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

A combination of sulfamethoxazole and trimethoprim (Bactrim) was given orally to 35 cancer pattients with infections. Thirty-two patients did not respond to an initial antibiotic regimen that consisted primarily of carbenicillin disodium and an aminoglycoside. There were 18 single-organism, Gram-negative infections. The overall cure rate was 54%. The most common infection was pneumonia (47% responded to treatment). Eighty precent of the cases of septicemia were cured. The most common infecting organism was Klebsiella pneumoniae (45% with this infection responded). Eight cases of infection of unknown origin occurred (63% responded to treatment). Overall, 47% of the patients whose neutrophil count remained unchanged or decreased responded, while 61% of those whose neutrophil count remained unchanged or increased responded. There was no close correlation between the minimum inhibitory concentrations and the clinical responses. Sulfamethoxazole-trimethoprim orally is a well tolerated and effective form of antimicrobial therapy.
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PMID:Sulfamethoxazole-trimethoprim for infections in cancer patients. 57 66

AIDS is one of the most perplexing diseases to confront modern medicine today. AIDS will rank just behind accidents, heart disease and cancer as a major cause of potential life lost in the USA by 1991. Over half million AIDS cases are predicted by 1993 in the United States alone. There has been a great improvement in the understanding and treatment of opportunistic infections in AIDS. The most important concept is prophylactic treatment of the most common infectious complications as the immune system deteriorates. The major advance has been the prophylactic treatment of Pneumocystic Carinii Pneumonia (PCP) with either aerosolized Pentamidine or low dose Bactrim. Some experts advocate a low dose antibiotic prophylaxis for latent toxoplasma and cryptococcal infection in those patients whose immune systems are deteriorating. Prophylaxis would be instituted as the T4 helper lymphocyte count decreases. Finally, any patient found to be lately infected with either tuberculosis or syphilis, while HIV positive, must be thoroughly treated for these infections prior to any immunocompromise. The minimum follow-up of HIV positive individuals should include T4 lymphocyte counts and perhaps P24 antigen levels as well as beta 2-microglobulin levels. As these parameters worsen, patients should be directed to explore safe available treatments such as Antabuse, Naltrexone and Dextran sulfate. Any healthy patient with T4 helper counts under 400 should be directed to AIDS treatment evaluation units for enrolment in research protocols. At present over 100 drugs are being tested for the treatment of AIDS. However, researchers predict that no more than one or two drugs will be discovered over the next three years that will be helpful in the treatment of AIDS. If ever there was a more powerful argument to institute a new way of evaluating research drugs, it is this prediction. Due to the epidemic proportions of this disease, it seems reasonable to test epidemic proportions of this disease, it seems reasonable to test drugs shown to have some effect in groups of three of four drugs per patient. It is well demonstrated that AZT (Zidovudine) loses its anti-retroviral effect at about twelve to eighteen months. Drug resistance is seen in the treatment of a similar infectious agent, M. tuberculosis. Acute infection of MTB necessitates the use of three antibacterial agents. In AIDS infection, it seems logical to test two or three anti-retrovirals combined with one immunostimulant.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acquired immunodeficiency syndrome: molecular biology and its therapeutic intervention (review). 251 41

A 79-year-old white male was admitted to the hospital for treatment of a right-lower-lobe pneumonia. His past medical history included: mild congestive heart failure, asymptomatic ventricular tachycardia, and ethanol abuse. He was initially treated with furosemide for his heart failure, lidocaine for his arrhythmias, and Bactrim for his pneumonia. On day 13 of hospitalization he experienced a tonic-clonic seizure during the time he was being converted from lidocaine to tocainide. At the time of the seizure both tocainide and lidocaine were well within their respective therapeutic ranges. Since the seizure, the patient has tolerated treatment with each drug separately, and at serum concentrations similar to those preceding the seizure, without neurological complications, indicating the possibility of a tocainide-lidocaine induced seizure.
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PMID:A seizure induced by concurrent lidocaine-tocainide therapy--is it just a case of additive toxicity? 308 Feb 99

The therapeutic effectiveness of a single oral dose (60 and 200 mg/kg body weight) of fosfomycin trometamol (FT), norfloxacin, trimethoprim sulfamethoxazole (Bactrim) and pipemidic acid against experimental cystitis in the rat were compared. Infections were produced with clinical isolates of Klebsiella pneumoniae, Proteus mirabilis and Escherichia coli in a total of 135 Sprague-Dawley albino rats. Oral treatment with all four drugs consistently lowered the numbers of CFU in bladder tissue, especially E. coli and P. mirabilis. Fosfomycin trometamol appeared to be as effective as norfloxacin for treatment of E. coli cystitis even thoughs its minimal inhibitory concentration (MIC) in vitro is 100 times greater than that of the quinolonic antibiotic. Fosfomycin trometamol, pipemidic acid and Bactrim were equally effective against P. mirabilis infection, but FT was less active than norfloxacin or Bactrim for treatment of K. pneumonia cystitis. In conclusion, single dose treatment with fosfomycin trometamol was effective for treatment of experimental cystitis in the rat and might, by extrapolation, be of use in clinical practice for single dose treatment of uncomplicated urinary tract infections.
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PMID:Treatment of experimental cystitis in the rat with a single dose of fosfomycin trometamol. 325 10

The acquired immune deficiency syndrome (AIDS) represents a new epidemic of major proportions. Risk factors include homosexuality, intravenous drug abuse, Haitian descent, and multiple transfusion in the presence of hemophilia A. The etiology of AIDS remains unknown, but there is increasing evidence implicating a transmissible infectious agent and/or multiple antigenic exposures inducing a loss of immunoregulation. In a high-risk patient, the features of weight loss, generalized lymphadenopathy, and fever should arouse suspicion of AIDS. Diagnostic confirmation includes demonstration of reduced numbers of T lymphocytes with reversal of helper-suppressor T-lymphocyte ratio, presence of unusual opportunistic infections, and a progressive downhill course. The most common infection in AIDS is Pneumocystis carinii pneumonia. Treatment failures with trimethoprim-sulfamethoxazole (Bactrim, Septra) are common; pentamidine isethionate (Lomidine) may be more effective in eradicating the infection. In spite of initial improvement, recurrences of P carinii pneumonia and other opportunistic infections are common. In addition, other protozoan, viral, fungal, and atypical mycobacterial infections are frequent in patients with AIDS. Finally, rare neoplasms such as Kaposi's sarcoma and B-cell lymphoma, including primary lymphoma of the brain, are also being recognized as complications. At present there is no specific therapy for AIDS, and the disease is usually fatal. Continued research will hopefully result in immunomodulation techniques and specific vaccines to combat this serious epidemic.
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PMID:Acquired immune deficiency syndrome. A deadly new disease. 660 12

A recent Spanish study has shown that Bactrim, a treatment for PCP pneumonia, can be taken three times a week instead of once daily. Using Bactrim, also known as Septra, in this manner produces fewer side effects while still remaining effective. The study confirms the results of several previous small studies done in the U.S.
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PMID:Some good news about preventing PCP pneumonia. 1136 25

In July 1993, the United States Public Health Service and the Infectious Disease Society of America gave a set of recommendations for early intervention and prevention of opportunistic infections in HIV-positive people. These guidelines follow CD4 counts. According to the guidelines, CD4 counts above 500 should be monitored every 4 to 6 months and screenings for tuberculosis, sexually transmitted diseases, and other diseases should also be done. At a CD4 count of 75, a prophylaxis of rifabutin against Mycobacterium avium complex (MAC) is advised. Oral ganciclovir has been effective in preventing or delaying cytomegalovirus in people with CD4 counts below 50. HIV-positive patients should be vaccinated for streptococcal pneumonia, hepatitis B, and influenza and avoid alcohol, drugs, and nicotine. AZT is still considered the first line therapy when symptoms appear or when CD4 counts fall. Combination antiretroviral therapies (AZT and ddI, AZT and ddC, and AZT and 3TC) are thought to be the best way to fight HIV. If symptoms include thrush, a prophylaxis against Pneumocystis carinii pneumonia should be started, such as TMP-SMX (Bactrim or Septra), dapsone, or aerosolized pentamidine.
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PMID:Early intervention and prevention options. 1136 17

In the last decade, a growing number of patients with pneumonia, caused by unusual gram positive rods have been observed. Mostly, the patients had been infected as a consequence of impaired immunity. In some cases, bioterrorist activities may also induce pneumonia by gram positive rods (B. anthracis). In order to bring these organisms to the attention of the medical community, we present three clinical cases and describe six species of gram positive rods, known to provoke this kind of pneumonias. Case 1 was a 84 years old patient with impaired lung function. He was suspicious of tuberculosis (Tbc). Nocardia spec. was isolated. Case 2 was an alcoholic of 46 years with pneumonia. Reactivation of Tbc was suspected. Actinomadura madurae has been isolated. Case 3 was a patient of 58 years with myelodysplastic syndrome (MDS) and pneumonia. N. asteroides was isolated. All patients shared impaired immunity (age, alcoholism, MDS) with impaired lung functions; Tbc had been suspected (Case 1 + 2). Infection by A. madurae was contained by Clindamycin. Therapy of Nocardia with Moxifloxacin (Case 1) or Bactrim (Case 3) was only partly effective. In the appendix, six species of gram positive rods which are known to cause pneumonia, are summarized (Nocardia, Actinomyceta, Actinomadura, Rhodococcus, Corynebacterium and Bacillus).
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PMID:[Unusual gram positive rods, causing pneumonia]. 1278 78

A 15-year-old girl with abnormal findings detected on a medical check-up chest x-ray film was admitted to our center. High-resolution computed tomography, performed upon hospitalization, demonstrated panlobular nodular darkening in left lung fields, and an expanding, blended, map-like darkening near the pleura. Since a Grocott stain-positive cyst was confirmed histopathologically by transbronchial lung biopsy, the patient was given a diagnosis of Pneumocystis carinii pneumonia. Drug therapy was initiated with sulfamethoxaxole trimethoprim (Baktar), and on the 58th day, chest CT confirmed that the darkening observed at admission had virtually disappeared. Underlying diseases, such as AIDS, malignant lymphoma and secondary immunodeficiency caused by immunosuppressive agents or adrenocorticosteroids, were excluded as the cause of P. carinii pneumonia based on clinical/laboratory findings. Under the suspicion of the possibility of primary immunodeficiency, various immunological competence tests were performed. However, no abnormal findings indicating cell-mediated immunity, humoral immunity, complement immune function, neutrophil phagocytic capacity, or bactericidal capacity were recognized. Since significant increase of serum IgE suggested hyper-IgE syndrome, IgE antibody specific to Staphylococcal enterotoxin A and B, and the exotoxins of Staphylococcus aureus were measured with positive results. Since all three diagnostic criteria for hyper-IgE syndrome (i.e., high serum IgE values, positive IgE antibody specific to Staphylococcal enterotoxin and recurrent infection) were fulfilled, hyper-IgE syndrome was diagnosed. This is a rare case of hyper-IgE syndrome as a result of P. carinii pneumonia.
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PMID:[Pneumocystis carinii pneumonia in a patient with hyper-IgE syndrome]. 1755 82

Nicotinamide dinucleotide phosphate oxidase-deficient (p47(phox-/-)) mice are a model of human chronic granulomatous disease; these mice are prone to develop systemic infections and inflammatory diseases. The use of antibiotic (Bactrim) prophylaxis in a specific pathogen-free environment, however, impedes infection in the majority of p47(phox-/-) mice. We examined infection-free p47(phox-/-) mice between 1 and 14 months of age and found that they developed proliferative macrophage lesions containing Ym1/Ym2 protein and crystals in lung, bone marrow, lymph nodes, and spleen. Here, we show that the lung lesions progressed from single macrophages with intracellular Ym1/Ym2 protein crystals to severe diffuse crystalline macrophage pneumonia without histological evidence of either granulation tissue or pulmonary fibrosis. Ym1/Ym2 is a chitinase-like secretory protein that is transiently induced in alternatively activated macrophages during T-helper (Th)2-biased pathogenesis and during chemical and traumatic inflammation. Bronchoalveolar lavage from p47(phox-/-) mice contained significantly higher levels of Th-1 (interferon-gamma), Th-2 (interleukin-4), and Th-17 (interleukin-17)-associated cytokines than wild-type mice, as well as copious amounts of interleukin-12, indicating that Ym1-secreting p47(phox-/-) macrophages are also integrated into classically activated macrophage responses. These results suggest that p47(phox-/-) macrophages are extremely pliable, due in part to an intrinsic dysfunction of macrophage activation pathways that allows for distinct classical or alternative activation phenotypes.
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PMID:p47phox deficiency induces macrophage dysfunction resulting in progressive crystalline macrophage pneumonia. 1909 58


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