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

Respiratory disorders during the course of infections in children who are HIV positive are frequent. These are interstitial pneumonia (IP) and bacterial pneumonia. The acute IP are most often infectious in particular opportunist infection, and are dominated by Pneumocystis carinii (PC, 82 to 86% of the infectious agents isolated). This is often a presenting feature of an HIV infection and the radiological picture is very variable and the diagnosis rests on bronchoalveolar lavage which is readily achievable even in the infant. The immediate outcome is usually favourable and cotrimoxazole is efficacious and well tolerated. However pneumonia to PC points to a poor prognosis because they are always associated with a profound deficit or cellular immunity. All these criteria are against the likelihood of lymphoid PI which is, however, much more frequent in children than in adults. It is the chronic interstitial pneumonia with a "large grain" miliary radiological pattern and preserved cellular immunity and the absence of opportunistic infections in particular PC pneumonia. In addition, beyond the absence of PC, the bronchoalveolar lavage liquid shows a constant hyperlymphocytosis without polymorphonuclear leucocytes which is significantly different from that which is observed during the course of PC pneumonia. The long term prognosis of chronic PI, however, remains guarded with the possibility of seeing a worsening of the immune function. As for bacterial pneumonias they usually present as an acute lobar pneumonia with a banal organism but severe gram negative pneumonias are possible justifying a detailed systematic approach in certain cases.
Rev Mal Respir 1990
PMID:[Respiratory manifestations of HIV infections in children]. 227 Mar 39

The lung is directly affected by HIV virus early in the disease and is the site of a specific lymphocytic alveolitis. Neoplastic pulmonary disease linked to the virus occurs (Kaposi sarcoma, lymphoma and epidermoid tumour) but it is principally following opportunistic infections that patients with AIDS come under the care of a respiratory physician. Certain of the responsible infectious agents causing opportunistic pneumonia are probably present in a latent fashion before the disease presents and are reactivated by the immuno-depression. They may occur successively such as tuberculosis, toxoplasmosis (in this case pulmonary), infection to CMV and pneumocystis. Other infectious agents are transported by the environment and lead to recurrent bacterial infections, mycotic infections or infections with atypical mycobacteria. The clinical management of these different diseases has advanced greatly from a diagnostic therapeutic prophylactic and curative viewpoint.
Rev Mal Respir 1990
PMID:[Clinical management by the respiratory physician of patients with HIV infections]. 227 Mar 40

A 39 year old man who was HIV positive and was treated with trimethoprim-sulfamethoxazole for pneumocystis with hypoxaemia. During the acute episode he had a persistent fever of 38 degrees and hypoxaemia with a PaO2 of 65 mm/Hg and bilateral opacities both radiologically and on a CT scan, which were of alveolar type, with bronchograms identical to those observed before the treatment of the pneumocystis. In view of the negative evidence for a respiratory or extra respiratory infection, a surgical biopsy was performed and this revealed lesions of bronchiolitis obliterans with an organising pneumonia (BOOP). After the thoracotomy, there was a spontaneous clinical cure in a few days and radiological clearance in a month. This very rare diagnosis should be added to the list of causes of alveolar pneumopathy with infiltration and fever occurring during the course of an HIV infection.
Rev Mal Respir 1990
PMID:[Bronchiolitis obliterans, pneumocystosis and HIV infection]. 227 Mar 52

An analysis of 7 cases of thoracic actinomycoses were recorded over 25 years enabling a better appreciation of the radiological and clinical criteria: a low grade pneumonia with haemoptysis and an alteration in the general physical state, with pseudo-tuberculous radiological images or "pseudo-tumoral" with bronchograms and parietal wall disease. This clinical picture calls for endoscopic biopsies or biopsies under CT scanning for a study combining both histological and bacteriological diagnosis on appropriate culture media, enabling an exploratory thoracotomy to be avoided, the latter the classic method of diagnosis. This approach should reduce the number of pneumonias which are not confirmed bacteriologically which are sensitive to the usual antibiotics and determine better the true frequency of actinomycoses.
Rev Mal Respir 1989
PMID:[Is thoracic actinomycosis underestimated? Reflections on 7 cases]. 260 17

A case of acute interstitial pneumonia with hypoxaemia is described; this occurred after the cessation of cortico steroids in a patient suffering from myeloma treated with melphalan. The absence of any microbes and the lymphocytosis in the bronchoalveolar lavage and the rapid and favourable improvement on cortico steroids led to a diagnosis of melphalan induced pneumonia. This acute form is probably due to a hypersensitivity mechanism and should be distinguished from the majority of cases of sub-acute fibrosing pneumonitis due to melphalan which have been published before. Urgent treatment with glucocorticoids is justified as well as the immediate and final cessation of the medication responsible, because it is this which will affect prognosis.
Rev Mal Respir 1989
PMID:[Acute, reversible, interstitial pneumopathy induced by melphalan]. 269 Feb 10

A retrospective study analyzing the case notes of 49 hospitalized adults, either in intensive care (n = 26) or in thoracic medicine units (n = 23), for acute bacteriologically proven pneumococcal pneumonia based on samples obtained other than by sputum examination. The mortality was 54% in intensive care and 17% in the thoracic medicine unit. This significant difference may be explained in part by a respiratory distress syndrome in whom there were adequate criteria on admission for 7 patients in the intensive care group. Among these latter only one patient had had a splenectomy. The others did not have underlying disorders (three were chronic alcoholics); 7 patients were shocked on admission, four with a leukopenia less than 5,000/mm3 and six had a thrombocytopenia less than 100,000/mm3; finally 6 had a temperature of less than 38 degrees C. 7 patients died in less than four days (mean 2 days) in a clinical context of refractory hypoxemia. The significance of the respiratory distress syndrome is probably very different from the usual pneumonia; it seems rather to be an integration of the toxins induced by the pneumococcus. Its presentation can be particularly misleading as regards the diagnosis; the prescription of antibiotics once a diagnosis is obtained would seem insufficient by itself in this context to obtain a cure.
Rev Mal Respir 1989
PMID:[Adult respiratory distress syndrome, a manifestation of severe pneumococcal infection]. 274 May 92

This is a case report of a diffuse interstitial pneumonia which developed rapidly in a 45-year-old patient who was occupationally exposed to regular inhalations of motor oil spray. The diagnosis of lipid pneumonia was based on a lung biopsy carried out by thoracoscopy. The biochemical analysis of the lipid extracted from the alveolar lavage and of the pleural liquid showed the presence of hydrocarbons, which were analogous to those found in motor oil and the strippings that were used. The subsequent progress without treatment after removal from the risk showed a partial regression of the radiological abnormalities. The incidence of occupational pneumonia to mineral oils is relatively low when the frequency of exposure is taken into account: objective data on the extent and the nature of exposure are often incomplete in published observations. The occurrence of respiratory symptoms or radiological changes in exposed subjects requires, nevertheless, a search for a possible lipid pneumonia. The diagnosis rests on a biochemical and cytological analysis of the alveolar liquid and on a lung biopsy.
Rev Mal Respir 1989
PMID:[Lipid pneumopathy caused by occupational exposure to cutting oil]. 274 May 95

Terlipressin (Glypressin) is a "pro-hormone"; after intravenous injection the glycyl radicals are slowly cleaved by enzymatic action, liberating vasopressin. We have assessed the efficacy of terlipressin in the treatment of severe hemoptysis. The study was performed on 20 patients: in 5 cases there was very copious hemoptysis and in 15 cases there was repeated hemoptysis of lesser volume. The cause was distributed as follows: 6 cases of neoplasms, 5 were sequelae of tuberculosis, bronchial dilatation 2 cases, pneumonia with abscess 2 cases, chronic airflow obstruction (COPD) 2 cases and 3 cases of silicosis. The treatment consisted of a slow intravenous injection of 2 mgm 4 times per day (9 patients), then in 11 patients an injection of 2 mgm at the time of acute episodes followed by 1 mgm every 6 hours. The patients received an average of between 15 and 20 mgm of the product for a treatment lasting over 5 days at the maximum. The results were as follows: total success 12 cases; partial success (a reduction to at least one-third of the initial hemoptysis): 5 cases; failure: 3 cases. The failures were linked in two cases to neoplastic disease and in one case there was an intolerance to the drug which did not allow the treatment to be pursued.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Mal Respir 1989
PMID:[Treatment of severe hemoptysis with terlipressin. Study of the efficacy and tolerance of this product]. 279 45

Specimens obtained by broncho-alveolar lavage (LBA) allow for an examination for viral antigens by a direct technique using monoclonal antibodies and by culture, and the level of IgM and IgG antibodies by the ELISA technique. LBA is used in the screening of immuno-depressed subjects and in the search for an aetiology in overt cases of interstitial pneumonia. Ninety-six specimens of LBA from 76 patients were analysed [38 had immunological deficits of whom 14 had haematological disorders, 15 were transplant cases and there were 9 in the miscellaneous group (group A). There were 38 pneumonias occurring in pre-existing chronic disorders (group B)]. Twenty respiratory viral infections were identified (26.3%): 17 by direct examination or culture (22.4%), 3 by serology. CMV was identified in 14 cases, HSV1 in 4 cases, VZV and VRS in one case each. In the haematological cases there was a positivity of 28.6%, 66% in the transplants (100% for heart transplants), and from 11 to 13.2% in other groups. Ten patients in 56 (17.8%) possessed anti CMV IgG antibodies (the mean level was 745) and 5 had IgM (mean level 18) (9%). One case of pneumonia due to VZV with IgM and IgG in the LBA was reported. In summary, a direct examination by LBA is positive in a quarter of the cases and a culture in three quarters. The conventional methods failed here, showing the frequency of purely localised infections in the respiratory tract.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Mal Respir 1988
PMID:[The role of bronchoalveolar lavage in the diagnosis of viral pneumopathies. Apropos of 76 cases]. 283 75

The invasive aspergillus pneumonias have been described particularly in chemotherapy for patients with haematological disorders. In respiratory disorders such cases are exceptional. The authors report a case of invasive aspergillus pneumonia, occurring during treatment of a small cell cancer; the rapid commencement of anti-fungal treatment by Amphotericin "B" and Flucytosine enabled an apparent cure of the tumour by radiotherapy and chemotherapy. The authors stress the difficulty of definitive diagnostic criteria at the beginning of the disorder and also the need to start anti-fungal treatment as soon as possible.
Rev Mal Respir 1985
PMID:[Invasive aspergillar pneumopathy during the treatment of microcellular bronchial cancer. Efficacy of early antifungal treatment]. 301 20


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