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

Legionellae, which are important causes of pneumonia in humans, continue to be incorrectly labeled as exotic pathogens. The ability to diagnose Legionella infection is limited by the nonspecific nature of clinical features and the shortcomings of diagnostic tests. Despite recent improvements, existing diagnostic tests for Legionella infection either lack sensitivity for detecting all clinically important legionellae or are unable to provide results within a clinically useful time frame. Understanding local Legionella epidemiology is important for making decisions about whether to test for Legionella infection and which diagnostic tests to use. In most situations, the use of both the urinary antigen test plus sputum culture is the best diagnostic combination. Polymerase chain reaction (PCR) is a promising tool, but standardized assays are not commercially available. Further work needs to focus on the development of urinary antigen tests assays that detect a wider range of pathogenic legionellae and on the development of standardized PCR assays.
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PMID:Diagnosis of Legionella infection. 1249 Dec 4

We present a case of pyothorax-associated T-cell lymphoma in which Epstein-Barr virus (EBV) genome is not detected in the tumor cells. An 80-year-old male came to our hospital because of a left chest pain. Chest computed tomography (CT) showed a mass at the lower-dorsal part of the pyothorax wall, which involved the adjacent chest wall. The surgical biopsy specimen showed a predominant infiltration of atypical lymphocytes. Results of immunohistochemical analysis were as follows: CD3+, CD4-, CD8+, CD20-, CD30-, CD45RO+ and CD79a-. We diagnosed this case as a type of peripheral T-cell lymphoma. In situ hybridization using EBV-encoded RNA-1 (EBER-1) did not reveal the positive signals in the nucleus of tumor cells. Polymerase chain reaction (PCR) analysis yielded a negative result for human herpesvirus 8 (HHV8). Radiation therapy at 54 Gy reduced the tumor size by 90%. Visual and hearing disturbances of unknown etiology developed just before the completion of radiotherapy. The symptoms progressively worsened and the patient became bedridden. He died of pneumonia 2 months after the completion of radiotherapy. Autopsy did not reveal abnormalities to which the neurological disturbances were attributable.
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PMID:Pyothorax-associated T-cell lymphoma: a case report. 1267 93

Approximately one third of community acquired pneumonia cases are caused by atypical pneumonia agents, Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae (formerly Chlamydia pneumoniae). The laboratory diagnosis of these organisms is difficult and time-consuming by conventional microbiological techniques. Polymerase chain reaction (PCR) is one of the important tools which can circumvent this problem. A multiplex PCR assay was developed to achieve the diagnosis of these three organisms in a single tube. Primers used in PCR were selected in a way that they amplified different length DNA fragments from different agents but they all worked at the same amplification conditions. Therefore the organisms could be diagnosed according to the length of amplified products by agarose gel electrophoresis without using any hybridization probes. After development of the multiplex PCR method, totally 309 clinical samples which were sent to our laboratory for single-agent PCR, were also evaluated by this technique. The results showed that the multiplex PCR assay is a sensitive, useful, cheap, and rapid diagnostic tool for the management of pneumonia patients.
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PMID:Rapid detection of bacterial atypical pneumonia agents by multiplex PCR. 1506 98

Human herpesvirus-6 (HHV-6), a beta herpesvirus closely related to cytomegalovirus (CMV), infects the majority of the population in childhood. Human herpesvirus-6 can be reactivated in the immunosuppressed patient. After bone marrow and orthotopic liver transplant, it has been linked to various clinical syndromes, including undifferentiated febrile illness, encephalitis, pneumonitis and bone marrow suppression. To date its infectious role after orthotopic heart transplant has not been well documented. We present the case of a 32-year-old cardiac transplant recipient who initially presented 8 weeks after his transplant with high fever and headache. He developed increasing confusion, pulmonary infiltrates and neutropenia. Cytomegalovirus viral loads were negative. Polymerase chain reaction (PCR) of blood and cerebrospinal fluid detected HHV-6 DNA, consistent with HHV-6-related encephalitis, pneumonitis and bone marrow suppression. He was treated with foscarnet with gradual improvement in clinical status. We review the literature on the significance of this virus post cardiac transplant.
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PMID:Encephalitis owing to human herpesvirus-6 after cardiac transplant. 1519 83

Pregnant women who have an urogenital Chlamydia trachomatis infection may transmit the infection to their infants. Conjunctivitis and nasopharyngeal infection are the most frequent manifestations. Less frequently the infants may develop pneumonia. We report a case of a 5-week-old girl with poor feeding, staccato cough and clinical signs of pneumonia. Chest radiography revealed severe bronchopneumonia. Despite of intravenous therapy with ampicillin and gentamicin respiration deteriorated and oxygen supplementation became necessary. After additional treatment with oral erythromycin (50 mg/kg per day) had been started the clinical condition improved. Polymerase chain reaction with a nasopharyngeal specimen was found to be positive for Chlamydia trachomatis.
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PMID:[A young infant with afebrile pneumonia caused by Chlamydia trachomatis]. 1688 99

Mycoplasma pneumoniae is a human pathogen with worldwide distribution. This microorganism is a common cause (10-30%) of community-acquired pneumonia, also called primary atypical pneumonia because of the spectrum of clinical and radiological findings. The immune response is mainly based on rapid antibody production against peptide and glycolipid antigens derived from this microorganism. During the primary infection, IgM levels generally rise within the first week, and are then followed by an IgG response. Titers of IgG and IgA increase in reinfections. Microbiological diagnosis is based on specific antibody detection. Polymerase chain reaction (PCR) techniques performed on sputum or pharyngeal/nasopharyngeal exudates, as well as the development of multiplex PCR reactions allowing identification of M. pneumoniae and other respiratory pathogens, would by highly useful in routine diagnosis. The most common serological techniques are complement fixation, immunofluorescence, particle agglutination, and enzyme immunoassay. Diagnosis should be performed by selecting the most appropriate test according to functional criteria and population groups. Specific detection of IgM antibodies should not be included in the differential diagnosis in adults and young people. Diagnostic criteria including seroconversion or rising IgG titers may not be clinically useful, because of the time delay and the difficulty of obtaining a second serum specimen for testing, given the mildness of the clinical symptoms.
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PMID:[Serologic diagnosis of Mycoplasma pneumoniae infections]. 1712 64

Infection is the main cause of morbidity and mortality in liver transplant patients. Infections appear in three different periods following transplantation and are related to surgical factors, the degree of immunosuppression, environmental exposure and the type of prophylaxis used. Bacterial infections occur in the first two months after transplantation as bacteremia, surgical wound and intra-abdominal infection, or pneumonia. Tuberculosis in the liver transplant recipient is more aggressive than in immunocompetent persons. Viruses produce direct infection in these patients; moreover, some viruses (e.g., cytomegalovirus and human herpes virus 6) are immunomodulators and can facilitate other infections and graft rejection. Polymerase chain reaction and antigenemia techniques have made possible prompt diagnosis of cytomegalovirus infection and the implementation of prophylactic strategies. Fungal infections still have a high associated mortality rate, despite new diagnostic techniques and new antifungal drugs.
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PMID:[Infections in liver transplant recipients]. 1758 54

The present case is the first description of a triple infection with canine distemper virus (CDV), canine adenovirus (CAV) type 2, and Mycoplasma cynos in a dog. The 5-month-old female Miniature Pinscher was euthanized because of dyspnea, croaking lung sounds, weight loss, and lymphopenia. Pathologic examination revealed a fibrinous necrotizing pneumonia with large amphophilic intranuclear and acidophilic intracytoplasmatic inclusion bodies in different lung cells. Immunohistochemically, CDV antigen was present in lung and many other organs. In situ hybridization for detection of CAV nucleic acid showed positive signals in the lung only. Polymerase chain reaction of lung tissue and consecutive sequencing of the amplification product identified CAV type 2. Bacteriologic examination of lung tissue yielded large amounts of M cynos. This infection was confirmed by immunohistochemistry detecting abundant positive signals in the lung tissue.
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PMID:Simultaneous canine distemper virus, canine adenovirus type 2, and Mycoplasma cynos infection in a dog with pneumonia. 1760 12

Striped skunks (Mephitis mephitis) from Cape Cod, Massachusetts, U.S.A. were necropsied (n=34; 1995-1997) or clinically evaluated (n=25, 2002-2003) to characterize a lameness and polyarthritis, reported by wildlife veterinarians and rehabilitators, and unsuccessfully treated with antibiotics. Overall, 22 affected skunks had one or multiple swollen joints, swollen paws, and subcutaneous abscesses. Purulent exudate was located in joint spaces, in periarticular connective tissue between muscle fascicles and tendons, and between and along flexor and extensor tendons of the paws. Histologic examination revealed suppurative arthritis, with necrosis and erosion of articular cartilage, and suppurative osteomyelitis. Special stains failed to reveal a causative microorganism within affected joints, and routine bacteriologic cultures failed to isolate a pathogen with any significant frequency or consistency. Polymerase chain reaction (PCR) experiments were performed using DNA extracted from archived, formalin-fixed joint samples of 11 affected skunks, and DNA from joints of 7 of 11 affected skunks yielded amplicons with sequences highly similar to sequences of Mycoplasma fermentans within the Mycoplasma bovis cluster, whereas DNA samples from joints of four unaffected skunks were negative by PCR. Skunks from Connecticut, U.S.A. (n=21; 1995-2003) were similarly examined and were found not to have suppurative polyarthritis, suggesting a unique geographic distribution of this condition. Concurrent pathologic conditions in adult skunks from both Cape Cod and Connecticut included verminous pneumonia, gastric nematodiasis, arthropod ectoparasitism, and canine distemper. Amyloidosis was present in skunks with and without suppurative polyarthritis, and the amyloid was immunohistochemically identified as AA-amyloid. This is the first report of suppurative polyarthritis in wild skunks with evidence of a mycoplasmal etiology.
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PMID:Suppurative polyarthritis in striped skunks (Mephitis mephitis) from Cape Cod, Massachusetts: detection of mycoplasma DNA. 1793 47

Cytomegalovirus pneumonitis in a patient with pulmonary tuberculosis has been rarely reported. We report on a patient with nephrotic syndrome and documented pulmonary tuberculosis who received antituberculous therapy. Chest radiography showed a newly developed patch, and he underwent high-resolution computed tomography examination of the chest and open lung biopsy. Histopathologic studies of the lung showed interstitial pneumonitis, which had focal syncytial pneumocytes with focal nuclei atypia, inclusion bodies, and prominent eosinophilic nucleoli. Polymerase chain reactions for cytomegalovirus were positive in the sputum and biopsy specimen. The patient recovered well with ganciclovir treatment. When new pulmonary infiltrates develop in patients with pulmonary tuberculosis during antituberculous therapy, cytomegalovirus pneumonitis should not be overlooked.
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PMID:Cytomegalovirus pneumonitis in a patient with nephrotic syndrome receiving low-dose prednisolone and pulmonary tuberculosis. 1800 95


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