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Query: UMLS:C0085593 (chills)
 4,268 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chemotherapy-related pneumonitis developed in eight patients during treatment for breast cancer. Six were receiving adjuvant therapy and two were being treated for metastatic disease. Fever, chills, dyspnea, and dry cough were the initial symptoms. Observations from chest roentgenograms varied from normal to bilateral interstitial-alveolar infiltrates. Results of pulmonary function tests were markedly abnormal, with a decreased diffusing capacity being the most characteristic abnormality. The pneumonitis developed in six patients while receiving 20 mg or less per day of prednisone and appeared temporarily related to tapering of steroid therapy in four patients. All patients recovered clinically, although prednisone therapy of 60 mg/day or its equivalent was required in three cases. Mild pulmonary function abnormalities persisted. Drug-induced pneumonitis should be considered in the differential diagnoses of patients with breast cancer in whom unexplained fever, dyspnea, or infiltrates develop during multidrug chemotherapy.
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PMID:Chemotherapy-associated pulmonary toxic reactions during treatment for breast cancer. 660 32

An outbreak of metal fume fever (MFF) among workers involved in cutting brass pipes with electric cutting torches in an enclosed, poorly ventilated steam condenser is described. Twenty-six workers were affected. Symptoms most commonly reported were fever (21), dyspnea (23), chills (21), headache (21), and nausea (19). Fourteen of the workers experienced the symptom of an unusual sweet or metallic taste in the mouth. Clinical signs were limited to wheezing or rales in eight patients. Leukocytosis and an increase in band cell forms were noted in 21 and 20 of 24 workers, respectively. The median time interval between exposure and onset of symptoms was five hours. None of three workers who spent less than one hour in the condenser became ill, whereas 25 of 26 of those who spent more than one hour became ill (p = .001). Five of 12 workers had urine copper levels in excess of 0.05 mg/l. To our knowledge, this is the first reported outbreak of MFF for which urinary copper levels have been measured.
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PMID:An outbreak of metal fume fever. Diagnostic use of urinary copper and zinc determinations. 665 23

Symptoms consistent with hypersensitivity pneumonitis (HP) occurred in 26 of 50 employees working in a localized area of a large factory. This area was served by a single heating-cooling unit utilizing a water humidification system. The illness consisted of flu-like symptoms with fever, chills, headache, cough, dyspnea. Most of the subjects affected demonstrated precipitating antibodies to a variety of organisms associated with HP, and inhalation challenge with water from the humidification system resulted in the reproduction of symptoms in one employee with a history suggestive of HP. Removal of the humidification system has resulted in a "cure" in that symptoms have not recurred during a one year followup period since the removal.
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PMID:Humidifier lung. An outbreak in office workers. 676 70

M. pneumoniae is a common cause of pneumonia. The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell count is normal or only slightly elevated, and the Gram stain of the sputum (if any can be obtained) reveals polymorphonuclear leukocytes and few bacteria. The diagnosis is more difficult when the patient presents with symptoms not suggestive of pneumonia including lethargy, dyspnea, and a 1- to 4-week history of shortness of breath without cough or fever in association with diffuse reticulonodular or interstitial pulmonary infiltrates. The disease in the previously healthy host is usually benign and self-limiting. However, the course is shortened by the administration of tetracycline derivatives or erythromycin. M. pneumoniae pneumonia can occur in association with other diseases including sickle cell anemia, sarcoidosis, systemic lupus erythematosus, Hodgkin's disease, and various other immunodeficiency states. In these patients mycoplasma pneumonia can be very serious. Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients.
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PMID:Mycoplasma pneumonia. 676 79

A case report is given of a 61 year old female patient, who came to the hospital with chronic pain in the right upper abdominal quadrant, fever, chills, dyspnea, and general weakness. 4 days later she died in hemorrhagic shock after having had melena. At postmortem an actinomycotic abscess of the size of a childs head was found in the left lobe of the liver; in addition there was a highly differentiated leiomyosarcoma of the duodenum. Isolated visceral actinomycosis is rare; it should however be thought of when the causes of liver abscesses are being scrutinized. Diagnosis can be established only bacterioiogically or histologically.
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PMID:[Actinomycosis of the liver (author's transl)]. 696 13

A case of hypersensitivity pneumonitis due to pigeon-dropping antigens is reported in a 9 year old girl, and compared with other seven previous reports in children. The insidious nature of this disease, as well as the importance of detailed environmental information in children with unexplained respiratory disease are emphasized. In this case, lung function tests showed a classic restrictive ventilatory defect, and a serious obstructive ventilatory defect evidenced in the narrowing of the smaller airways, and a reduction in the forced expiratory flow at small lung volumes. Hypersensitivity pneumonitis is a lung disease that results from sensitization by inhalation of a variety of organic dusts. Patients usually have circulating antibodies against the etiologic agents. Most patients with this disease also have sensitized T-cells to these agents. Long-term exposure can lead to irreversible lung disease. The histopathologic features are chronic interstitial and alveolar inflammation frequently accompanied by a granulomatous response. The most common symptomatic features are fever, chills and dyspnea 4 to 8 hours after exposure. Antibody activity to antigens is detected in the serum of both symptomatic and asymptomatic breeder's lung. Cellular hypersensitivity to antigens is demonstrated "in vitro" with peripheral lymphocyte populations in almost all symptomatic patients.
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PMID:[Bird breeder's lung in children]. 697 Oct 47

In 1978 and 1979, eight sporadic cases of Legionella pneumonia were observed in the Berne and Ticino areas of Switzerland. In all cases the diagnosis was established serologically using indirect immunofluorescence. Seroconversion was observed in five patients. In three cases initially high antibody titers decreased progressively. The clinical picture was characterized by acute onset with high fever, frequent chills, and dry cough. Occasional concomitant symptoms included muscular pains, headache, thoracic pain, dyspnea, hemoptysis, and gastrointestinal and central nervous symptoms. Laboratory findings showed markedly increased BSR as well as slightly increased WBC with a pronounced shift to the left. In all cases, X-ray examinations demonstrated extended, mainly unilateral and often remarkedly peripheral infiltrations of the lung. On the basis of the clinical course, two groups could be distinguished: (a) non-complicated cases of pneumonia with rapid improvement within 2-3 weeks; and (b) cases with a protracted sometimes severe course with persistence of the infiltrations up to 4 months and more. All patients with a protracted course suffered from concomitant symptoms. Whereas none of the patients died of legionellosis, two patients died six months later from their underlying disease. Most patients were treated with several antibiotics. In three patients definite improvement occurred only after therapy had been changed to doxycycline. Erythromycin, currently recommended as the drug of choice, was used in none of these cases.
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PMID:[Clinical data on Legionnaires' disease. Report on 8 sporadic cases of Legionella pneumonia]. 720 64

Since August, 1978, an epidemic characterised by respiratory symptoms and fever spread rapidly in a restricted area near Tampere, Finland. Four months later over half of the adult population reported intermittent or constant symptoms. The most frequent symptoms were cough, dyspnoea, chills, fever, headaches, muscle pain and aching of joints. The symptoms appeared to be associated with exposure to water vapour derived from tap water. Consequently this disease, which resembled extrinsic allergic alveolitis, was given the name 'bathing fever' for lack of any prevailing diagnosis. In clinical provocation tests lung diffusion capacity usually decreased, the leucocyte count increased, and a slight rise in body temperature was observed. Despite many efforts the specific causative agent in the tap water has not been identified. Neither massive chlorination of the water nor changing the sand filter of the water-works had any significant effect on the quality of the water. Therefore the source of water supply was changed in April, 1979. The symptoms have subsequently disappeared. Present knowledge about bathing fever suggests that, though rare, it may be typical of the Scandinavian type of climate.
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PMID:Bathing fever epidemic of unknown aetiology in Finland. 744 43

The aim of the protocol was to evaluate the side-effects induced by repeated tumour-infiltrating lymphocyte (TIL) infusions in patients with metastatic melanoma (MM). Patients were to receive four TIL infusions at given intervals: every 3 weeks (two patients), every 2 weeks (3 patients) and weekly (4 patients). All patients were evaluated and received a total of 34 TIL infusions. The total number of TILs administered varied from 0.65 to 2.34 x 10(11) cells. TIL phenotypes were predominantly CD8+ (two patients), CD4+ (4 patients), CD4+ then CD8+ (two patients) or CD56+ (two patient). Autocytotoxicity was only observed for one culture. Six patients presented at least one WHO grade 3 side-effect: hypotension (5 patients), dyspnoea (two patients), fever (one patient), fatigue (one patient), chills (two patients), diarrhoea (one patient), agitation (one patient), locoregional pain (two patients). Hypotension was constantly seen in patients who were given TILs every week. Two cases of minor pericarditis were recorded. No objective response to treatment was observed; 1 stable disease occurred in one patient and progression in eight. However, five patients presented a partial response on a tumour site for 1-4 months. Three patients presented signs of inflammation or softening at one tumour site. Plasma tumour necrosis factor alpha (TNF-alpha) levels were increased 1.2- to 22-fold after TIL infusion. TILs could be produced in sufficient quantity to perform this study, so repetitive infusions of TIL became possible on a weekly basis. However, no objective response was observed even when TIL infusions were performed weekly. An increase in circulating TNF-alpha was noted after TIL infusion.
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PMID:A phase I trial of repeated tumour-infiltrating lymphocyte (TIL) infusion in metastatic melanoma. 753 Sep 84

Hypersensitivity pneumonitis or extrinsic allergic alveolitis is an immunologically mediated lung disease caused by repeated inhalations of organic antigens. The basic histological lesion consists of a diffuse mononuclear cell infiltration of alveolar wall, alveoli, terminal bronchioles, and neighboring interstitium. The inflammation is often followed by granulomas, which then may progress to fibrosis. Unlike other infectious and noninfectious granulomatous disorders, hypersensitivity pneumonitis is limited to the lung. The disease occurs more frequently in men than in women and children. The acute form of hypersensitivity pneumonitis, characterized by fever, chills, myalgias, cough, and dyspnea, may be confused with acute pneumonitis. Although there is no single radiological, physiological, or immunologic test specific for hypersensitivity pneumonitis, the diagnosis can often be suspected on the basis of a compatible temporal relationship between pulmonary symptoms and a history of environmental or occupational exposure. Once the diagnosis is suspected, the presence of serum precipitating antibodies (immunoglobulin [lg] G), suppressor cytotoxic lymphocytosis in bronchoalveolar lavage (BAL) fluid, and granulomatous alveolitis in lung biopsy specimens is extremely helpful in confirming the diagnosis. For patients in whom the diagnosis is confirmed, avoidance of the causative antigen is the best therapy, although corticosteroids are used to suppress inflammation. Once the fibrosis has developed, the patient may gradually develop respiratory failure or cor pulmonale, possibly resulting in death.
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PMID:Hypersensitivity pneumonitis: a noninfectious granulomatosis. 756 4


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