1/502. Severe mycoplasma pneumoniae pneumonia.Four cases of severe mycoplasma pneumoniae infection are reported which were treated in a single hospital over the course of 4 years. The difficulties in the diagnosis of M. pneumoniae infections are eminently demonstrated by these cases. Because of the fact that it generally takes 2-o weeks to make this diagnosis, the physician must utilize clues of limited reliability. If gram stains and culture of sputum fail to demonstrate any bacterial pathogen and the patient has a chest X-ray compatible with this diagnosis as well as a white blood count less than 15,000/mm3, M. pneumoniae infection may be present. A good antimicrobial choice in such a situation is erythromycin.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/502. Pneumonia in febrile neutropenic patients and in bone marrow and blood stem-cell transplant recipients: use of high-resolution computed tomography.PURPOSE: To obtain statistical data on the use of high-resolution computed tomography (HRCT) for early detection of pneumonia in febrile neutropenic patients with unknown focus of infection. MATERIALS AND methods: One hundred eighty-eight HRCT studies were performed prospectively in 112 neutropenic patients with fever of unknown origin persisting for more than 48 hours despite empiric antibiotic treatment. Fifty-four of these studies were performed in transplant recipients. All patients had normal chest roentgenograms. If pneumonia was detected by HRCT, guided bronchoalveolar lavage was recommended. Evidence of pneumonia on chest roentgenograms during follow-up and micro-organisms detected during follow-up were regarded as documentation of pneumonia. RESULTS: Of the 188 HRCT studies, 112 (60%) showed pneumonia and 76 were normal. documentation of pneumonia was possible in 61 cases by chest roentgenography or micro-organism detection (54%) (P < 10(-6)). Sensitivity of HRCT was 87% (88% in transplant recipients), specificity was 57% (67%), and the negative predictive value was 88% (97%). A time gain of 5 days was achieved by the additional use of HRCT compared to an exclusive use of chest roentgenography. CONCLUSION: The high frequency of inflammatory pulmonary disease after a suspicious HRCT scan (> 50%) proves that pneumonia is not excluded by a normal chest roentgenogram. Given the significantly longer duration of febrile episodes in transplant recipients, HRCT findings are particularly relevant in this subgroup. patients with normal HRCT scans, particularly transplant recipients, have a low risk of pneumonia during follow-up. All neutropenic patients with fever of unknown origin and normal chest roentgenograms should undergo HRCT.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
3/502. methotrexate pneumonitis induced by intrathecal methotrexate therapy: a case report with pharmacokinetic data.A patient with adenocarcinoma of the breast metastatic to the leptomeninges was treated with 10 doses of intrathecal methotrexate (MTX) administered at intervals of 2 days. Following these treatments she developed fever, hypoxemia, and bilateral pulmonary infiltrates without documented pulmonary infection. autopsy findings were consistent with the pneumonitis that has been associated with intermittent oral, intramuscular, and intravenous MTX therapy. It is suggested that this patient's pulmonary process represented MTX pneumonitis following intrathecal MTX. cerebrospinal fluid and serum MTX concentrations determined retrospectively on frozen samples reflect an atypically rapid transport of MTX from this patient's cerebrospinal fluid to a slowly decaying systemic pool. Because of this, serum MTX levels probably exceeded 10-8M during the entire 20-day course of therapy, thus exposing the pulmonary parenchyma to significant drug concentrations for a prolonged interval. It is suggested that these unfavorable pharmacokinetics may have contributed to this patient's susceptibility to MTX pneumonitis.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
4/502. How useful is the chlamydia micro-immunofluorescence (MIF) test for the gynaecologist?Three patients with a chlamydial respiratory tract infection showed significant titre rises for the three chlamydial micro-immunofluorescence tests, performed with chlamydia pneumoniae, C. psittaci and C. trachomatis. Such cross-reactions procure an inaccurate discrimination between the various chlamydia species which remains speculative anyhow when only a positive serological profile against one chlamydial subspecies is performed. We consider that using the serologic assay as proof for past sexually transmitted C. trachomatis infection falls outside the limits of prudent interpretation of laboratory tests.- - - - - - - - - - ranking = 0.66666666666667keywords = infection (Clic here for more details about this article) |
5/502. nocardia farcinica pneumonia in chronic granulomatous disease.infection with nocardia poses a diagnostic challenge in patients with chronic granulomatous disease (CGD) because the signs and symptoms are often nonspecific, delay in diagnosis is common, and invasive procedures are frequently required to obtain appropriate tissue specimens. We present the first reported case of N farcinica pneumonia in an adolescent with X-linked CGD. Differentiation of N farcinica from other members of N asteroides complex is important because of its propensity for causing disseminated infection and antimicrobial resistance. physicians caring for patients with CGD should maintain a high index of suspicion for nocardiosis, especially in those receiving chronic steroid therapy. early diagnosis remains critical for decreased morbidity and occasional mortality.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
6/502. delirium associated with vitamin B12 deficiency after pneumonia.A case is presented of a 65-year-old man with chronic schizophrenia who, after four years of remission, developed psychotic symptoms after pneumonia. The patient was found to be deficient in vitamin B12. His psychosis remitted within 5 days of administration of vitamin B12 and folic acid. This case emphasizes the need to measure vitamin B12 in psychogeriatric patients, especially when they present with a severe infection and organic mental symptoms.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
7/502. Atypical measles infections in leukaemic children on immunosuppressive treatment.One case of giant-cell pneumonia and two of encephalopathy, all due to measles infection in children in leukaemic remission on immunosuppressive treatment, were seen recently. The clinical syndromes were variable and atypical and the antibody responses unpredictable. Conventional doses of pooled immunoglobulin failed to protect the two children to whom it was given. Degeneration rather than inflammation seems to characterise the encephalopathy in immunosuppressed children infected with measles virus.- - - - - - - - - - ranking = 1.6666666666667keywords = infection (Clic here for more details about this article) |
8/502. A rare coexistence of two gastric outlet obstructive lesions: infantile hypertrophic pyloric stenosis and organoaxial gastric volvulus.Infantile pyloric stenosis is one of the most common conditions requiring surgery during the first few weeks of life. The association of infantile pyloric stenosis with gastric volvulus in an extremely uncommon occurrence. A 10-month-old male infant operated for infantile pyloric stenosis at two months of age is presented. His current problem was recurrent pulmonary infections and he was diagnosed to have organoaxial gastric volvulus and gastroesophageal reflux. The common features of presentation, radiological findings, surgical procedures and possible mechanisms of gastric volvulus associated with infantile pyloric stenosis are discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
9/502. Acute pneumonitis with pulmonary hemorrhage an uncommon and potentially fatal complication of systemic lupus erythematosus: a case report.Acute pneumonitis with diffuse alveolar haemorrhage is potentially fatal. When it occurs in a patient of systemic lupus erythematosus, the primary disease itself may be responsible for it; rather than any complicating infection or metabolic/physiological derangement. Diagnosis of primary pulmonary involvement by systemic lupus erythematosus can only be made on open lung biopsy coupled with immunofluorescent and/or ultrastructural studies. early diagnosis of acute pulmonary complications in systemic lupus erythematosus patients is essential as specific management is reported to improve the chances of recovery.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
10/502. toxoplasma gondii pneumonia in a pancreas transplant patient.A 41-year-old woman had fever of 3 days' duration. She had had pancreas transplantation 2 years previously and had recently completed a course of antirejection medication. temperature spikes occurred during treatment with broad spectrum antibiotics. No obvious cause for the fever was found. The patient's condition worsened, with development of shortness of breath, bilateral pulmonary infiltrates on chest radiographs, sepsis, and shock. Fiberoptic bronchoscopy with bronchoalveolar lavage showed the presence of toxoplasma gondii. pyrimethamine and clindamycin were started, and the patient improved. toxoplasma gondii occurs in contaminated food containing oocysts or cysts. organ transplantation and blood transfusions are other routes of transmission. Most recent cases have occurred in human immunodeficiency virus (hiv) patients with reactivation of previous infection. serology and tissue biopsies are used for diagnosis. Treatment includes a combination of pyrimethamine and sulfadiazine or trisulfapyrimidines.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
| | Next -> |