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

During a pertussis epidemic, the majority of children admitted with respiratory disease were under one year old and had pneumonia, with or without pertussis syndrome; heart failure was common. A greater proportion of those with 'pneumonia alone' were slightly older, were malnourished, were admitted earlier and recovered slightly faster than those who had 'pertussis with pneumonia'. Differential white cell count was of little help in diagnosis and chest X-ray findings seldom altered management. Eight percent of the pertussis and 3 percent of the pneumonia groups died: all had pneumonia and additional complications, and 71 percent of those who died were under one year of age. Results suggest that two or more infections of triple antigen may protect some children from an attack of pertussis so severe that hospital care would be needed.
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PMID:Childhood pertussis and pneumonia admissions in the highlands of Papua New Guinea. 27 31

We have reviewed the clinical presentation of pneumonia to the Goroka paediatric ward. In comparison to survivors, children dying from pneumonia more often (p less than 0.05) had malnutrition (weight-for-age under 80%), anaemia (haemoglobin under 9g%), and a marked leucocytosis (total white cell count over 30,000 cells per c.m.m.). Children dying from pneumonia had been ill for longer and had been given more antibiotics prior to admission. There was no significant difference between children dying from pneumonia and survivors in age distribution, pulse rate, incidence of cardiac failure or duration of stay in hospital. 70% of the children dying from pneumonia at Goroka Hospital are infants under 12 months of age. Pneumococcal vaccine gives a poor antibody response in infants, and overseas studies using lung aspiration suggest that Haemophilus influenzae and Staphylococcus aureus might be causative organisms as well as Streptococcus pneumoniae. A study to determine the aetiology of pneumonia in Highlands children is required to enable a rational choice of routine antibiotic therapy and to plan further research on vaccination against pneumonia.
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PMID:Childhood pneumonia at Goroka Hospital. 29 32

The safety and efficacy of a 10-day course of ganciclovir therapy was assessed in 17 consecutive patients with proven cytomegalovirus infection. The patients were receiving immunosuppressive therapy for a variety of non-malignant renal conditions, including renal transplantation (seven patients), small vessel vasculitis (six patients), systemic lupus erythematosus (three patients) and Goodpasture's disease (one patient). Fifteen patients were pyrexial at the time of their cytomegalovirus infection. Twelve patients had pneumonitis manifesting as a pulmonary parenchymal infiltrate or a reduction in gas transfer. Fourteen patients had a significant lymphopenia (lymphocyte count less than 1 x 10(9)/l), nine were leucopenic (white cell count less than 3.5 x 10(9)/l) and nine had abnormal liver biochemistry. One patient had an infection of the ileum and one an infection of the larynx. All these disease manifestations responded completely to a single course of ganciclovir therapy. There were no clinical relapses and no side effects were observed. Ganciclovir is a safe and effective therapy when administered early in the course of cytomegalovirus infection in immunosuppressed patients with renal impairment.
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PMID:Ganciclovir treatment for cytomegalovirus infection in immunocompromised patients with renal disease. 166 44

This study was carried out retrospectively to evaluate the pattern of diseases associated with fever among infants aged 1-6 months at Gunung Wenang General Hospital Manado. During the period of January 1988-December 1989, 189 infants with age ranging 1-6 months, were evaluated. Diseases associated with fever predominantly occurred in infants of 3 months old (73.0%). The final clinical diagnosis of diseases associated with fever were gastroenteritis (39.15%), pneumonia (28.05%), meningitis (9%), respiratory tract infection (15.4%), post vaccination (4.20%) and septicemia (4.3%). The fever ranged from 37.8-38.3 degrees C (38%), 38.4-39.5 degrees C (49%), 39.6-41 degrees C (10%) and more than 41 degrees C (3%). The elevated body temperature was significantly related to the duration of fever (p 0.01). Increased erythrocyte sedimentation rate and thrombocytopenia were not correlated significantly (p greater than 0.05) with elevated body temperature while the total white cell count had a significant relationship (p less than 0.05).
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PMID:Pattern of diseases associated with fever among infants aged 1-6 months. 179 90

Patients with chronic granulomatous disease (CGD), an uncommon inherited disorder of phagocytes resulting in the defective production of reactive oxygen intermediates, are prone to bacterial and fungal infections. In the case presented, therapeutic efforts including white cell transfusions, and amphotericin B and IFN gamma administration were undertaken to treat pneumonia caused by Aspergillus fumigatus. During a phase of artificial respiration, transfused white cells in peripheral blood and bronchoalveolar lavage fluid were monitored in order to examine their kinetics and functional activity. Using flowcytometrical methods, host-derived and transfused neutrophils could be distinguished by cytochrome b558 expression using the monoclonal antibody 7D5 for immunofluorescent staining as well as by production of reactive oxygen intermediates. Transfused PMN could be detected in both compartments and their kinetics could be followed up to 24 hours after transfusion. Using flowcytometry, even small numbers of transfused PMN could be measured during episodes of extreme leukocytosis. Since functionally intact transfused PMN were found in the bronchioalveolar lavage fluid, white cell transfusions in combination with antibiotic and immunomodulating therapy should be considered a part of the therapeutic regimens for life-threatening infections in CGD patients.
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PMID:Kinetics of transfused neutrophils in peripheral blood and BAL fluid of a patient with variant X-linked chronic granulomatous disease. 195 82

After a follow up of 22 months we report results of treatment on 44 patients (22 males), aged 16 to 63 years, with acute non lymphoblastic leukemia. Complete remission was obtained in 22 patients. This was significantly more frequent in patients under 40 years of age with white cell counts under 35,000 and without metabolic complications nor disseminated intravascular coagulation before treatment. Delaying chemotherapy for 5 days after diagnosis was also associated to a better prognosis. Overall actuarial survival rate was 37% at 15 months, 55% for those experiencing a first remission. A total of 25 patients [corrected] have died, 15 during induction of therapy, 7 after complete remission and 3 after failure of induction. Infections are the main cause of death during induction, with a high lethality for sepsis (33%) and pneumonia (40%).
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PMID:[Treatment of acute non-lymphoblastic leukemia in adults. Preliminary report from the national protocol on antineoplastic drugs]. 213 62

We have used the polymerase chain reaction to investigate HIV-1 infection of lung macrophages from 44 AIDS patients with pneumonia. Proviral HIV-1 DNA was detected in the lung macrophages of 47% (21 of 44) of patients tested; 32% (seven of 21) of the patients had Pneumocystis carinii pneumonia (PCP), and 56% (11 of 21) had pneumonia caused by other aetiological agents. Matched peripheral blood specimens were obtained from 22 patients in this study, and HIV-1-specific DNA was detected in 100% (22 out of 22) of non-adherent white cell preparations tested. HIV was detected in blood monocytes of 11 out of 22 patients (50%), and a virus signal was also found in the lung macrophages of eight of these patients. Our results indicate that PCP does not predispose lung macrophages to HIV-1, nor does HIV-1 infection of lung macrophages increase the probability of contracting PCP.
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PMID:Detection of HIV-1 in human lung macrophages using the polymerase chain reaction. 228 85

To identify predictors of mortality, the records of 133 elderly patients with pneumonia admitted to a small rural midwestern hospital were examined using a retrospective cohort design. All recorded clinical information available to the patient's physician within the first hours of admission was reviewed. Twenty-one (15.8%) patients died during the hospitalization. Patients with preexisting coronary heart disease, dementia, urinary incontinence, and impaired mobility were more likely to die. Impaired mental status, absence of fever, rapid respiratory rate, hypotension, cyanosis, and diffuse abnormalities on chest examination were also associated with mortality. Logistic regression analysis revealed five predictive indicators of mortality: impaired level of consciousness (odds ratio [OR] = 11.3), tachypnea (OR = 10.8), temperature lower than normal (OR = 14.2), white cell count higher than 20 X 10(9)/L (20,000 mm-3) (OR = 12.2), and cyanosis (OR = 8.6). A risk score based on this regression model demonstrated that 1 of 95 patients with a score lower than 3 (1%), 7 of 22 with a score of 3 (32%), and 13 of 15 patients with a score higher than 3 (87%) died during their hospitalization. The validity of this risk-scoring system was confirmed in another sample of 40 patients. Studies such as this may be useful in identifying information of important prognostic value that enables physicians, patients, and family members to make more effective decisions.
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PMID:Factors predicting mortality in rural elderly hospitalized for pneumonia. 229 10

A 42-year-old man with an atypical pneumonia. He had chest pain and a dry cough for 3 weeks, was dull at the left base clinically, and had left lower zone consolidation on chest radiography. The pneumonia spread despite oral ampicillin and cloxacillin. Blood culture grew Listeria monocytogenes and white cell count showed a monocytosis. He responded to intravenous penicillin and gentamicin with complete X-ray clearance.
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PMID:Listeria pneumonia. A case report. 291 43

The mortality of patients admitted to intensive care units with haematological malignancy is high. A humane approach to the management of the critically ill as well as efficient use of limited resources requires careful selection of those patients who are most likely to benefit from intensive care. To delineate more accurately the factors influencing outcome in these patients the records of 60 consecutive admissions to the intensive care unit (37 male, 23 female) with haematological malignancy were reviewed retrospectively. Fifty patients were in acute respiratory failure, most commonly (34 patients) with a combination of pneumonia and septicaemic shock. The severity of the acute illness was assessed by the APACHE II (acute physiology and chronic health evaluation II) score and number of organ systems affected. Thirteen patients survived to leave hospital. The mortality of patients with haematological malignancy was consistently higher than predicted from a large validation study of APACHE II in a mixed population of critically ill patients. Moreover, no patient with an APACHE II score of greater than 26 survived. Mortality among the 22 patients with relapsed malignancy (21 deaths), was significantly higher than among the 35 patients at first presentation (26 deaths). On discharge from the intensive care unit all survivors had responded well to chemotherapy and had normal or raised peripheral white cell counts. They included seven patients who had recovered from leucopenia (white cell count less than 0.5 X 10(9)/l). In contrast, 36 of the 47 patients who died were leucopenic at the time of death. The overall mortality of critically ill patients with haematological malignancy is higher than equivalently ill patients without cancer. The dysfunction of an increasing number of organ systems, an APACHE II score of greater than 30, failure of the malignancy to respond to chemotherapy, and persistent leucopenia all point to a poor outcome.
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PMID:Prognosis of patients receiving intensive care for lifethreatening medical complications of haematological malignancy. 313 Jan 23


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