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

Pneumonia is a rare but serious complication of varicella during pregnancy. Maternal mortality has been reported to be 41% with fetal and neonatal mortality at 65%. Treatment has included respiratory support and prophylactic antibiotics. Acyclovir has been prescribed with the intent to decrease the impact of the infection. It was added to the treatment protocol of two cases of varicella pneumonia in pregnancy. Despite the high maternal and perinatal mortality both pairs of patients and infants survived. Acyclovir did not appear to adversely influence the fetus, and may have contributed to the survival of mother and child.
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PMID:Varicella pneumonia during pregnancy. Treatment of two cases with acyclovir. 327 33

Virus replication is described, and the clinical trials and indications for amantadine, rimantadine, vidarabine, vidarabine phosphate, acyclovir, ribavirin, and other promising antiviral agents are reviewed. Amantadine and rimantadine are useful for the treatment and prophylaxis of viral influenza A infections. Vidarabine is a second-line agent and is effective for the treatment of herpes simplex encephalitis, neonatal herpes simplex types 1 and 2, and varicella-zoster infections. Vidarabine phosphate (also known as vidarabine monophosphate) has a similar spectrum of activity and can be administered in smaller volumes than vidarabine. Acyclovir has demonstrated clinical efficacy for chickenpox, shingles (herpes zoster), genital herpes, and other herpes simplex infections. Acyclovir is also useful for the suppression of herpes infections. Systemically administered ribavirin is indicated for the treatment of Lassa fever. Aerosol ribavirin is effective for the treatment of respiratory syncytial virus pneumonia in children and infants and influenza A infections in adults. Only acyclovir, amantadine, ribavirin, and vidarabine are used in clinical practice. Vidarabine phosphate and investigational agents such as rimantadine, ganciclovir (DHPG, BW B759U), phosphonoformate, and bromovinyl-deoxyuridine (BVDU) need further investigation.
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PMID:Recent advances in antiviral therapy. 354 44

A patient with recurrent simultaneous chronic infections, including cytomegalovirus pneumonia, disseminated zoster and perineal herpes simplex infection, whose immune responses were deficient (immunodeficient), is presented. Following treatment with acyclovir (19-(2-hydroxyethoxymethyl)guanine), this patient had a rapid remission of these viral infections. The patient's clinical improvement is remarkable considering the duration of the viral infections and the continued immune deficiency. Acyclovir appears to act by a highly selective activation by and inhibition of viral enzymes. Prospective trials of this agent in immunosuppressed patients with herpes virus infections seem warranted.
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PMID:Successful treatment with acyclovir of an immunodeficient patient infected simultaneously with multiple herpesviruses. 625 42

Cytomegalovirus pneumonia is a serious complication of marrow transplantation, with a 90 percent fatality rate. Acyclovir, a new antiviral agent with variable in vitro activity against cytomegalovirus, was administered to eight marrow transplant patients with biopsy-proven cytomegalovirus pneumonia; one patient survived. Doses were between 400 and 1200 mg/m2 and peak plasma levels between 47 and 316 microM were attained. Possible marrow toxicity occurred in three patients, and mild neurotoxicity occurred in one. High-dose acyclovir had mild toxicity but was not effective as treatment for cytomegalovirus pneumonia after marrow transplantation.
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PMID:Treatment of cytomegalovirus pneumonia with high-dose acyclovir. 628 16

A case of neonatal herpes simplex infection is discussed that presented as pneumonia, with subsequent development of skin lesions. The virus was isolated from skin scrapings. In spite of treatment with vidarabine, skin lesions continued to develop, and central nervous system involvement occurred. Acyclovir therapy led to prompt resolution of symptoms.
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PMID:A case of neonatal herpes simplex with pneumonia. 631 91

Despite the lack of virus-specified thymidine kinase activity, human cytomegalovirus may be sensitive to acyclovir in vitro at concentrations between 10 and 25 mg/l. The inhibitory effect of acyclovir can be further increased by the presence of small amounts of human alpha or beta interferon. Twenty-one allogeneic marrow graft recipients with biopsy-proven cytomegalovirus pneumonia were treated with either high doses of acyclovir (eight patients) or the combination of acyclovir and human alpha (leukocyte) interferon (13 patients). Acyclovir doses of 400 to 1200 mg/m2/dose and interferon doses of 2 to 40 X 10(4) units/kg/day were used. There was no consistent effect of treatment on the likelihood or duration of survival, titre of virus in paired lung specimens, or shedding of virus. However, four patients survived and four others had 2-log or greater decreases in the amount of virus in paired lung specimens, suggesting a possible effect on cytomegalovirus strains with increased sensitivity to these agents. Acyclovir treatment of cytomegalovirus infection may be more effective in patients with lesser degrees of immunosuppression, but was not effective in the treatment of marrow transplant patients with cytomegalovirus pneumonia.
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PMID:The use of acyclovir for cytomegalovirus infections in the immunocompromised host. 631 97

Therapeutic intervention of varying potency and toxicity is now available for bacterial, fungal, parasitic, and viral pneumonia, but the problem of establishing the precise origin to evaluate treatment protocols remains. Antibacterial agents reduce postinfluenzal morbidity and mortality. Earlier appropriate treatment of gram-positive coccal infections has reduced mortality to less than 10 percent unless bacteremia is present. Gram-negative bacillary pneumonia remains a major problem and response rates do not exceed 65 percent except in selected series in which two effective antimicrobial agents have been used. Nevertheless, the superiority of two agents has not convincingly been demonstrated in any retrospective series or prospective randomized trial; more efficacy data in patients with gram-negative pneumonia treated with the newer beta-lactam agents would be useful. Little information is available on the laboratory correlates of successful treatment of gram-negative pneumonia, such as sputum antibiotic levels. Moreover, aerosolization of antimicrobial agents has been used with reported success by some investigators, but this therapeutic approach remains controversial. Pneumonia or lung abscess due to anaerobes may require increasingly larger doses of penicillin or alternative antianaerobe agents. Parasitic pneumonias such as those due to Pneumocystis carinii have responded well to trimethoprim-sulfamethoxazole. Acyclovir appears effective against some herpes viruses (simplex and varicella zoster), but it has failed to affect cytomegalovirus pneumonia even when combined with interferon. Opportunistic fungal pneumonias are poorly treated with all available agents and usually do not respond unless there is amelioration of predisposing factors or improvement in underlying disease. The latter statement appears relevant in most patients with severely compromised host defenses and pulmonary infection.
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PMID:Treatment of respiratory infections in the patient at risk. 637 80

Patients with the acquired immune deficiency syndrome (AIDS) occasionally develop hepatitis, pneumonia or esophagitis due to herpes simplex virus type 2 (HSV-2) infection. HSV hepatitis is a rare but serious complication in liver transplantation. Acyclovir-resistant HSV strains may emerge in immunocompromised patients. Following intraperitoneal inoculation, HSV-2 induces necrotizing hepatitis in mice. We studied the virus spread and mortality following intraperitoneal inoculation of HSV-2 RK (an acyclovir-resistant recombinant virus with altered thymidine kinase activity) as compared to its parent virus 8620K. Neither the 50% lethal dose (LD50) nor the average survival time was significantly different between the two strains. Parenteral acyclovir treatment was found to be effective against 8620K but not RK infection. Parenteral foscarnet treatment was effective against both RK and 8620K, and also inhibited the spread of either virus to the liver, spinal cord and brain. Peroral foscarnet administration was found to prevent the virus growth in the liver.
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PMID:Suppression of infectious virus spread to the liver by foscarnet following lethal infection of acyclovir-resistant herpes simplex virus type 2 in mice. 748 49

We report the case of a 33 year old man with herpetic bronchitis and bilateral pneumonitis. He presented without mucocutaneous lesions, and his cellular and humoral immunity were not compromised. Diagnosis was established on histological and cytological findings and confirmed by serology. Acyclovir treatment led to a favourable outcome.
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PMID:Herpes simplex pneumonia in a young immunocompetent man. 792 91

A 22 weeks pregnant women was affected by a life-threatening pneumonia and a paresis of the proximal muscles with cerebrospinal fluid pleocytosis. Her past medical history had been unremarkable except for recurrent episodes of paraumbilical herpes zoster. The clinical findings suggested a dissemination of varicella-zoster virus without skin lesions. Acyclovir was added to the therapy, and the clinical picture began to improve. Varicella-zoster virus DNA was detected in placental tissue by DNA-hybridisation analysis.
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PMID:Severe pneumonia in pregnancy three months after resolution of cutaneous zoster. 792 22


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