1/16. gastric outlet obstruction and pulmonary infiltrate in a patient with Crohn's disease: successful treatment by Billroth-II-resection.We present a 28-year-old women with a 3 yr history of duodenal ulcers. Following four treatment attempts to eradicate helicobacter pylori she was admitted because of gastric outlet obstruction and a weight loss of 20 kg within the last two years. endoscopy and x-ray showed a circular inflammatory stenosis of the proximal duodenum extending over 8 cm. Additionally, chest x-ray showed a circumscript infiltrate in the third segment of the right lung. Mycobacterial infection could be excluded. Ileocolonoscopy and small intestinal follow-through beyond the duodenum were unremarkable, and Zollinger-Ellison-syndrome was ruled out. Bronchopulmonary histology showed intramucosal epithelioid-cell granulomas and bronchiolitis obliterans. Because the patient did not improve under conservative therapy a Billroth-II-resection was carried out. Histologically the resected specimen showed Crohn-like lesions. Postoperatively, severe peripheral arthritis was treated by steroids over 6 weeks. At follow-up the patient regained 20 kg and was free of symptoms without any medication. The pulmonary infiltrate had subsided almost completely. In summary, this extremely rare coincidence of isolated stenosing duodenal Crohn's disease and pulmonary involvement was successfully treated by Billroth-II-resection. This course of disease is compatible with the hypothesis that Crohn's disease may be maintained by antigens derived from ingested food.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/16. Primary pulmonary botryomycosis: an important differential diagnosis for lung cancer.This is the sixteenth reported case of pulmonary botryomycosis, an uncommon suppurative bacterial infection of the lung. We describe the case of a 69-year-old man who presented with a chronic cough and intermittent haemoptysis and on subsequent chest computed tomographic scan imaging was found to have a right lower lobe mass. He underwent a right lower lobectomy for presumed lung cancer. Histological analysis however revealed a bacterial aetiology. The past literature is reviewed outlining the pathogenesis and difficulties of clinical and radiological diagnosis. Primary pulmonary botryomycosis forms an important curative differential diagnosis for lung cancer.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/16. Septic arthritis caused by nocardia asteroides in a renal transplant recipient.Although articular complications are common following renal transplantation, septic arthritis is not frequent. Previous bacterial infection in an another site is a consistent finding and the knee is the most often affected joint. We present a 30-year-old female renal transplant recipient with recurrent pulmonary infiltrates preceding septic arthritis of her left knee. Cultures of the aspirated synovial fluid yielded a gram-positive, rod-shaped bacterium later identified as nocardia asteroides. The patient was treated with oral trimethoprim-sulfamethoxazole without any side effect. Nocardia is a rare but serious cause of infection in renal transplant recipients but there is no well-known predisposing factor. Recently mycophenolate mofetil has been implicated as a factor associated with nocardia infections. Prolonged courses of treatment with sulphonamides are recommended.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/16. Cell profiles in serial bronchoalveolar lavage after human heart-lung transplantation.The aim of this study was to investigate serial changes in bronchoalveolar lavage (BAL) cell profiles after human heart-lung transplantation and to assess the clinical value of BAL cytology in the differential diagnosis of complications in the transplanted lung. BAL was performed serially on 23 occasions on four patients. Elevated counts of neutrophils (4-48%) were observed in all preparations, with peak values in the early postoperative phase, in bacterial infections and in cytomegalovirus pneumonitis. In the last condition, BAL cytology also showed relative lymphocytosis (less than or equal to 50%) with high proportions (less than or equal to 50%) of HLA DR-positive T lymphocytes. No characteristic light microscopic pattern was observed in acute pulmonary rejection. However, scanning electron microscopy revealed elevated counts (greater than 5%) of "villous" macrophages in BAL obtained during or shortly after episodes of rejection. BAL cytology may be helpful in differentiating viral and bacterial infections, while scanning electron microscopy seems to be more suitable to the diagnosis of acute pulmonary rejection.- - - - - - - - - - ranking = 2keywords = bacterial infection (Clic here for more details about this article) |
5/16. Acute severe deterioration in cystic fibrosis associated with influenza a virus infection.BACKGROUND: The role of non-bacterial infection in respiratory exacerbations of cystic fibrosis has been studied less than that of bacterial infection. Some non-bacterial infections, such as influenza A, may be associated with acute respiratory deterioration and may be preventable. methods AND RESULTS: Three patients with cystic fibrosis showed severe deterioration in lung function and general wellbeing during the influenza a virus epidemic in the winter of 1989-90. Serological confirmation of influenza a virus infection was obtained in each case. CONCLUSIONS: As immunisation against influenza a virus is safe and provokes an adequate antibody response in patients with cystic fibrosis, it is concluded that patients with cystic fibrosis should be offered immunisation at the beginning of each influenza season. Rapid diagnostic tests and the use of antiviral drugs may have a prophylactic role in minimising lung damage.- - - - - - - - - - ranking = 3keywords = bacterial infection (Clic here for more details about this article) |
6/16. mycobacterium kansasii diffuse pulmonary infection in a patient with acquired immune deficiency syndrome. Successful therapy with an antituberculous regimen.mycobacterium kansasii is a rare cause of disseminated mycobacterial infection in patients with the acquired immune deficiency syndrome (AIDS). It occurs as the index AIDS diagnosis in only 0.2% of AIDS cases. Previously reported cases of AIDS-associated M. kansasii infection have manifested as diffuse interstitial pneumonitis and diffuse small bowel inflammation and have been refractory to antimycobacterial therapy. The authors now report success in treating a hypoxemic patient with AIDS-associated M. kansasii diffuse granulomatous interstitial pneumonitis that was diagnosed by open lung biopsy. The patient has no evidence of mycobacterial disease after 12 months of therapy with isoniazid, rifampin, and ethambutol.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
7/16. The Hermansky-Pudlak syndrome. Report of three cases and review of pathophysiology and management considerations.Three Puerto Rican siblings with the Hermansky-Pudlak syndrome are described, and the literature on this syndrome is reviewed with regard to clinical factors, pathology, pathophysiology, and management of the disorder. The three patients all manifested oculocutaneous albinism and platelet storage pool disease with a moderate bleeding tendency. The oldest sibling died from restrictive lung disease and another has evidence of reduced functional residual capacity, although he is asymptomatic. None of the patients had evidence of inflammatory bowel disease, which has been reported in some cases. All of the patients had an increased incidence of bacterial infections, and they were anergic. Whether their immunological defect(s) is related to the Hermansky-Pudlak syndrome is not known. Two of the patients were treated with oral vitamin e. Bleeding symptoms in both were markedly reduced, although major changes in platelet aggregation were not seen. vitamin e therapy did not appear to affect the progression of lung disease in the patient with fatal restrictive lung disease.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
8/16. corynebacterium equi: a review of 12 cases of human infection.corynebacterium equi, an aerobic, variably acid-fast, gram-positive "diphtheroid," is an unusual cause of pulmonary infection in immunosuppressed patients. Initially, infection with C. equi may be mistaken for a mycobacterial infection. Two cases in a two-year period were observed and compared with the 10 cases previously reported in the literature. All but one patient had pulmonary involvement, and the presentation of all other patients was typically insidious, with fatigue, fever, and nonproductive cough. Chest roentgenograms showed cavitary lesions in seven of 11 patients. Four of 12 patients had associated bacteremias, and three of 12 had subcutaneous abscesses or lymphadenitis. One of our patients developed multiple brain abscesses. overall mortality was 25%. The organism is susceptible to vancomycin, erythromycin, aminoglycosides, and chloramphenicol. Optimal duration of antibiotic therapy and the proper role of surgery in treatment is uncertain, but relapses have been common and many weeks of antibiotic therapy have generally been required for cure.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
9/16. Pulmonary mycobacteriosis and malignancy presumed activation by irradiation.It has been widely believed that pulmonary tuberculosis may be activated by irradiation. Although mycobacterial infections are not rare in the immunocompromised host, activation of disease by irradiation has not been described in previous reviews of mycobacterial infections associated with malignancy. This report presents a case of a patient in whom activation of pulmonary infection with mycobacteria of the avium-intracellulare complex was believed to be linked to local irradiation for carcinoma of the breast. The differentiation of pulmonary infection from the effects of irradiation in this setting may be difficult and it is important that irradiation not be blamed for changes that may result from an infectious agent.- - - - - - - - - - ranking = 2keywords = bacterial infection (Clic here for more details about this article) |
10/16. Lobectomy for traumatic pulmonary pseudocysts with disseminated intravascular coagulation: case report.A 10-year-old boy was injured in a traffic accident, and computed tomography revealed cavitary pulmonary lesions in the left lower lobe. Although there was no evidence of bacterial infection, thrombocytopenia due to disseminated intravascular coagulation progressed. We performed a left lower lobectomy, and the patient improved rapidly.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
| | Next -> |