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

To determine if examination of respiratory secretions is useful in diagnosing Pneumocystis carinii pneumonia, smear preparations of expectorated sputum, tracheal aspirates, and transtracheal aspirates stained by the Gomori methenamine silver nitrate method were examined. Pneumocysts were observed more frequently in material obtained by transtracheal aspiration than in secretions obtained by the other methods. Transtracheal aspiration yielded material containing pneumocysts in 8 (13%) of 60 patients; each had pulmonary infiltrates and clinical courses consistent with P carinii pneumonia. Of 330 smear preparations examined from expectorated sputum, three patients had pneumocysts in their sputum and one had organisms in both transtracheal aspiration and expectorated sputum; all three had pneumonia. This study provides evidence that transtracheal aspiration is a useful initial step in the approach to the diagnosis of P carinii pneumonia.
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PMID:Pneumocystis carinii pneumonia. Diagnosis by examination of pulmonary secretions. 6 65

Percutaneous transthoracic needle aspiration was performed on 228 occasions to obtain lung specimens from 202 patients with suspected Pneumocystis carinii pneumonitis. In 121 patients the diagnosis was established by identifying P carinii organisms in lung aspirates. Six patients whose aspirates did not contain P carinii were found to have the organism at autopsy. Findings from toluidine blue O and Gomori methenamine silver nitrate stains were equally satisfactory for detecting P carinii, but the percentage of specific diagnosis was higher when specimens were stained with both. Pneumothorax that required a thoracotomy tube occurred in 39 patients. Other infectious agents, either bacteria or fungi, were found in only four patients. Percutaneous pulmonary needle aspiration--when performed under fluoroscopic guidance--is a rapid and effective method for the diagnosis of P carinii pneumonitis.
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PMID:Percutaneous transthoracic needle aspiration of the lung. Diagnosing Pneumocystis carinii pneumonitis. 7 Jan 67

Unlike most pneumonias, the diagnosis of Pneumocystis carinii pneumonia is based solely on identifying organisms by stain, usually with methenamine-silver. Because of technical problems involved with adequate staining, control samples usually are done concurrent with tissue specimens to be examined. Lung containing fungi often is used as a control. We recently observed false-negative biopsy specimens in a case of P carinii pneumonia where the Pneumocystis organism failed to stain with methenamine-silver on several occasions, although fungal controls were positive. This report emphasizes the importance of using P carinii as a control whenever attempting to diagnose P carinii pneumonia.
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PMID:False negative biopsy in Pneumocystis carinii pneumonia. 8 33

The acute lesion in Legionnaires' disease pneumonia is an acute fibrinopurulent bronchopneumonia in which the alveoli are filled with many neutrophils and macrophages and abundant fibrin. There is only slight necrosis. Although characteristic, the lesion is not specific for this agent. However, the association with this lesion of myriad small pleomorphic rods, which stain well with Dieterle's silver-impregnation method but poorly or not at all with Gram-type stains, is uncommon except in Legionnaires' disease pneumonia. Final diagnosis requires isolation of the organism or immunofluorescent studies of the tissue, sera or both. The full spectrum of the pneumonia is not known, but organization has been reported once. No definite anatomic correlate for the extrathoracic manifestations of Legionnaires' disease has been identified nor has the organism been found at extrathoracic sites.
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PMID:Pathology of Legionnaires' disease. 8 11

Morphological changes in the lymphatic link of the microcirculation of serous coats were studied by the method of non-injection impregnation with silver nitrate in rheumatism, lupus erythematosus, chronic nonspecific pneumonia, pulmonary tuberculosis. There were identified 4 types of the state of lymphatic capillaries and postcapillaries, namely: functioning, dystrophized, sclerosing, and regenerating, reflecting a state of the lymphatic system at a given stage of a disease. Regeneration of lymphatic capillaries, as well as formation of lymphatic cisterns, cysts etc., the author classifies as manifestations of compensatory-adaptive processes of the organism aimed at preservation of the hemato-lymphatic balance. The hemo- and lymphocirculation functions as one integral system.
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PMID:[The lymphomicrocirculatory bed of serous membranes in several human diseases]. 30 36

To assess the accuracy of pulmonary lavage in diagnosing pneumonia due to Pneumocystis, we used animals as a model and then prospectively studied 33 immunosuppressed adults with diffuse pulmonary infiltrates. In rats treated with cortisone, Pneumocystis organisms could be found in the effluent from lavage as early as in sections of pulmonary tissue, and the effluent from lavage remained diagnostic throughout the ten weeks of observation. Subsegmental lavage in adult patients was performed through the wedged fiberoptic bronchoscope. Pneumocystis organisms were demonstrated in seven patients by lavage, and no false-negative results were recorded. Pneumocystis organisms were readily identified among the sheets of alveolar macrophages seen in smears of the effluent from lavage that were stained with methenamine silver. Subsegmental lavage via the fiberoptic bronchoscope is an accurate and safe technique for establishing the diagnosis of pneumonia due to Pneumocystis in patients whose respiratory embarrassment or thrombocytopenia makes biopsy of the lung hazardous.
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PMID:Diagnosis of pneumonia due to Pneumocystis by subsegmental pulmonary lavage via the fiberoptic bronchoscope. 30 82

Pneumocystis carinii pneumonitis is a diffuse bilateral alveolopathy encountered in the immunocompromised host with cancer, a congenital immune deficiency disorder, an organ transplant, severe protein-energy malnutrition or recipients of immunosuppressive therapy for other conditions. The onset is abrupt with fever and tachypnea. No rales are heard and the roentgenogram reveals a diffuse alveolar disease. Once the pneumonitis is evident, the infection is usually fatal if no treatment is given. The diagnosis is best established by the demonstration of the causative organism in specimens obtained by open lung biopsy, or other invasive methods, and stained with Gomori's methenamine silver nitrate, toluidine blue O or polychrome stains. Of the two drugs available for treatment, trimethoprim-sulfamethoxazole is preferred over pentamidine isethionate because of relative difference in adverse effects. With either drug the recovery rate is about 75%. The infection can be prevented in high risk patients by the administration of trimethoprim-sulfamethoxazole prophylactically.
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PMID:Pneumocystis pneumonia: a plague of the immunosuppressed. 30 68

Patients with acute Legionnaires' disease (LD) pneumonia may have persistent chronic pulmonary changes, as shown by the histologic appearance of specimens of lung from patients who had survived and autopsy specimens from patients who died after a protracted clinical course. Acute pneumonia was not seen in these lungs, and LD organisms could not be identified by the direct fluorescent antibody technique or the Dieterle silver impregnation strain; instead, there was organizing pneumonia with various degrees of interstitial inflammation and fibrosis. The LD pneumonia may fail to resolve, and the lung parenchyma in areas of previous acute inflammation is not restored to normal in some patients.
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PMID:Pulmonary sequelae of acute Legionnaires' disease pneumonia. 43 33

A series of 645 consecutive burn injuries are analysed. There were 175 patients in the control group, 156 in the Maphenide (Sulfamylon) group and 314 in the Silver Sulphadiazine (S. S. D.) group. The Maphenide group and S.S.D. group are compared statistically with the control group. S.S.D. proved superior in relation to clinical infection rate and culture rate in reduction of Pseudomonas and Staphylococcus. Other culture rates were analysed. There were significant reductions in both groups for E. coli and Candida albicans. Pneumonias were significantly increased in both groups and the mortality rate reduced with S.S.D. Overall S.S.D. gave better results than Maphenide.
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PMID:Clinical comparison of maphenide and silver sulphadiazine. 45 87

Autopsy tissues and protocols from 26 epidemiologically defined fatal cases of Legionnaires' disease occurring during the 1976 Philadelphia outbreak were reviewed. Consistent pathologic features were limited to the lung, where an acute pneumonia characterized by intra-alveolar exudation of neutrophils, macrophages, and fibrin was observed. An etiologic agent common to most of the victims of Legionnaires' disease was identified within the pneumonic process by application of the Dieterle silver impregnation stain. In some cases, other pulmonary histologic findings were noted, chiefly acute diffuse alveolar damage. However, the importance of acute diffuse alveolar damage is not understood.
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PMID:Legionnaires' disease. Pathological and historical aspects of a 'new' disease. 58 Aug 65


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