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

Phosphorylcholine is an immunodominant determinant of pneumococcal teichoic acids. Antibodies to phosphorylcholine are naturally occurring in man and decline in amount with age. Since antibodies to phosphorylcholine are markers of the immune responsiveness to polysaccharides and since anti-polysaccharide antibodies are highly protective against most bacterial pneumonia we expected a higher rate of pneumonia in elderly individuals with low levels of antibodies to phosphorylcholine. The relationship between the levels of antibodies to phosphorylcholine and mortality was analyzed prospectively in a representative sample of elderly individuals. A significant anti-phosphorylcholine antibody response occurred in a subgroup of the probands. There was a strong association (p less than 0.0001) between high levels of antibodies to phosphorylcholine in the serum at 70 years of age and pneumonia related death up to 14 years later. A similarly strong association was not observed between mortality and the antibody titer to another naturally occurring polysaccharide antigen: the blood group B antigen. Furthermore, there was no association between mortality due to diseases other than pneumonia and the levels of antibodies to phosphorylcholine. The association between antibody levels and subsequent fatal pneumonia provides a means of detecting individuals at risk for pneumonia-related death.
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PMID:High anti-phosphorylcholine antibody levels and mortality associated with pneumonia. 235 41

To obtain data on the clinical manifestations of infection, the age distribution, and the underlying conditions of children with influenza severe enough to lead to hospital referral, we performed a retrospective study of children treated at Turku University Hospital (Turku, Finland) in 1980-1999. Influenza A or B antigen was detected in the nasopharyngeal aspirates of 683 of the 15,420 children studied. The median age of children with influenza A was 2.0 years (n=544), and that of children with influenza B was 4.2 years (n=139) (P<.001). One-fourth of the children had an underlying medical condition. High fever, cough, and rhinorrhea were the most frequently recorded symptoms. Acute otitis media developed in 24% of the children, and pneumonia developed in 9% of the children. The study shows that the majority of patient hospitalizations for pediatric influenza involve previously healthy infants and young children. Laboratory confirmation of influenza is particularly important for children because the clinical presentation of the infection is less characteristic than that seen in adults.
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PMID:Influenza A and B virus infections in children. 1253 71

Patients with severe community acquired pneumonia (CAP) need continuous surveillance and monitoring at intensive care units (ICU), where they can receive specialized support as mechanical ventilation and/or hemodynamic support. Patients that require ICU admittance represent 10 to 30% of all patients interned because a pneumonia. In this category, high complication rate, prolonged hospital stay and high mortality rate are the rule. The American Thoracic Society (ATS) criteria for severe pneumonia establishes the following main criteria: necessity of mechanical ventilation and presence of septic shock; minor criteria: systolic blood pressure < 90 mmHg, radiological multilobar involvement and PaO2/FiO2 < 250 mmHg. British Thoracic Society (BTS) criteria for severe CAP are: respiratory rate over 30 breaths/min, diastolic blood pressure under 60 mmHg, BUN > 20 mg/dl and mental confusion. In all patients with CAP it is recommended the evaluation of its severity at admission. This evaluation should be done in conjunction with an experienced physician, and if criteria for poor prognosis are met, an early admission to ICU is recommended. ATS and BTS modified criteria (CURB) are useful in this procedure. In severely ill patients with CAP it is recommended to perform the following microbiological analysis: sputum Gram stain and culture, blood culture, pleural fluid Gram stain and culture, if present and tapped, Legionella pneumophila urine antigen test, influenza A and B antigen detection tests (epidemic period: autumn and winter), and serology for atypical bacteria (Mycoplasma pneumoniae and Chlamydia pneumoniae).
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PMID:[Severe community-acquired pneumonia in adults]. 1616 19

We report a complication of the novel H1N1 influenza A viral infection not yet described during this 2007-2009 pandemic. Pulmonary hemorrhage is a known complication of influenza pneumonia, including well documented reports from previous pandemics. A 57-year-old African American female presented with fevers, progressive shortness of breath, and cough. After being admitted with an initial diagnosis of myocardial infarction, hemoptysis developed. Nasopharyngeal swabs rapid testing was negative for influenza A and B antigen, but a polymerase chain reaction test for influenza A type H1N1 was positive. A fiberoptic bronchoscopy for ongoing hemoptysis demonstrated diffuse erythema and bleeding, and bronchoalveolar lavage was consistent with alveolar hemorrhage. Progressive hypoxemic respiratory failure ensued, eventually leading to her demise. Our case highlights one of the more feared complications that may have been more common in prior outbreaks, such as the 1918 "Spanish Flu." Autopsy studies from the 1918 influenza pandemic found severe tracheobronchitis (oftentimes hemorrhagic), septal edema, necrotizing bronchiolitis, alveolitis, and extensive hemorrhage, as opposed to the more benign laryngitis and tracheobronchitis that is commonplace in other influenza infections. Similar pathology appearances, including pulmonary hemorrhage, have also been described in H5N1 outbreaks in China and Thailand. It is crucial for pandemic preparedness planning that additional careful and complete autopsy study of this present pandemic influenza infection be performed and reported to answer questions regarding the natural history, pathology, and pathogenesis of this novel H1N1 influenza.
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PMID:Novel H1N1 influenza A viral infection complicated by alveolar hemorrhage. 2042 Jul 34