PMID:Chest radiographic findings in childhood lipoid pneumonia following aspiration of animal fat. 850 40

Waterproofing agents consist of mixtures of solvents, repellents and propellants. Because of a fatality and a number of acute respiratory illnesses in humans following the exposure to a waterproofing agent, the aerosol mixtures were tested in mice. Inhalation of the waterproofing agent resulted in pulmonary collapse and pneumonia in mice. By testing fractions of the waterproofing agent it was determined that the fluororesin repellents in the waterproofing agent were responsible for the acute respiratory illness. The water-repelling agent, such as fluororesin, may counteract the surfactant in the alveoli of the lung and cause diffuse pulmonary collapse followed by acute respiratory distress. The recent substitution of less toxic and environmentally more friendly solvents in waterproofing agents may facilitate fluororesin inhalation by increasing the amount of airborne aerosol and changing the diameter of the aerosol particles. This would explain the apparent recent increase of respiratory symptoms following the use of these agents. In this experiment the mice were exposed intermittently to overcome the CNS effects of the solvents.
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PMID:Pulmonary collapse and pneumonia due to inhalation of a waterproofing aerosol in female CD-1 mice. 852 84


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