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Sample records for acute eosinophilic pneumonia

  1. Second-Hand Tobacco Smoke and Acute Eosinophilic Pneumonia

    Avci, Zekai; ALİOĞLU, Bülent; ÖZBEK, Emel ÖZYÜREK Namık

    2008-01-01

    We present the case reports of two children with a parasitic infestation associated with hypereosinophilia. One of those patients, who had been exposed to excessive second-hand tobacco smoke, was diagnosed as having acute eosinophilic pneumonia. The second patient had neither a history of exposure to second-hand smoke nor a prior diagnosis of acute eosinophilic pneumonia. We suggest that passive smoking may trigger acute eosinophilic pneumonia, a condition that develops frequently in children...

  2. Eosinophilic pneumonias. A clinical case of acute eosinophilic pneumonia associated with sertraline and literature review

    Roberto Serini

    2013-04-01

    Full Text Available Background: Acute eosinophilic pneumonia (AEP is one of the heterogeneous group of disorders termed eosinophilic lung diseases showing an abnormal accumulation of eosinophils in distal airways, air spaces, and the interstitial compartment of the lung. AEP is characterized by acute febrile respiratory failure, a typical radiographic pattern similar to that of acute pulmonary edema, eosinophilia in bronchoalveolar lavage (BAL, a dramatic response to corticosteroid therapy with no relapse when tapering or withdrawing treatment in the absence of infection. It can be idiopathic o secondary to known causes such as drugs, or fungal and parasitic infections. Clinical case: We report a case of a 76-year-old woman who developed symptoms, respiratory signs, and radiological and histological findings compatible with secondary AEP, we assessed as being associated with sertraline assumption (second case in literature. Discussion: The AEP we detected could be related to a secondary hypersensitivity syndrome to drug exposure (DRESS syndrome: Drug Rush with Eosinophilia and Systemic Symptoms characterized by 1 skin rush, 2 increased eosinophilia, and 3 systemic involvement. The presence of all three criteria confirmed our diagnosis.

  3. Acute eosinophilic pneumonia as a complication of influenza A (H1N1) pulmonary infection.

    Larranaga, Jose Maria; Marcos, Pedro J; Pombo, Francisco; Otero-Gonzalez, Isabel

    2016-01-01

    Acute eosinophilic pneumonia (AEP) is a rare disease characterized by its acute onset and a clinical presentation simulating a bacterial pneumonia. Although it can be idiopathic, it has been described related to drugs, toxic agents and infections, mostly parasitic. We describe the case of influenza A (H1N1) severe pneumonia complicated by an acute eosinophilic pneumonia. Patient presented with respiratory failure and diffuse ground-glass opacities at chest-computed tomography. Clinical suspicion for this complication and bronchoalveolar lavage with cellular count analysis is crucial. PMID:27055842

  4. Emergency cesarean section as a result of acute eosinophilic pneumonia during pregnancy.

    Kotani, Yasushi; Shiota, Mitsuru; Umemoto, Masahiko; Nakai, Hidekatsu; Tobiume, Takako; Tsuritani, Hiromitsu; Shimaoka, Masao; Doh, Kunihiko; Hoshiai, Hiroshi

    2009-11-01

    Acute eosinophilic pneumonia is a disease of unknown etiology characterized by peripheral blood eosinophilia and pulmonary infiltrative shadows on radiography. Acute eosinophilic pneumonia follows an acute course within 1 week and the symptoms include fever, dyspnea, and cough. Acute eosinophilic pneumonia has a good prognosis and responds promptly to steroid treatments. Here we present a critical case of acute eosinophilic pneumonia during pregnancy, which led to emergency cesarean section because of fetal distress. The patient was a 24-year-old gravida at 34 + 6 weeks gestation, with fever, and an elevated CRP; thus antibiotics were started. At 35 + 1 weeks gestation, cardiotocography (CTG) revealed late decelerations, fetal distress was diagnosed, and an emergency cesarean section was performed. The pre-operative maternal blood gas analysis showed a low PaO(2) of 55.7 mmHg and a chest X-ray revealed ground-glass opacities and pleural effusions in the middle lower lung fields bilaterally. A male of 2,336 g in weight was delivered with Apgar scores of 8 and 8 at 1 and 5 min, respectively. Due to the clinical progress and the elevated eosinophil count (532/microl) in the peripheral blood differential leukocyte count, the diagnosis of acute eosinophilic pneumonia was made. With the administration of oxygen and steroid treatment, the patient's general condition recovered. Both the mother and the baby were discharged on the 10(th) post-operative day and the patient has been leading a normal life with no recurrence for > 3 years since delivery. PMID:19851054

  5. Idiopathic acute eosinophilic pneumonia in a 14-month-old girl

    Ha Neul Park

    2013-01-01

    Full Text Available Idiopathic acute eosinophilic pneumonia (IAEP, characterized by acute febrile respiratory failure associated with diffuse radiographic infiltrates and pulmonary eosinophilia, is rarely reported in children. Diagnosis is based on an association of characteristic features including acute respiratory failure with fever, bilateral infiltrates on the chest X-ray, severe hypoxemia and bronchoalveolar lavage fluid >25% eosinophils or a predominant eosinophilic infiltrate in lung biopsies in the absence of any identifiable etiology. We present a 14-month-old girl who was admitted to our pediatric intensive care unit because of acute respiratory distress. She had a fever, dry cough, and progressive dyspnea for 1 day. Chest X-ray showed multifocal consolidations, increased interstitial markings, parenchymal emphysema and pneumothorax. IAEP was confirmed by marked pulmonary infiltrates of eosinophils in the lung biopsy specimen. Most known causes of acute eosinophilic pneumonia, such as exposure to causative drugs, toxins, second-hand smoking and infections were excluded. Her symptoms were resolved quickly after corticosteroid therapy.

  6. Idiopathic chronic eosinophilic pneumonia

    Cordier Jean-François; Marchand Eric

    2006-01-01

    Abstract Idiopathic chronic eosinophilic pneumonia (ICEP) is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most cases, usually in excess of 1000/mm3. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage eosinophilia. ICEP is typically associated with eosinophil counts higher than ...

  7. Clinical Characteristics and Factors Influencing the Occurrence of Acute Eosinophilic Pneumonia in Korean Military Personnel.

    Yoon, Chang-Gyo; Kim, Se Jin; Kim, Kang; Lee, Ji Eun; Jhun, Byung Woo

    2016-02-01

    Acute eosinophilic pneumonia (AEP) is an uncommon inflammatory lung disease, and limited data exist concerning the clinical characteristics and factors that influence its occurrence. We retrospectively reviewed the records of AEP patients treated at Korean military hospitals between January 2007 and December 2013. In total, 333 patients were identified; their median age was 22 years, and all were men. All patients presented with acute respiratory symptoms (cough, sputum, dyspnea, or fever) and had elevated levels of inflammatory markers including median values of 13,185/µL for white blood cell count and 9.51 mg/dL for C-reactive protein. All patients showed diffuse ground glass opacity/consolidation, and most had pleural effusion (n = 265; 80%) or interlobular septal thickening (n = 265; 85%) on chest computed tomography. Most patients had normal body mass index (n = 255; 77%), and only 30 (9%) patients had underlying diseases including rhinitis, asthma, or atopic dermatitis. Most patients had recently changed smoking habits (n = 288; 87%) and were Army personnel (n = 297; 89%).The AEP incidence was higher in the Army group compared to the Navy or Air Force group for every year (P = 0.002). Both the number of patients and patients with high illness severity (oxygen requirement, intensive care unit admission, and pneumonia severity score class ≥ III) tended to increase as seasonal temperatures rose. We describe the clinical characteristics of AEP and demonstrate that AEP patients have recently changed smoking habits and work for the Army. There is an increasing tendency in the numbers of patients and those with higher AEP severity with rising seasonal temperatures. PMID:26839479

  8. Idiopathic chronic eosinophilic pneumonia

    Cordier Jean-François

    2006-04-01

    Full Text Available Abstract Idiopathic chronic eosinophilic pneumonia (ICEP is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most cases, usually in excess of 1000/mm3. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage eosinophilia. ICEP is typically associated with eosinophil counts higher than lymphocyte counts in the bronchoalveolar lavage. ICEP is a rare disorder of unknown cause. Its exact prevalence remains unknown. ICEP may affect every age group but is rare in childhood. It is twice as frequent in women as in men. One third to one half of the ICEP patients have a history of asthma. The mainstay of treatment of ICEP is systemic corticosteroids. Response to oral corticosteroid therapy is dramatic and has led to the consideration of corticosteroid challenge as a diagnostic test for ICEP. Nevertheless, relapses or development of severe asthma are frequent when tapering or withdrawing treatment. Long-term oral corticosteroid therapy is necessary in up to half of the patients.

  9. The utility of thoracic ultrasound in patients with acute eosinophilic pneumonia.

    Hee Yoon

    Full Text Available Thoracic ultrasound (TUS is an easy-to-use imaging modality that aids physicians in the differential diagnosis of respiratory diseases. However, no data exist on the TUS findings of acute eosinophilic pneumonia (AEP or their clinical utility in patients with AEP. Thus, we performed an observational study on TUS findings and their clinical utility for follow-up in patients with AEP. We prospectively screened patients who visited the emergency department for acute respiratory symptoms at the Armed Forces Capital Hospital in South Korea between February 2014 and July 2014. Of them, patients suspected to have AEP underwent an etiological investigation, including flexible bronchoscopy with bronchoalveolar lavage and TUS, and we evaluated TUS findings and serial changes on TUS during the treatment course compared with those from chest radiographs. In total, 22 patients with AEP were identified. The TUS examinations revealed that all patients exhibited multiple diffuse bilateral B-lines and lung sliding, with (n = 5 or without pleural effusion, which was consistent with alveolar-interstitial syndrome. B-line numbers fell during the course of treatment, as the lines became thinner and fainter. A-lines were evident in 19 patients on day 7 of hospitalization, when B-lines had disappeared in 13 patients, and all pleural effusion had resolved. All patients exhibited complete ultrasonic resolution by day 14, along with clinicoradiological improvement. Chest radiographs of five patients taken on day 7 seemed to show complete resolution, but several abnormal B-lines were evident on TUS performed the same day. As a result, our data show common TUS findings of AEP and suggest that AEP may be included as a differential diagnosis when multiple diffuse bilateral B-lines with preserved lung sliding are identified on a TUS examination in patients with acute symptoms, and that TUS is a useful modality for evaluating the treatment response in patients with AEP.

  10. Cisplatin-Induced Eosinophilic Pneumonia

    Hideharu Ideguchi

    2014-01-01

    Full Text Available A 67-year-old man suffering from esophageal cancer was admitted to our hospital complaining of dyspnea and hypoxemia. He had been treated with cisplatin, docetaxel, and fluorouracil combined with radiotherapy. Chest computed tomography revealed bilateral ground-glass opacity, and bronchoalveolar lavage fluid showed increased eosinophils. Two episodes of transient eosinophilia in peripheral blood were observed after serial administration of anticancer drugs before the admission, and drug-induced lymphocyte stimulation test to cisplatin was positive. Thus cisplatin-induced eosinophilic pneumonia was suspected, and corticosteroid was effectively administered. To our knowledge, this is the first reported case of cisplatin-induced eosinophilic pneumonia.

  11. Acute Eosinophilic Pneumonia Leading to Acute Respiratory Failure in a Current Systemic Corticosteroid User

    Shin, Hwa Yong; Choe, Ju Won; Kwon, Minsuk; Jang, Ju Young; Jung, Jae Woo; Choi, Jae Chol; Shin, Jong Wook; Park, In Won; Choi, Byoung Whui; Kim, Jae Yeol

    2013-01-01

    A 69-year-old female patient visited the emergency room with fever (38.3℃) and dyspnea. She had been taking prednisolone (5 mg once per day) and methotrexate (2.5 mg once per week) for rheumatoid arthritis for 2 years. Chest computed tomography (CT) showed bilateral, multifocal ground glass opacity with interlobular septal thickening. Peripheral blood leukocyte count was 6,520/mm3 (neutrophils, 77.4%; eosinophils, 12.1%). During the night, mechanical ventilation was initiated due to the devel...

  12. Minocycline-induced acute eosinophilic pneumonia: A case report and review of the literature

    Sharon W. Hung

    2015-01-01

    Minocycline is commonly used for pneumonia, acute bronchitis, urinary tract infections, and acne and is likely the cause of AEP in our patient. There are 26 case reports of minocycline-induced AEP. In most cases, outcomes were favorable and symptoms rapidly resolved upon discontinuation of minocycline, with 11 cases employing steroids, one case twelve hours of CPAP and another 5 days of intubation. None resulted in mortality. Although it is difficult to evaluate without further studies, steroids should be recommended for minocycline-induced AEP, especially for those with severe or persistent symptoms.

  13. Acute fibrinous and organising pneumonia

    Guimarães, Catarina; Sanches, Inês; Ferreira, Catarina

    2012-01-01

    Acute fibrinous and organising pneumonia (AFOP) was recently described as an unusual pattern of diffuse lung disease. Particular characteristics make the differential diagnosis with the well recognised clinical patterns of diffuse alveolar damage, cryptogenic organising pneumonia or eosinophilic pneumonia. The lack of hyaline membranes, the presence of intra-alveolar fibrin, absence of noticeable eosinophils and patchy distribution suggests that AFOP define a distinct histological pattern. Th...

  14. Chronic eosinophilic pneumonia: CT findings

    Objective: To assess the usefulness of computerized tomography (CT) in the diagnosis of chronic eosinophilic pneumonia. Material and Methods: A double helical CT was performed in 6 patients referred to our center because of a chest X-ray with pulmonary infiltrates. Clinical presentation was cough, fever and eosinophilia in peripheral blood. Patients' age ranged from 25 to 55 years; 4 were women and 2 were men, one of the latter had a history of bronchial asthma. All patients received treatment with corticosteroids, with remission of the clinical and radiological parameters. Three patients underwent a control CT. Results: Findings consisted in focal parenchymal alterations, with areas of pulmonary consolidation and areas of 'ground glass' appearance; both patterns coexisted in certain areas. In 3 cases the lesions extended from the apices to the pulmonary bases, with predominance of the upper and middle fields. In 1 patient, there was frank predominance in the left hemi thorax. In another patient, who had a history of asthma, there were signs of pulmonary hyperinflation, with diffuse thickening of the bronchial walls, added to the previously mentioned findings, which involved the entire lung. In the mediastinum, 1 patient had lymph nodes larger than 1 cm, 3 had lymph nodes that were not enlarged but were more numerous than usual, and in the remaining patients no lymph nodes were found. The control CT's showed almost total resolution of the pulmonary infiltrates. Conclusion: The combination of eosinophilia and characteristic pulmonary infiltrates with a likely clinical presentation, associated with an optimal response to treatment with corticosteroids allows to make a reliable diagnosis and avoids the need for a pulmonary biopsy. (author)

  15. Primary Cytomegalovirus-Related Eosinophilic Pneumonia in a Three-year-old Child with Acute Lymphoblastic Leukaemia: Case report and literature review

    Mohammed Al Reesi

    2014-10-01

    Full Text Available A diagnosis of eosinophilic pneumonia (EP is rare in patients with acute lymphoblastic leukaemia (ALL. We report a case of EP in association with a primary cytomegalovirus (CMV infection in a three-yearold Omani child with ALL. The patient presented with fever while undergoing maintenance chemotherapy. He was admitted to the Child Health Department of Royal Hospital, in Muscat, Oman, in November 2011. He was initially thought to have sepsis but failed to respond to antibiotics. Chest computed tomography showed diffuse ground glass lung opacification. Bronchoalveolar lavage (BAL cytology was consistent with the diagnosis of EP. Polymerase chain reaction tests for CMV were performed on the BAL and blood samples and were both markedly elevated. The patient made a full recovery after treatment with prednisolone and ganciclovir. The association between CMV infection and EP as well as the management of this combination in immunocompromised patients has never been reported in the English literature.

  16. Chronic eosinophilic pneumonia: a paediatric case

    Tassinari, Davide; Di Silverio Carulli, Chiara; Visciotti, Francesca; Petrucci, Roberta

    2013-01-01

    Chronic eosinophilic pneumonia (CEP) is a rare disorder in children, characterised by respiratory and systemic symptoms, with a generally good prognosis. A 11-year-old asthmatic girl was admitted to our clinic with a 3-month history of progressive cough, dyspnoea, weight loss and asthenia. Peripheral blood eosinophilia, multiple bilateral pulmonary infiltrates to the x-ray, multiple nodules with a surrounding ground-glass halo and peripheral predominance to the chest CT suggested the diagnosi...

  17. Minocycline induced eosinophilic pneumonia: case report and review of literature

    Klerkx, S; K. Pat; Wuyts, Wim

    2009-01-01

    A 51-year-old woman with eosinophilic pneumonia due to minocycline is described and a review of available literature is added. Until now, only 49 cases have been described, mainly in the Japanese population. Minocycline induced eosinophilic pneumonia is probably underreported and even underdiagnosed. This case highlights the importance of careful history taking, especially the use of drugs. Relatively safe drugs (like minocycline) can cause serious adverse events. On presentation, the disease...

  18. Acute and subacute idiopathic interstitial pneumonias.

    Taniguchi, Hiroyuki; Kondoh, Yasuhiro

    2016-07-01

    Idiopathic interstitial pneumonias (IIPs) may have an acute or subacute presentation, or acute exacerbation may occur in a previously subclinical or unrecognized chronic IIP. Acute or subacute IIPs include acute interstitial pneumonia (AIP), cryptogenic organizing pneumonia (COP), nonspecific interstitial pneumonia (NSIP), acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) and AE-NSIP. Interstitial lung diseases (ILDs) including connective tissue disease (CTD) associated ILD, hypersensitivity pneumonitis, acute eosinophilic pneumonia, drug-induced lung disease and diffuse alveolar haemorrhage need to be differentiated from acute and subacute IIPs. Despite the severe lack of randomized controlled trials for the treatment of acute and subacute IIPs, the mainstream treatment remains corticosteroid therapy. Other potential therapies reported in the literature include corticosteroids and immunosuppression, antibiotics, anticoagulants, neutrophil elastase inhibitor, autoantibody-targeted treatment, antifibrotics and hemoperfusion therapy. With regard to mechanical ventilation, patients in recent studies with acute and subacute IIPs have shown better survival than those in previous studies. Therefore, a careful value-laden decision about the indications for endotracheal intubation should be made for each patient. Noninvasive ventilation may be beneficial to reduce ventilator associated pneumonia. PMID:27123874

  19. Acute interstitial pneumonia

    The paper refers to a 71 year-old patient, to who is diagnosed acute interstitial pneumonia; with square of 20 days of evolution of cough dry emetizant, fever, general uneasiness, migraine, progressive dyspnoea and lost of weight

  20. Evidence for eosinophil degranulation in acute appendicitis

    Santosh G

    2008-04-01

    Full Text Available Finding of increased numbers of eosinophils in the muscle in cases of acute appendicitis has led to the hypothesis that it may have an allergic origin. This study aimed to measure the eosinophil degranulation resulting in a rise in the serum of eosinophil granule proteins that would be expected in such cases. The levels of serum eosinophil cationic protein (ECP measured by chemiluminescence assay in acute appendicitis were compared, with those of appropriate controls. Mean (95% CI serum ECP (µg/L levels were: acute appendicitis 45.3 (27.7-63.0; normal appendix 22.7 (16.0-29.3; asthma 24.2 (4.6-43.8; and healthy volunteers 13.2 (8.3-18.1. In cases of acute appendicitis, there is an inverse relationship between duration of symptoms and serum ECP. However, this was not statistically significant. Significant local eosinophil activation and degranulation occurs in acute appendicitis, enough to cause a rise in serum levels of eosinophil chemotactic protein

  1. Unusual Presentation of Chronic Eosinophilic Pneumonia with “Reversed Halo Sign”: A Case Report

    Gholamnejad, Mahdia; Rezaie, Nader

    2014-01-01

    The reversed halo sign (RHS) may sometimes be seen in patients with cryptogenic organizing pneumonia (COP), but is rarely associated with other diseases. Herein, we present a case of a 21-year-old woman with chronic eosinophilic pneumonia, with high resolution computed tomography (HRCT) finding of RHS. This is an unusual and rare presentation of chronic eosinophilic pneumonia.

  2. Unusual Presentation of Chronic Eosinophilic Pneumonia with “Reversed Halo Sign”: A Case Report

    The reversed halo sign (RHS) may sometimes be seen in patients with cryptogenic organizing pneumonia (COP), but is rarely associated with other diseases. Herein, we present a case of a 21-year-old woman with chronic eosinophilic pneumonia, with high resolution computed tomography (HRCT) finding of RHS. This is an unusual and rare presentation of chronic eosinophilic pneumonia

  3. Feedlot Acute Interstitial Pneumonia.

    Woolums, Amelia R

    2015-11-01

    Acute interstitial pneumonia (AIP) of feedlot cattle is a sporadically occurring respiratory condition that is often fatal. Affected cattle have a sudden onset of labored breathing. There is no confirmed effective treatment of feedlot AIP; however, administration of antibiotics effective against common bacterial respiratory pathogens and nonsteroidal anti-inflammatory drugs, especially aspirin, has been recommended. Protective strategies are not well defined, but efforts to limit dust exposure and heat stress; to ensure consistent formulation, mixing, and delivery of feed; and to identify and treat infectious respiratory disease in a timely manner may decrease rates of feedlot AIP. PMID:26253266

  4. Chronic eosinophilic pneumonia involving with mediastinal lymph nodes: radiologic study of three cases

    Chronic eosinophilic pneumonia (CEP) is an uncommon disorder in our setting. Chest x-ray is essential to diagnosis. To date, we have found only three reported cases in which mediastinal lymph nodes were involved. We present three additional cases with standard thoracic study. (Author)

  5. Complication of chronic eosinophilic pneumonia in an elderly patient with Sjögren syndrome.

    Waseda, Koichi; Hagiya, Hideharu; Hanayama, Yoshihisa; Terasaka, Tomohiro; Kimura, Kosuke; Tsuzuki, Takao; Hasegawa, Kou; Nada, Takahiro; Nakamura, Eri; Murakami, Kazutoshi; Kondo, Eisei; Otsuka, Fumio

    2015-01-01

    An 81-year-old Japanese male with primary Sjögren syndrome (pSS) developed a low-grade fever and productive cough which were refractory to antibiotic therapy. Based on the high level of eosinophils observed in his bronchial alveolar lavage, he was diagnosed with chronic eosinophilic pneumonia (CEP) and successfully treated by oral prednisolone. Interstitial lung diseases associated with pSS (pSS-ILDs) usually present as nonspecific interstitial pneumonia or usual interstitial pneumonia; therefore, the present case is extremely unique in that the patient's condition was complicated with CEP. A diagnosis of advanced gallbladder cancer was made in the patient's clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients. PMID:25899635

  6. [A case of eosinophilic pneumonia caused by inhalation of nickel dusts].

    Toyoshima, M; Sato, A; Taniguchi, M; Imokawa, S; Nakazawa, K; Hayakawa, H; Chida, K

    1994-05-01

    A 16-year-old male, an industrial high school student working at an ironworks, without a dust mask, began to complain of dry cough and fever several hours after inhalation of stainless steel dusts including 0.1% nickel. A chest X-ray film revealed ground glass shadows, patchy shadows and Kerley B lines in the right lung fields. A high resolution chest CT scan showed fusing panlobular densities, thickening of bronchial walls and thickening of interlobular septa. Blood cells counts revealed leucocytosis with eosinophilia. Arterial blood gas analysis revealed hypoxemia. A bronchoalveolar lavage fluid specimen showed a marked increase in the total cell count and in eosinophils. A transbronchial biopsy specimen showed eosinophilic and lymphocytic infiltration in the alveolar septa. Steroid therapy with methylpredonisolne (250 mg x three days) resulted in clinical remission. As we suspected nickel-induced eosinophilic pneumonia, an inhalation provocation test with 0.5% nickel sulfate solution was carried out with the patient's informed consent. Six hours after inhalation he developed a dry cough and fever with leucocytosis and A-aDo2 widening. The positive results of the inhalation provocation test provided a definite diagnosis of nickel induced eosinophilic pneumonia. A review of the world literature revealed three case reports of nickel induced PIE syndrome, all of whom were clinically diagnosed without biopsy however. We believe that this is the first case diagnosed by transbronchial biopsy-proven tissue eosinophilia and a positive nickel inhalation provocation test. PMID:8084105

  7. Surfactant protein-A suppresses eosinophil-mediated killing of Mycoplasma pneumoniae in allergic lungs.

    Julie G Ledford

    Full Text Available Surfactant protein-A (SP-A has well-established functions in reducing bacterial and viral infections but its role in chronic lung diseases such as asthma is unclear. Mycoplasma pneumoniae (Mp frequently colonizes the airways of chronic asthmatics and is thought to contribute to exacerbations of asthma. Our lab has previously reported that during Mp infection of non-allergic airways, SP-A aides in maintaining airway homeostasis by inhibiting an overzealous TNF-alpha mediated response and, in allergic mice, SP-A regulates eosinophilic infiltration and inflammation of the airway. In the current study, we used an in vivo model with wild type (WT and SP-A(-/- allergic mice challenged with the model antigen ovalbumin (Ova that were concurrently infected with Mp (Ova+Mp to test the hypothesis that SP-A ameliorates Mp-induced stimulation of eosinophils. Thus, SP-A could protect allergic airways from injury due to release of eosinophil inflammatory products. SP-A deficient mice exhibit significant increases in inflammatory cells, mucus production and lung damage during concurrent allergic airway disease and infection (Ova+Mp as compared to the WT mice of the same treatment group. In contrast, SP-A deficient mice have significantly decreased Mp burden compared to WT mice. The eosinophil specific factor, eosinophil peroxidase (EPO, which has been implicated in pathogen killing and also in epithelial dysfunction due to oxidative damage of resident lung proteins, is enhanced in samples from allergic/infected SP-A(-/- mice as compared to WT mice. In vitro experiments using purified eosinophils and human SP-A suggest that SP-A limits the release of EPO from Mp-stimulated eosinophils thereby reducing their killing capacity. These findings are the first to demonstrate that although SP-A interferes with eosinophil-mediated biologic clearance of Mp by mediating the interaction of Mp with eosinophils, SP-A simultaneously benefits the airway by limiting inflammation

  8. Acute pneumonia in a fire-eater.

    Dell' Omo, M; Murgia, N; Chiodi, M; Giovenali, P; Cecati, A; Gambelunghe, A

    2010-01-01

    Fire-eater's lung, an acute exogenous lipoid pneumonia, is caused when street performers accidentally inhale pyrofluids. We report the case of a young fire-eater who, 12 hours after inhaling an iso-alkanebased pyrofluid, developed fever, dyspnoea, dry cough and intense right chest pain. Radiographic signs of pneumonia emerged two days later. Computed tomography (CT) scans visualized an irregular area of parenchymal consolidation with an air bronchiologram and peripheral ground-glass opacities in the right middle lobe. The diagnostic work-up included microbiological and lung function tests, optic fibre bronchoscopy and an in-depth cyto-immunological analysis of bronchoalveolar lavage fluid. Symptoms gradually improved over a few days. A CT scan one month later showed the thickened parenchymal area in the right middle lobe had almost completely disappeared. PMID:21244782

  9. Eosinophilic cholecystitis: an infrequent cause of acute cholecystitis

    María del Moral-Martínez

    2015-01-01

    Full Text Available Eosinophilic cholecystitis (EC is a rare disease that is characterised by eosinophilic infiltration of the gallbladder. Its pathogenesis is unknown, although many hypotheses have been made. Clinical and laboratory manifestations do not differ from those of other causes of cholecystitis. Diagnosis is histological and usually performed after analysis of the surgical specimen. We report the case of a woman aged 24 years, with symptoms of fever, vomiting and pain in the right upper quadrant. When imaging tests revealed acalculous cholecystitis, an urgent cholecystectomy was performed. Histological examination of the surgical specimen revealed eosinophilic cholecystitis. No cause of the symptoms was found.

  10. Eosinophilic pneumonia associated with daptomycin: a case report and a review of the literature

    Fanourgiakis Panagiotis

    2011-01-01

    Full Text Available Abstract Introduction Although several studies did not demonstrate that daptomycin may cause significantly higher rates of pulmonary adverse effects when compared with vancomycin or penicillinase-resistant penicillins, there have been a few case reports of severe pulmonary complications associated with daptomycin administration. Case presentation A rare case of eosinophilic pneumonia occurring 10 days after daptomycin administration in a 78-year-old Caucasian man with possible infectious endocarditis is described. He developed new onset fever, up to 38.5°C, with bilateral pulmonary crackles on physical examination and with no signs of severe respiratory failure. A chest computed tomography-scan showed bilateral nodular consolidations with air bronchograms and pleural effusions. Immediate discontinuation of daptomycin was followed by vigorous improvement of clinical signs and symptoms with progressive resolution of pulmonary consolidations a month later. Conclusion Physicians should be aware of this rare but serious complication during daptomycin treatment, and prompt discontinuation of the offending agent, with or without additional supportive treatment, must occur immediately.

  11. Coinfection with Mycoplasma Pneumoniae and Chlamydia Pneumoniae in ruptured plaques associated with acute myocardial infarction

    Higuchi Maria de Lourdes

    2003-01-01

    Full Text Available OBJECTIVE: To study atheromas, Mycoplasma pneumoniae (M. pneumoniae, and Chlamydia pneumoniae (C. pneumoniae. METHODS: C. pneumoniae was studied with immunohistochemistry and M. pneumoniae with in situ hybridization (ISH, in segments of coronary arteries (SCA as follows: group A - thrombosed ruptured plaques (TRP of 23 patients who died due to acute myocardial infarction (AMI; group B - 23 nonruptured plaques (NRP of group A patients; group C - NRP of 11 coronary patients who did not die due to AMI; and group D - 11 SCA from patients with dilated cardiomyopathy or Chagas' disease without atherosclerosis. RESULTS: The mean number of C. pneumoniae+ cells/400x in groups A, B, C, and D was, respectively, 3.3±3.6; 1.0±1.3; 1.2±2.4; and 0.4±0.3; and the percentage of M. pneumoniae area was, respectively, 3.9±3.5; 1.5± 1.6; 0.9±0.9; and 0.4±0.2. More M. pneumoniae and C. pneumoniae were found in of group A than in group B (P<0.01. Good correlation was seen between the area of the vessel and the M. pneumoniae area in the plaque (r = 0.46; P=0.001 and between C. pneumoniae+ cells and CD4+ T lymphocytes (r = 0.42; P<0.01. The number of C. pneumoniae+ cells correlated with CD20+ B cells (r=0.48; P<0.01. CONCLUSION: M. pneumoniae and C. pneumoniae are more frequently found in TRP correlate with the intensity of the inflammation and diameter of the vessel (positive remodeling.

  12. Clinical and pulmonary thin-section CT findings in acute Klebsiella Pneumoniae pneumonia

    Okada, Fumito [Oita University Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Oita (Japan); Oita University Faculty of Medicine, Department of Radiology, Oita (Japan); Ando, Yumiko; Honda, Koichi; Nakayama, Tomoko; Kiyonaga, Maki; Ono, Asami; Tanoue, Shuichi; Maeda, Toru; Mori, Hiromu [Oita University Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Oita (Japan)

    2009-04-15

    The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia. We retrospectively evaluated thin-section CT examinations performed between January 1991 and December 2007 from 962 patients with acute Klebsiella pneumoniae pneumonia. Seven hundred and sixty-four cases with concurrent infectious diseases were excluded. Thus, our study group comprised 198 patients (118 male, 80 female; age range 18-97 years, mean age 61.5). Underlying diseases and clinical findings were assessed. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusion. CT findings in patients with acute Klebsiella pneumoniae pneumonia consisted mainly of ground-glass attenuation (100%), consolidation (91.4%), and intralobular reticular opacity (85.9%), which were found in the periphery (96%) of both sides of the lungs (72.2%) and were often associated with pleural effusion (53%). The underlying conditions in patients with Klebsiella pneumoniae pneumonia were alcoholism or smoking habit. (orig.)

  13. Clinical and pulmonary thin-section CT findings in acute Klebsiella Pneumoniae pneumonia

    The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia. We retrospectively evaluated thin-section CT examinations performed between January 1991 and December 2007 from 962 patients with acute Klebsiella pneumoniae pneumonia. Seven hundred and sixty-four cases with concurrent infectious diseases were excluded. Thus, our study group comprised 198 patients (118 male, 80 female; age range 18-97 years, mean age 61.5). Underlying diseases and clinical findings were assessed. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusion. CT findings in patients with acute Klebsiella pneumoniae pneumonia consisted mainly of ground-glass attenuation (100%), consolidation (91.4%), and intralobular reticular opacity (85.9%), which were found in the periphery (96%) of both sides of the lungs (72.2%) and were often associated with pleural effusion (53%). The underlying conditions in patients with Klebsiella pneumoniae pneumonia were alcoholism or smoking habit. (orig.)

  14. Acute Myelomonocytic Leukemia with Abnormal Eosinophils: A Case Report with Multi- Modality Diagnostic Work-up

    Ching-Cherng Tzeng

    2006-10-01

    Full Text Available Acute myeloid leukemia (AML with recurrent genetic abnormalities often carries a favorableprognosis. AML with inv(16(p13q22 occurs predominantly in younger patients and usually showsgranulocytic and monocytic differentiation with abnormal eosinophils. It is referred to as acutemyelomonocytic leukemia with abnormal eosinophils (AMML Eo. We report a case in a 27-year-oldman with leukocytosis (10.6x103/μL with 34% blasts, thrombocytopenia and splenomegaly. Marrowaspiration showed 47% blasts and 33% eosinophils, of which 19% were morphologically abnormalwith both eosinophilic and basophilic cytoplasmic granules. Cytochemically, the blasts were positivefor myeloperoxidase while the granules of abnormal eosinophils were positive for naphthol ASDchloroacetate esterase. With flow cytometric immunophenotyping the blasts expressed CD13, CD33,CD117, myeloperoxidase and CD34. Marrow trephine showed 90% cellularity with 40% blastsexpressing CD34, CD117, and myeloperoxidase on immunohistochemistry. Chromosomal analysisreveled a karyotype of 46, XY, inv(16(p13q22. This case illustrates a typical AMML Eo confirmedby a multi-modality diagnostic approach including morphology, cytochemistry, flow cytometry,immunohistochemistry, and conventional cytogenetic study.

  15. Acute community acquired Aspergillus pneumonia in a presumed immunocompetent host

    Sridhar, Varun; Rajagopalan, Natarajan; C, Shivaprasad; Patil, Mahantesh; Varghese, Jaicob

    2012-01-01

    Infection from Aspergillus results in a wide range of diseases from simple Aspergillus pneumonia to fatal invasive Aspergillosis. Though the fungus is known to predominantly affect the immunocompromised host, it has also been known to cause acute pneumonia in immunocompetent hosts which is invariably fatal. It presents as an acute pneumonia with bilateral chest infiltrates on radiograph. Early clinical suspicion and microbiological identification by measures such as broncho alveolar lavage and initiation of therapy with voricanozole significantly increase the chances of survival. In this article the authors discuss a case of acute community acquired Aspergillus pneumonia in an immunocompetent host who survived due to early identification and prompt treatment with appropriate antifungal medication. PMID:22605848

  16. Chronic eosinophilic pneumonia involving with mediastinal lymph nodes: radiologic study of three cases. Neumonia eosinofila cronica asociada a adenopatias mediastinicas: estudio radiologico de tres casos

    Calvo Garcia, A.; Gordillo Gutierrez, I.; Guembe Urtiaga, P. (Hospital Gregorio Maraon, Madrid (Spain))

    1994-01-01

    Chronic eosinophilic pneumonia (CEP) is an uncommon disorder in our setting. Chest x-ray is essential to diagnosis. To date, we have found only three reported cases in which mediastinal lymph nodes were involved. We present three additional cases with standard thoracic study. (Author)

  17. Lymphatic fluctuation in the parenchymal remodeling stage of acute interstitial pneumonia, organizing pneumonia, nonspecific interstitial pneumonia and idiopathic pulmonary fibrosis

    E.R. Parra; C.A.L. Araujo; J.G. Lombardi; A.M. Ab’Saber; C.R.R. Carvalho; Kairalla, R A; Capelozzi, V.L.

    2012-01-01

    Because the superficial lymphatics in the lungs are distributed in the subpleural, interlobular and peribroncovascular interstitium, lymphatic impairment may occur in the lungs of patients with idiopathic interstitial pneumonias (IIPs) and increase their severity. We investigated the distribution of lymphatics in different remodeling stages of IIPs by immunohistochemistry using the D2-40 antibody. Pulmonary tissue was obtained from 69 patients with acute interstitial pneumonia/diffuse alveola...

  18. Mycoplasma pneumoniae pneumonia in hospitalized children diagnosed at acute stage by paired sera

    LIU Chun-ling; WEI Ming; LIU Zhen-ye; WANG Gui-qiang; ZHANG Bo; XU Hua; HU Liang-ping; HE Xiao-feng; WANG Jun-hua; ZHANG Jun-hong; LIU Xiao-yu

    2010-01-01

    Background Mycoplasma pneumoniae (M. pneumoniae) is a frequent cause of respiratory tract infections. However,there is deficient knowledge about the clinical manifestations of M. pneumoniae infection. We described the clinical and laboratory findings of M. pneumoniae pneumonia in hospitalized children who were all diagnosed by a ≥ fourfold increase in antibody titer.Methods M. pneumoniae antibodies were routinely detected in children admitted with acute respiratory infection during a one-year period. The medical history was re-collected from children whose M. pneumoniae antibody titer increased≥fourfold at the bedside by a single person, and their frozen paired serum samples were measured again for the M.pneumoniae antibody titer.Results Of the 635 children whose sera were detected for the M. pneumoniae antibody, paired sera were obtained from 82 and 29.3% (24/82) showed a ≥ fourfold increase in antibody titer. There were 24 cases, nine boys and 15 girls, aged from two to 14 years, whose second serum samples were taken on day 9 at the earliest after symptom onset; the shortest interval was three days. All children presented with a high fever (≥38.5℃) and coughing. Twenty-one had no nasal obstruction or a runny nose, and five had mild headaches which all were associated with the high fever. The disease was comparatively severe if the peak temperature was >39.5℃. All were diagnosed as having pneumonia through chest X-rays. Four had bilateral or multilobar involvement and their peak temperatures were all ≤ 39.5℃. None of the children had difficulty in breathing and all showed no signs of wheezing.Conclusions The second serum sample could be taken on day 9 at the earliest after symptom onset meant that paired sera could be used for the clinical diagnosis of M. pneumoniae pneumonia in children at the acute stage. M. pneumoniae is a lower respiratory tract pathogen. Extrapulmonary complications were rare and minor in our study. High peak temperature (

  19. Acute solitary localized pneumonia: CT diagnosis

    Objective: To evaluate CT in the differential diagnosis of solitary localized pneumonia. Method: Only plain CT without contrast study was done because of different types of CT scanners weed. There were 25 cases with localized pneumonia with initial diagnosis as suspected peripheral bronchogenic carcinoma. All patients were over forty years of age, 84% 50-80 years, 13(52%) patients were asymptomatic, 5(20%) patients had bloody sputum. Results: The CT features were divided into three patterns: (1) irregular nodule with relatively well-defined margin, ground-glass opacity and a few punctuate high densities. (2) irregular nodule with sharply circumscribed, spiculate border and homogeneous density. (3) regular nodule with relatively well-defined margin, and homogeneous density. The third type was most frequent (60%) with predilection for the dorsal segments of the lower lobes, or the posterior basal segments. Of the 25 patients 3 had operation, the remaining cases were treated as pneumonia, the lesions were resolved in 18(82%) patients in 2-3 weeks. Conclusions: Sometimes it is very difficult to differentiate localized pneumonia from peripheral lung cancer on the basis of clinical presentation and imaging. The spiculate margins of irregular nodule shown on CT could be indeterminate on chest radiography, and as a result chest radiograph is helpful in differential diagnosis of localized pneumonia. Change in size of the lesion as observed at the same cross-section scan, smaller at mediastinal window than at lung window is in favor of localized pneumonia, however, with the exception of alveolar carcinoma, treatment with antibiotic therapy for a period of 2-3 weeks, helps differentiate these diseases

  20. Lymphatic fluctuation in the parenchymal remodeling stage of acute interstitial pneumonia, organizing pneumonia, nonspecific interstitial pneumonia and idiopathic pulmonary fibrosis

    E.R. Parra

    2012-05-01

    Full Text Available Because the superficial lymphatics in the lungs are distributed in the subpleural, interlobular and peribroncovascular interstitium, lymphatic impairment may occur in the lungs of patients with idiopathic interstitial pneumonias (IIPs and increase their severity. We investigated the distribution of lymphatics in different remodeling stages of IIPs by immunohistochemistry using the D2-40 antibody. Pulmonary tissue was obtained from 69 patients with acute interstitial pneumonia/diffuse alveolar damage (AIP/DAD, N = 24, cryptogenic organizing pneumonia/organizing pneumonia (COP/OP, N = 6, nonspecific interstitial pneumonia (NSIP/NSIP, N = 20, and idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP, N = 19. D2-40+ lymphatic in the lesions was quantitatively determined and associated with remodeling stage score. We observed an increase in the D2-40+ percent from DAD (6.66 ± 1.11 to UIP (23.45 ± 5.24, P = 0.008 with the advanced process of remodeling stage of the lesions. Kaplan-Meier survival curves showed a better survival for patients with higher lymphatic D2-40+ expression than 9.3%. Lymphatic impairment occurs in the lungs of IIPs and its severity increases according to remodeling stage. The results suggest that disruption of the superficial lymphatics may impair alveolar clearance, delay organ repair and cause severe disease progress mainly in patients with AIP/DAD. Therefore, lymphatic distribution may serve as a surrogate marker for the identification of patients at greatest risk for death due to IIPs.

  1. Eosinophilic Fasciitis and Acute Encephalopathy Toxicity from Pembrolizumab Treatment of a Patient with Metastatic Melanoma.

    Khoja, Leila; Maurice, Catherine; Chappell, MaryAnne; MacMillan, Leslie; Al-Habeeb, Ayman S; Al-Faraidy, Nada; Butler, Marcus O; Rogalla, Patrik; Mason, Warren; Joshua, Anthony M; Hogg, David

    2016-03-01

    Anti-PD-1 inhibitors have significant activity in metastatic melanoma. Responses often occur early and may be sustained. The optimal duration of treatment with these agents is unknown. Here, we report the case of a 51-year-old woman treated with pembrolizumab, as part of the Keynote-001 trial, as first-line treatment for metastatic disease. She experienced a complete response after 13.8 months of treatment with no adverse events. One month after the last drug infusion and 18 months from starting treatment, the patient presented with eosinophilic fasciitis. She then developed acute confusion and weakness, thought to be due to intracranial vasculitis. High-dose steroids were initiated with resolution of the fasciitis. Aspirin was commenced for presumed vasculitis with resolution of the neurologic symptoms. To our knowledge, there are no previous reports of eosinophilic fasciitis or cerebral vasculitis due to anti-PD-1 agents. This case demonstrates that toxicity may occur in association with pembrolizumab treatment after a prolonged period of treatment without toxicity. Future trials should explore the optimal duration of treatment with pembrolizumab. PMID:26822024

  2. Acute Herpes Simplex Viral Esophagitis Occurring in 5 Immunocompetent Individuals With Eosinophilic Esophagitis

    Criblez, Dominique H.; Dellon, Evan S.; Bussmann, Christian; Pfeifer, David; Froh, Matthias; Straumann, Alex

    2016-01-01

    Herpes simplex esophagitis (HSE) is an acute, severe viral infection of the esophagus, rarely occurring in immunocompetent individuals. Eosinophilic esophagitis (EoE) is a rare immune-mediated esophageal disorder. We recently observed 5 severe HSE cases in diagnosed EoE patients. Four of the 5 patients had active, untreated EoE at the time of infection, so HSE is not likely a side effect of swallowed topical corticosteroids, the first-line medical treatment of EoE. However, this coincidence of these 2 rare conditions raises the question of a causal relationship between these 2 forms of esophagitis, and whether active EoE might predispose to HSE infection.

  3. Acute pulmonary injury: high-resolution CT and histopathological spectrum

    Obadina, E T; Torrealba, J M; Kanne, J P

    2013-01-01

    Acute lung injury usually causes hypoxaemic respiratory failure and acute respiratory distress syndrome (ARDS). Although diffuse alveolar damage is the hallmark of ARDS, other histopathological patterns of injury, such as acute and fibrinoid organising pneumonia, can be associated with acute respiratory failure. Acute eosinophilic pneumonia can also cause acute hypoxaemic respiratory failure and mimic ARDS. This pictorial essay reviews the high-resolution CT findings of acute lung injury and ...

  4. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid

    Yasui, Hideki; Yokomura, Koshi; Suda, Takafumi

    2016-01-01

    Acute exogenous lipoid pneumonia is a rare disorder in adults. A treatment of choice for lipoid pneumonia has not been established, and systemic corticosteroid use remains controversial. We report the case of a 32-year-old man with schizophrenia who presented with kerosene-induced acute exogenous lipoid pneumonia that was treated with a systemic corticosteroid. In this case, supportive therapy did not improve the patient's condition, so systemic corticosteroid therapy was commenced four days ...

  5. Increased eosinophil activity in acute Plasmodium falciparum infection - association with cerebral malaria

    Kurtzhals, J A; Reimert, C M; Tette, E;

    1998-01-01

    To assess the eosinophil response to Plasmodium falciparum infection a cohort of initially parasite-free Ghanaian children was followed for 3 months. Seven of nine children who acquired an asymptomatic P. falciparum infection showed increase in eosinophil counts, while a decrease was found in sev...

  6. Can acute interstitial pneumonia be differentiated from bronchiolitis obliterans organizing pneumonia by high-resolution CT?

    In the early stages, clinical and chest radiographic findings of acute interstitial pneumonia (AIP) are often similar to those of bronchiolitis obliterans organizing pneumonia (BOOP). However, patients with AIP have a poor prognosis, while those with BOOP can achieve a complete recovery after corticosteroid therapy. The objective of this study was to identify differences in high-resolution CT (HRCT) findings between the two diseases. The study included 27 patients with AIP and 14 with BOOP who were histologically diagnosed [open-lung biopsy (n=7), autopsy (n=17), transbronchial lung biopsy (n=17)]. The frequency and distribution of various HRCT findings for each disease were retrospectively evaluated. Traction bronchiectasis, interlobular septal thickening, and intralobular reticular opacities were significantly more prevalent in AIP (92.6%, 85.2%, and 59.3%, respectively) than in BOOP (42.9%, 35.7%, and 14.3%, respectively) (p<0.01). Parenchymal nodules and peripheral distribution were more prevalent in BOOP (28.6% and 57.1%, respectively) than in AIP (7.4% and 14.8%, respectively) (p<0.01). Areas with ground-glass attenuation, air-space consolidation, and architectural distortion were common in both AIP and BOOP. For a differential diagnosis of AIP and BOOP, special attention should be given to the following HRCT findings: traction bronchiectasis, interlobular septal thickening, intralobular reticular opacities, parenchymal nodules, pleural effusion, and peripheral zone predominance. (author)

  7. Clinical Management of Acute Interstitial Pneumonia: A Case Report

    Yang Xia

    2012-01-01

    Full Text Available We describe a 51-year-old woman who was admitted to hospital because of cough and expectoration accompanied with general fatigue and progressive dyspnea. Chest HRCT scan showed areas of ground glass attenuation, consolidation, and traction bronchiectasis in bilateral bases of lungs. BAL fluid test and transbronchial lung biopsy failed to offer insightful evidence for diagnosis. She was clinically diagnosed with acute interstitial pneumonia (AIP. Treatment with mechanical ventilation and intravenous application of methylprednisolone (80 mg/day showed poor clinical response and thus was followed by steroid pulse therapy (500 mg/day, 3 days. However, she died of respiratory dysfunction eventually. Autopsy showed diffuse alveolar damage associated with hyaline membrane formation, pulmonary interstitial, immature collagen edema, and focal type II pneumocyte hyperplasia.

  8. Serum heat shock protein 47 levels are elevated in acute interstitial pneumonia

    Kakugawa, Tomoyuki; Yokota, Shin-ichi; Ishimatsu, Yuji; Hayashi, Tomayoshi; Nakashima, Shota; Hara, Shintaro; Sakamoto, Noriho; Kubota, Hiroshi; Mine, Mariko; Matsuoka, Yasuhiro; Mukae, Hiroshi; Nagata, Kazuhiro; Kohno, Shigeru

    2014-01-01

    Background Heat shock protein (HSP) 47, a collagen-specific molecular chaperone, is involved in the processing and/or secretion of procollagen. We hypothesized that HSP47 could be a useful marker for fibrotic lung disease. The aim of this study was to evaluate serum levels of HSP47 in patients with various idiopathic interstitial pneumonias (IIPs). Methods Subjects comprised 9 patients with acute interstitial pneumonia (AIP), 12 with cryptogenic organizing pneumonia (COP), 16 with nonspecific...

  9. Sorafenib-induced acute interstitial pneumonia in patients with advanced hepatocellular carcinoma: report of three cases

    Takeda, Haruhiko; Nishikawa, Hiroki; Iguchi, Eriko; Matsuda, Fumihiro; Kita, Ryuichi; Kimura, Toru; Osaki, Yukio

    2012-01-01

    Little is known about acute interstitial pneumonia (AIP) induced by sorafenib therapy in patients with advanced hepatocellular carcinoma (HCC). Here, we present three patients with advanced HCC who developed AIP during sorafenib therapy, with fatal complications in two cases. Case 1 was a 76-year-old man who developed dyspnea. Chest CT showed interstitial pneumonia. Sorafenib was discontinued immediately, and prednisolone was started. His pneumonia resolved. A drug-induced lymphocyte stimulat...

  10. Acute interstitial pneumonia in mink kits inoculated with defined isolates of Aleutian mink disease parvovirus

    Alexandersen, Søren; Larsen, S; Aasted, B;

    1994-01-01

    The present study addressed the causal role of Aleutian mink disease parvovirus (ADV) in acute interstitial pneumonia in mink kits. All the examined isolates of ADV caused interstitial pneumonia in newborn kits, although the severity of disease and the mortality varied. These findings indicate that...

  11. Acute Placental Infection Due to Klebsiella pneumoniae: Report of a Unique Case

    Sheikh, Salwa S.; Amr, Samir S.; Janice M. Lage

    2005-01-01

    A 40-year-old woman, gravida 9, with seven healthy children and a history of one abortion (p 7 + 1) , presented at 18 weeks of gestation with fever and malodorous vaginal discharge. Ultrasound revealed a macerated fetus. The placenta showed acute chorioamnionitis and acute villitis with microabscess formation. Blood and vaginal cultures both grew Klebsiella pneumoniae. This is the first reported case in English literature of Klebsiella pneumoniae causing suppurative placentitis leading to fet...

  12. Acute placental infection due to Klebsiella pneumoniae: report of a unique case.

    Janice M. Lage; Amr, Samir S.; Sheikh, Salwa S.

    2005-01-01

    A 40-year-old woman, gravida 9, with seven healthy children and a history of one abortion (p 7 + 1) , presented at 18 weeks of gestation with fever and malodorous vaginal discharge. Ultrasound revealed a macerated fetus. The placenta showed acute chorioamnionitis and acute villitis with microabscess formation. Blood and vaginal cultures both grew Klebsiella pneumoniae. This is the first reported case in English literature of Klebsiella pneumoniae causing suppurative placentitis leading to fet...

  13. Eosinophilic Disorders

    ... 2 Diabetes, Heart Disease a Dangerous Combo Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... eosinophils. High number of eosinophils The most common causes of a high number of eosinophils (called eosinophilia ...

  14. Acute respiratory distress syndrome caused by Mycoplasma pneumoniae without elevated pulmonary vascular permeability: a case report.

    Takahashi, Naoki; Shinohara, Tsutomu; Oi, Rie; Ota, Muneyuki; Toriumi, Shinichi; Ogushi, Fumitaka

    2016-05-01

    Sporadic patients with acute respiratory distress syndrome (ARDS) caused by Mycoplasma pneumoniae have been reported. However, knowledge about the pathophysiology and pharmacological treatment of this condition is insufficient. Moreover, the pulmonary vascular permeability in ARDS related to M. pneumoniae infection has not been reported. We report a case of ARDS caused by Mycoplasma pneumoniae without elevated pulmonary vascular permeability, which was successfully treated using low-dose short-term hydrocortisone, suggesting that pulmonary infiltration in ARDS caused by Mycoplasma pneumoniae does not match the criteria of permeability edema observed in typical ARDS. PMID:27162691

  15. Pneumonia

    ... viruses, such as the influenza virus (flu) and adenovirus . Other viruses, such as respiratory syncytial virus (RSV) ... your local health department to see when these vaccines are available. Because pneumonia ... influenza pneumonia, for example, someone may become sick as ...

  16. Acute fibrinous and organising pneumonia: a case report and review of the literature

    Tzouvelekis Argyris

    2009-10-01

    Full Text Available Abstract Introduction Organising pneumonia is a distinct histopathological entity characterized by intra-alveolar buds of granulation tissue, called Masson bodies, which mainly comprise of activated fibroblasts and loose connective tissue. This histopathologic pattern has been described in idiopathic cases, characterizing cryptogenic organising pneumonia as well as in the context of pulmonary infection, drug-induced pneumonitis and following lung transplantation. Although distinct as a clinical and pathological entity, community organising pneumonia may present with atypical clinical and pathological features, such as intra-alveolar fillings of fibrin balls and organising tissue that resembles acute respiratory distress syndrome or diffuse alveolar damage. The latter characteristics constitute a recently described anatomoclinical entity called acute fibrinous and organising pneumonia. Case presentation Here, we describe a rare case of acute fibrinous and organising pneumonia, in an otherwise healthy 65-year-old Greek woman who complained of dry cough, fever, weight loss and progressive dyspnoea. She had never been a smoker. Her clinical symptoms showed a rapid deterioration in the two weeks before admission, despite a course of oral antibiotics. After excluding infection and malignancy with routine laboratory tests and flexible bronchoscopy, high resolution computed tomography and video assisted thoracoscopic lung biopsy were performed. Diagnosis was based on radiological features typical of community organising pneumonia coupled with pathologic features characteristic of acute fibrinous and organising pneumonia. The patient was treated with corticosteroids and showed excellent clinical and radiological response three months after treatment initiation. Conclusion Acute fibrinous and organising pneumonia is an extremely rare pathologic entity, often misdiagnosed as typical community organising pneumonia. To our knowledge, this is the seventh case

  17. Acute necrotizing eosinophilic myocarditis in a patient taking Garcinia cambogia extract successfully treated with high-dose corticosteroids.

    Allen, Scott F; Godley, Robert W; Evron, Joshua M; Heider, Amer; Nicklas, John M; Thomas, Michael P

    2014-12-01

    A previously healthy 48-year-old woman was evaluated for lightheadedness and chest heaviness 2 weeks after starting the herbal supplement Garcinia cambogia. She was found to be hypotensive and had an elevated serum troponin level. The patient had a progressive clinical decline, ultimately experiencing fulminant heart failure and sustained ventricular arrhythmias, which required extracorporeal membrane oxygenation support. Endomyocardial biopsy results were consistent with acute necrotizing eosinophilic myocarditis (ANEM). High-dose corticosteroids were initiated promptly and her condition rapidly improved, with almost complete cardiac recovery 1 week later. In conclusion, we have described a case of ANEM associated with the use of Garcinia cambogia extract. PMID:25475477

  18. Sudden psychotic episode probably due to meningoencephalitis and Chlamydia pneumoniae acute infection

    Canas Nuno; Coromina Marta; Correa Bernardo; Xavier Miguel; Guimarães João

    2005-01-01

    Abstract Background Since 9% to 20% of all cases of acute psychosis presenting to an Emergency Department (ED) are due to a general medical condition, cautious medical workup should be mandatory in such patients. Differential diagnosis must consider conditions as diverse as renal failure or CNS infection. Acute Chlamydia pneumoniae infection usually causes a self-limited respiratory syndrome. Rarely, acute neurological complications occur, with acute meningoencephalitis most frequently report...

  19. Predictors of pneumonia in acute stroke in patients in an emergency unit

    Sara R. M. Almeida

    2015-05-01

    Full Text Available Objective To evaluate the risk factors and comorbid conditions associated with the development of pneumonia in patients with acute stroke. To determine the independent predictors of pneumonia. Method Retrospective study from July to December 2011. We reviewed all medical charts with diagnosis of stroke. Results 159 patients (18-90 years were admitted. Prevalence of pneumonia was 32%. Pneumonia was more frequent in patients with hemorrhagic stroke (OR: 4.36; 95%CI: 1.9-10.01, p < 0.001, higher National Institute of Health Stroke Scale (NIHSS (p = 0.047 and, lower Glasgow Coma Score (GCS (p < 0.0001. Patients with pneumonia had longer hospitalization (p < 0.0001. Multivariable logistic regression analysis identified NIHSS as an independent predictor of pneumonia (95%CI: 1.049-1.246, p = 0.002. Conclusion Pneumonia was associated with severity and type of stroke and length of hospital stay. The severity of the deficit as evaluated by the NIHSS was shown to be the only independent risk factor for pneumonia in acute stroke patients.

  20. Pneumonia

    ... restroom and before eating. Use lukewarm water and soap for at least 20 seconds. If soap and water are not available, using an alcohol- ... at higher risk for pneumonia? Do I have bacterial, viral or fungal pneumonia? What’s the best treatment? ...

  1. Novel Type of Streptococcus pneumoniae Causing Multidrug-Resistant Acute Otitis Media in Children

    Xu, Qingfu; Pichichero, Michael E.; Casey, Janet R.; Zeng, Mingtao

    2009-01-01

    After our recent discovery of a Streptococcus pneumoniae 19A “superbug” (Legacy strain) that is resistant to all Food and Drug Administration–approved antimicrobial drugs for treatment of acute otitis media (AOM) in children, other S. pneumoniae isolates from children with AOM were characterized by multilocus sequence typing (MLST). Among 40 isolates studied, 16 (40%) were serotype 19A, and 9 (23%) were resistant to multiple antimicrobial drugs. Two others had unreported sequence types (STs) ...

  2. Acute exogenous lipoid pneumonia, on a fire eating

    A case of an adult 19 years of age, fire juggler and manipulator is presented. The young came in to the medical emergency service of the Hospital Dr. Rafael A. Calderon Guardia, because of a sudden episode of right thoracic pain and dyspnea. A right pleural effusion was documented and a round mass at the base of the left lung. A suggestive clinic of bronchopneumonia started after hours, it was localized first as community acquired pneumonia. Considering his work history and clinical characteristics, the case was reoriented and concluded that this is what the medical literature in English is called fire-eater pneumonia, uncommon aspiration pneumonia which was a literature review. (author)

  3. Comparison of histological lesions in mink with acute hemorrhagic pneumonia associated with Pseudomonas aeruginosa or Escherichia coli

    Salomonsen, Charlotte Mark; Boye, Mette; Høiby, Niels; Jensen, Trine H.; Hammer, Anne Sofie

    2013-01-01

    Hemorrhagic pneumonia can be a major cause of mortality in farmed mink in the fall. In its classic form, hemorrhagic pneumonia is caused by the bacterium Pseudomonas aeruginosa. In recent years, however, outbreaks of this type of pneumonia that are associated with hemolytic Escherichia coli have also occurred in farmed mink. The purpose of this study was to compare histological lesions of acute hemorrhagic pneumonia associated with both P. aeruginosa and E. coli in mink, including a descripti...

  4. The Multidisciplinary Swallowing Team Approach Decreases Pneumonia Onset in Acute Stroke Patients

    Aoki, Shiro; Hirayama, Junko; Nakamori, Masahiro; Yoshikawa, Mineka; Nezu, Tomohisa; Kubo, Satoshi; Nagano, Yuka; Nagao, Akiko; Yamane, Naoya; Nishikawa, Yuichi; Takamoto, Megumi; Ueno, Hiroki; Ochi, Kazuhide; Maruyama, Hirofumi; Yamamoto, Hiromi; Matsumoto, Masayasu

    2016-01-01

    Dysphagia occurs in acute stroke patients at high rates, and many of them develop aspiration pneumonia. Team approaches with the cooperation of various professionals have the power to improve the quality of medical care, utilizing the specialized knowledge and skills of each professional. In our hospital, a multidisciplinary participatory swallowing team was organized. The aim of this study was to clarify the influence of a team approach on dysphagia by comparing the rates of pneumonia in acute stroke patients prior to and post team organization. All consecutive acute stroke patients who were admitted to our hospital between April 2009 and March 2014 were registered. We analyzed the difference in the rate of pneumonia onset between the periods before team organization (prior period) and after team organization (post period). Univariate and multivariate analyses were performed using a Cox proportional hazards model to determine the predictors of pneumonia. We recruited 132 acute stroke patients from the prior period and 173 patients from the post period. Pneumonia onset was less frequent in the post period compared with the prior period (6.9% vs. 15.9%, respectively; p = 0.01). Based on a multivariate analysis using a Cox proportional hazards model, it was determined that a swallowing team approach was related to pneumonia onset independent from the National Institutes of Health Stroke Scale score on admission (adjusted hazard ratio 0.41, 95% confidence interval 0.19–0.84, p = 0.02). The multidisciplinary participatory swallowing team effectively decreased the pneumonia onset in acute stroke patients. PMID:27138162

  5. Mycoplasma pneumonia : an unusual cause of acute myocarditis in childhood

    Formosa Gouder, Mireille; Bailey, Mark; Muscat, C; Grech, Victor E.; Barbara, Christopher

    2006-01-01

    Mycoplasma pneumoniae is primarily a respiratory pathogen but may affect exhibit a diverse range of presentations from asymptomatic infection to life threatening conditions. Myocarditis of varying severity is an unusual complication. We report a 6 year old with mycoplasma myocarditis, a rare age for such a presentation, and who responded well to treatment with no sequelae. Serological testing for Mycoplasma pneumoniae should be part of the routine work-up for myocarditis.

  6. Soluble Endothelial Selectin in Acute Lung Injury Complicated by Severe Pneumonia

    Daisuke Osaka, Yoko Shibata, Kazunori Kanouchi, Michiko Nishiwaki, Tomomi Kimura, Hiroyuki Kishi, Shuichi Abe, Sumito Inoue, Yoshikane Tokairin, Akira Igarashi, Keiko Yamauchi, Yasuko Aida, Takako Nemoto, Keiko Nunomiya, Koji Fukuzaki, Isao Kubota

    2011-01-01

    Full Text Available Background: Pneumonia is still one of the most frequent causes of death in the elderly. Complication of acute lung injury (ALI/acute respiratory distress syndrome (ARDS by pneumonia makes patients very ill due to severe respiratory failure. Biomarkers that can discriminate the presence of complicating ALI/ARDS are required for early detection. The aim of this research was to investigate whether soluble endothelial selectin (sES could be a biomarker for ALI.Methods: Serum sES levels were measured in 27 pneumonia patients, who were enrolled between April 2006 and September 2007. Among these patients, six had ALI or a condition that was clinically comparable to ALI (cALI. All patients who were enrolled were successfully treated and survived.Results: Circulating sES levels were elevated in pneumonia patients with ALI/cALI, and sES levels decreased following treatment of their pneumonia. Univariate and multivariate logistic regression analyses showed that sES was the only significant factor for identifying complicating ALI/cALI, independently of C-reactive protein (CRP and lactate dehydrogenase (LDH. By receiver operating characteristic (ROC curve analysis, the cut-off value for sES was 40.1 ng/mL, with a sensitivity of 0.8 and a specificity of 0.8.Conclusion: sES may be a useful biomarker for discriminating complicating ALI/cALI in patients with severe pneumonia.

  7. Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome

    Carlos R. Camara-Lemarroy

    2015-01-01

    Full Text Available Eosinophilic granulomatosis with polyangiitis (EGPA is a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs which commonly affects the peripheral nervous system. A 38-year-old female with a history of asthma presented with a 2-week history of bilateral lower extremity paresthesias that progressed to symmetric ascending paralysis. Nerve conduction studies could not rule out Guillain-Barre syndrome (GBS and plasmapheresis was considered. Her blood work revealed marked eosinophilia (>50%, she had purpuric lesions in her legs, and a head magnetic resonance image showed evidence of pansinusitis. Coupled with a history of asthma we suspected EGPA-associated neuropathy and started steroid treatment. The patient showed rapid and significant improvement. ANCAs were later reported positive. ANCA-associated vasculitides present most often as mononeuritis multiplex, but they can mimic GBS and should always be considered in the differential diagnosis, since the treatment strategies for these conditions are radically different.

  8. Acute hydrocarbon pneumonia after white spirit aspiration: sequential HRCT findings

    Hydrocarbon pneumonia is a very uncommon condition resulting from aspiration of mineral oil into the lung. We report the first description of early and sequential high-resolution computed tomographic (HRCT) findings of hydrocarbon pneumonia following attempted suicide by white spirit aspiration. Initial HRCT showed patchy opacities of coalescing masses with well-defined walls. They were visible in the middle lobe, lingula and lower lobes. Follow-up CT showed regression of the alveolar opacities, the presence of pneumatoceles and right asymptomatic pneumothorax. After 23 months of follow-up, the patient remained asymptomatic, and the follow-up CT scan was considered normal. The radiological features and a review of the relevant literature are briefly discussed. (orig.)

  9. Chest physiotherapy in children with acute bacterial pneumonia

    Lieselotte Corten

    2015-04-01

    Full Text Available Background: Pneumonia is the single leading cause of death in children younger than 5 years of age. Chest physiotherapy is often prescribed as an additional therapy in children with pneumonia. Different chest physiotherapy techniques are available that aim to improve airway clearance, gas exchange and reduce the work of breathing. However, it is unclear if these techniques are effective in this population.Objective: The present review aimed to determine the efficacy of different chest physiotherapy techniques compared with no physiotherapy or other chest physiotherapy treatments in hospitalised children with bacterial pneumonia.Method: Six electronic databases (PubMed, Medline, Cochrane Library, PEDro, CINAHL and Africa-wide information, clinicaltrials.gov and pactr.org were searched for eligible studies.Results: Two randomised controlled trials and one ongoing study were identified. Neither completed trial reported differences between the control and intervention groups, although one study reported a longer duration of coughing (p = 0.04 and rhonchi (p = 0.03 in the intervention group.Conclusion: Because of the limited number of included articles and different presentations of outcome measures, we could not reject or accept chest physiotherapy as either an effective or harmful treatment option in this population.

  10. Sudden psychotic episode probably due to meningoencephalitis and Chlamydia pneumoniae acute infection

    Canas Nuno

    2005-09-01

    Full Text Available Abstract Background Since 9% to 20% of all cases of acute psychosis presenting to an Emergency Department (ED are due to a general medical condition, cautious medical workup should be mandatory in such patients. Differential diagnosis must consider conditions as diverse as renal failure or CNS infection. Acute Chlamydia pneumoniae infection usually causes a self-limited respiratory syndrome. Rarely, acute neurological complications occur, with acute meningoencephalitis most frequently reported. Diagnosis requires a high level of suspicion and is difficult to confirm. Case report We describe a 22 year-old female Caucasian who, three days after a mild pharingitis, developed an acute psychosis with exuberant symptoms interspersed with periods of lucidity, in a background of normal consciousness and orientation. Initial medical and imagiological workup were inconclusive. After 20 days of unsuccessful treatment with antipsychotics she developed a high fever and was re-evaluated medically. Lumbar puncture revealed an inflammatory cerebrospinal fluid. MRI showed irregular thickening and nodularity of the lateral ventricles' lining. An anti-Chlamydia pneumoniae IgM antibody titter of 85 IU/ml was detected. All symptoms cleared after treatment with antibiotics and corticosteroids. Conclusion This is, to our knowledge, the first reported case of acute CP-associated meningoencephalitis manifesting as an acute psychotic episode. It illustrates the principle that non-organic psychiatric syndromes must remain a diagnosis of exclusion in first-time acute psychosis.

  11. A(H1N1)Influenza Pneumonia with Acute Disseminated Encephalomyelitis: A Case Report

    JUN YANG; YU-GUANG WANG; YUN-LIANG XU; XIAN-LING REN; YU MAO; XING-WANG LI

    2010-01-01

    @@ INTRODUCTION A 56-year-old Chinese female patient with A (H1N1) influenza pneumonia accompanied by acute disseminated encephalomyelitis (ADEM) of the Central Nervous System (CNS) is described in this article. The patient had typical clinical manifestation,and the diagnosis was reached after MRI and other examinations. From this case, we can conclude that the virus ofA (H1N1) influenza can infect CNS, and we should pay more attention to patients of A (H1N1)influenza pneumonia with neurological complications.

  12. Some points of the X-ray pattern of acute viral primary pneumonia caused by acute respiratory disease viruses

    An analysis is made of the results of the X-ray studies as well as of the virological and serological tests in 225 out-patients consulted in the first days of their complaints. A predominance of the viral (70.2%) over the viral-bacterial primary pneumonia is established. The acute viral primary pneumonia are caused mostly by single influenza viruses and more rarely - by single respiratory viruses; in the cases of combined influenza viruses influenza-influenza viruses prevail over the influenza-respiratory ones. The morphological changes in pneumonia due to isolated single influenza viruses involve mostly the interstitium and are projected on X-ray as patchy and stripped densities. The inflamatory changes in pneumonia caused by combined influenza viruses affect both ihe interstitium and the broncho-alveolar substrate of the lungs; they are manifested in two roentgenologic forms: creeping (migrating) and fusing (confluent). In viral-bacterial pneumonia the changes affect mostly the lobe. The right lung and the lower parts of the both lungs are affected in most cases. 5 figs., 21 refs

  13. Asthma and pneumonia among children less than five years with acute respiratory symptoms in Mulago Hospital, Uganda

    Nantanda, Rebecca; Tumwine, James K; Ndeezi, Grace;

    2013-01-01

    Pneumonia is considered the major cause of mortality among children with acute respiratory disease in low-income countries but may be over-diagnosed at the cost of under-diagnosing asthma. We report the magnitude of asthma and pneumonia among "under-fives" with cough and difficulty breathing, based...

  14. Novel type of Streptococcus pneumoniae causing multidrug-resistant acute otitis media in children.

    Xu, Qingfu; Pichichero, Michael E; Casey, Janet R; Zeng, Mingtao

    2009-04-01

    After our recent discovery of a Streptococcus pneumoniae 19A "superbug" (Legacy strain) that is resistant to all Food and Drug Administration-approved antimicrobial drugs for treatment of acute otitis media (AOM) in children, other S. pneumoniae isolates from children with AOM were characterized by multilocus sequence typing (MLST). Among 40 isolates studied, 16 (40%) were serotype 19A, and 9 (23%) were resistant to multiple antimicrobial drugs. Two others had unreported sequence types (STs) that expressed the 19A capsule, and 8 (88%) of the 9 multidrug-resistant strains were serotype 19A, including the Legacy strain with the new ST-2722. In genetic relatedness, ST-2722 belonged to a cluster of reported strains of S. pneumoniae in which all strains had 6 of the same alleles as ST-156. The multidrug-resistant strains related to ST-156 expressed different capsular serotypes: 9V, 14, 11A, 15C, and 19F. PMID:19331730

  15. Acute and subacute chemical-induced lung injuries: HRCT findings

    Lung injury caused by chemicals includes bronchitis, bronchiolitis, chemical pneumonitis, pulmonary edema, acute respiratory distress syndrome, organizing pneumonia, hypersensitivity pneumonitis, acute eosinophilic pneumonia, and sarcoid-like granulomatous lung disease. Each chemical induces variable pathophysiology and the situation resembles to the drug induced lung disease. The HRCT features are variable and nonspecific, however HRCT may be useful in the evaluation of the lung injuries and so we should know about HRCT features of lung parenchymal abnormalities caused by chemicals

  16. Acute and subacute chemical-induced lung injuries: HRCT findings

    Akira, Masanori, E-mail: Akira@kch.hosp.go.jp [Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai City, Osaka 591-8555 (Japan); Suganuma, Narufumi [Department of Environmental Medicine, Kochi Medical School (Japan)

    2014-08-15

    Lung injury caused by chemicals includes bronchitis, bronchiolitis, chemical pneumonitis, pulmonary edema, acute respiratory distress syndrome, organizing pneumonia, hypersensitivity pneumonitis, acute eosinophilic pneumonia, and sarcoid-like granulomatous lung disease. Each chemical induces variable pathophysiology and the situation resembles to the drug induced lung disease. The HRCT features are variable and nonspecific, however HRCT may be useful in the evaluation of the lung injuries and so we should know about HRCT features of lung parenchymal abnormalities caused by chemicals.

  17. The Infection of Chlamydia Pneumonia in Patients with Acute Myocardial Infarction

    李涛; 许香广; 张国良; 方卫华

    2004-01-01

    Objectives To study the association between infection with chlamydia pneumonia and acute myocardial infarction (AMI). Methods Serology of chlamydia pneumoniae specific IgG、IgM antibodies were measured by microimmunofluorescence test in groups of acute myocardial infarction (AMI) and health control(HC). Results The total infection positive rates were 30.6% in HC group and 88.1% in AMI group, including the previous infection rates which were 30.6% and 71.4%, while the acute infection rates were 0% and 16.7%. The frequency of total infection, previous infection and acute infection was significantly higher in AMI group than in the HC group. Odds Ratio for the development of AMI were 16.82, 5.68, 14.2, respectively(95% CI 5.83 to 48.54,2.46 to 13.11, 1.68 to 119.97). Geometric mean IgG titre was significantly higher in patients with AMI compared with the HC group (P< 0.01). There is no IgM positive in HC group but there were two cases in AMI group. Conclusions The presence of high titers of immmunoglobulin G in AMI. Chlamydia pneumonia infection may be a risk factor for the AMI .

  18. Clinical Predictors of Hospital-acquired Pneumonia Associated with Acute Ischemic

    Alexis Suárez Quesada

    2015-06-01

    Full Text Available Background: hospital-acquired pneumonia is a constant challenge given the current microbiological spectrum, antimicrobial resistance together with its high mortality, morbidity and hospital costs. Objective: to identify the clinical predictors of pneumonia associated with acute ischemic stroke. Methods: a prospective cohort study was conducted in 201 patients diagnosed with acute ischemic stroke consecutively admitted to the stroke unit of the General Carlos Manuel de Céspedes Teaching Hospital during the first seven days after the onset, from January 2012 through December 2013. The independent predictors of hospital-acquired pneumonia were obtained using multivariable logistic regression. Results: fifty six point seven percent were male. The mean age was 64.17 ± 14.33 years. Cases of hospital-acquired pneumonia associated with stroke accounted for 19, 9 %. Subjects who developed pneumonia were older (68.55 ± 13.51 vs. 63.08 ± 14.36 years, had a lower score in the Glasgow Coma Scale (8.00 ± 2.60 vs. 14.00 ± 2.82, and an increased number of leukocytes at admission (10.888 ± 3.487 vs. 9.233 ± 2.539 × 109/L. The following independent factors were identified: Glasgow Coma Scale ≤ 11 (OR: 26.099; 95 % CI 7.164-85.075, history of chronic obstructive pulmonary disease (OR: 8.896; 95 % CI 1.203-65.779, dysphagia (OR: 7.652; 95 % CI 2.369- 24.720, history of heart failure (OR: 4.583; 95 % CI 1.240- 16.932 and dysarthria/severe motor aphasia (OR: 4.222; 95 % CI 1.374- 12.975. Conclusions: the resulting logistic regression model is valid for predicting post-stroke pneumonia based on data routinely acquired.

  19. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid.

    Yasui, Hideki; Yokomura, Koshi; Suda, Takafumi

    2016-01-01

    Acute exogenous lipoid pneumonia is a rare disorder in adults. A treatment of choice for lipoid pneumonia has not been established, and systemic corticosteroid use remains controversial. We report the case of a 32-year-old man with schizophrenia who presented with kerosene-induced acute exogenous lipoid pneumonia that was treated with a systemic corticosteroid. In this case, supportive therapy did not improve the patient's condition, so systemic corticosteroid therapy was commenced four days after he ingested the kerosene. After corticosteroid commencement, the patient's symptoms and hypoxia improved within a few days. Although some radiological characteristics of this disorder have been reported previously, the process of radiological improvement of exogenous lipoid pneumonia is not well known. In this case, computed tomography findings changed dramatically after corticosteroid therapy was initiated. Extensive bilateral consolidations that were observed on admission improved. Although pneumatoceles developed two weeks after corticosteroid commencement, they were nearly gone after two months of the treatment. While corticosteroid therapy is not suitable for all cases, it should be considered for severe or refractory cases. PMID:27222789

  20. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid

    Hideki Yasui

    2016-01-01

    Full Text Available Acute exogenous lipoid pneumonia is a rare disorder in adults. A treatment of choice for lipoid pneumonia has not been established, and systemic corticosteroid use remains controversial. We report the case of a 32-year-old man with schizophrenia who presented with kerosene-induced acute exogenous lipoid pneumonia that was treated with a systemic corticosteroid. In this case, supportive therapy did not improve the patient's condition, so systemic corticosteroid therapy was commenced four days after he ingested the kerosene. After corticosteroid commencement, the patient's symptoms and hypoxia improved within a few days. Although some radiological characteristics of this disorder have been reported previously, the process of radiological improvement of exogenous lipoid pneumonia is not well known. In this case, computed tomography findings changed dramatically after corticosteroid therapy was initiated. Extensive bilateral consolidations that were observed on admission improved. Although pneumatoceles developed two weeks after corticosteroid commencement, they were nearly gone after two months of the treatment. While corticosteroid therapy is not suitable for all cases, it should be considered for severe or refractory cases.

  1. Protective role of murine norovirus against Pseudomonas aeruginosa acute pneumonia.

    Thépaut, Marion; Grandjean, Teddy; Hober, Didier; Lobert, Pierre-Emmanuel; Bortolotti, Perrine; Faure, Karine; Dessein, Rodrigue; Kipnis, Eric; Guery, Benoit

    2015-01-01

    The murine norovirus (MNV) is a recently discovered mouse pathogen, representing the most common contaminant in laboratory mouse colonies. Nevertheless, the effects of MNV infection on biomedical research are still unclear. We tested the hypothesis that MNV infection could alter immune response in mice with acute lung infection. Here we report that co-infection with MNV increases survival of mice with Pseudomonas aeruginosa acute lung injury and decreases in vivo production of pro-inflammatory cytokines. Our results suggest that MNV infection can deeply modify the parameters studied in conventional models of infection and lead to false conclusions in experimental models. PMID:26338794

  2. Case Report: Human Bocavirus Associated Pneumonia as Cause of Acute Injury, Cologne, Germany

    Krakau, Michael; Gerbershagen, Kathrin; Frost, Ulrich; Hinzke, Markus; Brockmann, Michael; Schildgen, Verena; Goßmann, Axel; Limmroth, Volker; Dormann, Arno; Schildgen, Oliver

    2015-01-01

    Abstract Although the human bocavirus (HBoV) is known since a decade, limited information about its pathogenesis is available due to the lack of an animal model. Thus, clinical cases and studies are the major source of novel information about the course of infection and the related pathophysiology. In this context, a clinical case of an adult patient suffering from severe HBoV-pneumonia is described that was associated with loss of consciousness followed by acute rib fracture and subsequent n...

  3. The Diagnostic Value of Serum C-Reactive Protein for Identifying Pneumonia in Hospitalized Patients with Acute Respiratory Symptoms

    Utrillo, Laia; Bielsa, Silvia; Falguera, Miquel; Porcel, José M.

    2016-01-01

    Background. The clinical diagnosis of pneumonia is sometimes difficult since chest radiographs are often indeterminate. In this study, we aimed to assess whether serum C-reactive protein (CRP) could assist in identifying patients with pneumonia. Methods. For one winter, all consecutive patients with acute respiratory symptoms admitted to the emergency ward of a single center were prospectively enrolled. In addition to chest radiographs, basic laboratory tests, and microbiology, serum levels of CRP were measured at entry. Results. A total of 923 (62.3%) of 1473 patients hospitalized for acute respiratory symptoms were included. Subjects with a final diagnosis of pneumonia had higher serum CRP levels (median 187 mg/L) than those with exacerbations of chronic obstructive pulmonary disease (63 mg/L) or acute bronchitis (54 mg/L, p CRP was accurate in identifying pneumonia (area under the curve 0.84, 95% CI 0.82–0.87). The multilevel likelihood ratio (LR) for intervals of CRP provided useful information on the posttest probability of having pneumonia. CRP intervals above 200 mg/L were associated with LR+ > 5, for which pneumonia is likely, whereas CRP intervals below 75 mg/L were associated with LR CRP may be a useful addition for diagnosing pneumonia in hospitalized patients with acute respiratory symptoms. PMID:27610265

  4. Clinical and Radiological Profile of Acute Fibrinous and Organizing Pneumonia: A Retrospective Study

    Jing-Hong Dai; Hui Li; Wei Shen; Li-Yun Miao; Yong-Long Xiao; Mei Huang; Meng-Shu Cao

    2015-01-01

    Background:Acute fibrinous and organizing pneumonia (AFOP) is a unique pathological entity with intra-alveolar fibrin in the form of "fibrin balls" and organizing pneumonia.It was divided into rare idiopathic interstitial pneumonia according to the classification notified by American Thoracic Society/European Respiratory Society in 2013.As a rare pathological entity,it is still not well known and recognized by clinicians.We reviewed the clinical features of 20 patients with AFOP diagnosed in a teaching hospital.Methods:The medical records of 20 patients with biopsy-proven diagnosis of AFOP were retrospectively reviewed.The patients' symptoms,duration of the disease,comorbidities,clinical laboratory data,pulmonary function testing,radiographic studies,and the response to treatment were extracted and analyzed.Results:Fever was the most common symptom and was manifested in 90% of AFOP patients.For clinical laboratory findings,systematic inflammatory indicators,including C-reactive protein and erythrocyte sedimentation rate,were significantly higher than normal in AFOP patients.In accordance with this increased indicators,injured liver functions were common in AFOP patients.Inversely,AFOP patients had worse clinical conditions including anemia and hypoalbuminemia.For pulmonary function testing,AFOP patients showed the pattern of restrictive mixed with obstructive ventilation dysfunction.For high-resolution computerized tomography (HRCT) findings,the most common pattern for AFOP patients was lobar consolidation which was very similar to pneumonia.However,unlike pneumonia,AFOP patients responded well to glucocorticoids.Conclusion:Patients with AFOP manifest as acute inflammatory-like clinical laboratory parameters and lobar consolidation on HRCT,but respond well to steroid.

  5. Acute exposure of mice to high-dose ultrafine carbon black decreases susceptibility to pneumococcal pneumonia

    Gordon Stephen

    2010-10-01

    Full Text Available Abstract Background Epidemiological studies suggest that inhalation of carbonaceous particulate matter from biomass combustion increases susceptibility to bacterial pneumonia. In vitro studies report that phagocytosis of carbon black by alveolar macrophages (AM impairs killing of Streptococcus pneumoniae. We have previously reported high levels of black carbon in AM from biomass smoke-exposed children and adults. We therefore aimed to use a mouse model to test the hypothesis that high levels of carbon loading of AM in vivo increases susceptibility to pneumococcal pneumonia. Methods Female outbred mice were treated with either intranasal phosphate buffered saline (PBS or ultrafine carbon black (UF-CB in PBS; 500 μg on day 1 and day 4, and then infected with S. pneumoniae strain D39 on day 5. Survival was assessed over 72 h. The effect of UF-CB on AM carbon loading, airway inflammation, and a urinary marker of pulmonary oxidative stress was assessed in uninfected animals. Results Instillation of UF-CB in mice resulted a pattern of AM carbon loading similar to that of biomass-smoke exposed humans. In uninfected animals, UF-CB treated animals had increased urinary 8-oxodG (P = 0.055, and an increased airway neutrophil differential count (P . pneumoniae, whereas morbidity and mortality after infection was reduced in UF-CB treated animals (median survival 48 h vs. 30 h, P . pneumoniae colony forming unit counts, and lower airway levels of keratinocyte-derived chemokine/growth-related oncogene (KC/GRO, and interferon gamma. Conclusion Acute high level loading of AM with ultrafine carbon black particles per se does not increase the susceptibility of mice to pneumococcal infection in vivo.

  6. Eosinophilic colitis

    Nnenna Okpara; Bassam Aswad; Gyorgy Baffy

    2009-01-01

    Eosinophilic colitis (EC) is a rare form of primary eosinophilic gastrointestinal disease with a bimodal peak of prevalence in neonates and young adults. EC remains a little understood condition in contrast to the increasingly recognized eosinophilic esophagitis. Clinical presentation of EC is highly variable according to mucosal, transmural, or serosal predominance of inflammation. EC has a broad differential diagnosis because colon tissue eosinophilia often occurs in parasitic infection, drug-induced allergic reactions,inflammatory bowel disease, and various connective tissue disorders, which require thorough searching for secondary causes that may be specifically treated with antibiotics or dietary and drug elimination.Like eosinophilic gastrointestinal disease involving other segments of the gastrointestinal tract, EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics.

  7. Acute exogenous lipoid pneumonia caused by accidental kerosene ingestion in an elderly patient with dementia: a case report.

    Gotanda, Hiroshi; Kameyama, Yumi; Yamaguchi, Yasuhiro; Ishii, Masaki; Hanaoka, Yoko; Yamamoto, Hiroshi; Ogawa, Sumito; Iijima, Katsuya; Akishita, Masahiro; Ouchi, Yasuyoshi

    2013-01-01

    Acute exogenous lipoid pneumonia is an uncommon condition caused by aspiration of oil-based substances, occurring mainly in children. Here, we report the case of an 83-year-old patient with Alzheimer's disease who presented with coughing and hypoxia. The diagnosis of acute exogenous lipoid pneumonia caused by accidental kerosene ingestion was made on the basis of the patient's clinical history, and typical radiological and cytological findings. The patient's cognitive impairment and an unsafe environment, in which the patient's 91-year-old husband stored kerosene in an old shochu bottle, were responsible for the accidental ingestion. Acute exogenous lipoid pneumonia should be considered in the differential diagnosis for acute respiratory disorders in the rapidly aging population. PMID:23286561

  8. Acute fibrinous and organising pneumonia: a rare histopathological variant of chemotherapy-induced lung injury.

    Gupta, Arjun; Sen, Shiraj; Naina, Harris

    2016-01-01

    Bleomycin-induced lung injury is the most common chemotherapy-associated lung disease, and is linked with several histopathological patterns. Acute fibrinous and organising pneumonia (AFOP) is a relatively new and rare histological pattern of diffuse lung injury. We report the first known case of bleomycin-induced AFOP. A 36-year-old man with metastatic testicular cancer received three cycles of bleomycin, etoposide and cisplatin, before being transitioned to paclitaxel, ifosfamide and cisplatin. He subsequently presented with exertional dyspnoea, cough and pleuritic chest pain. CT of the chest demonstrated bilateral ground glass opacities with peribronchovascular distribution and pulmonary function tests demonstrated a restrictive pattern of lung disease with impaired diffusion. Transbronchial biopsy revealed intra-alveolar fibrin deposits with organising pneumonia, consisting of intraluminal loose connective tissue consistent with AFOP. The patient received high-dose corticosteroids with symptomatic and radiographic improvement. AFOP should be recognised as a histopathological variant of bleomycin-induced lung injury. PMID:27053543

  9. The Diagnostic Value of Serum C-Reactive Protein for Identifying Pneumonia in Hospitalized Patients with Acute Respiratory Symptoms

    Ruiz-González, Agustín; Utrillo, Laia; Bielsa, Silvia; Falguera, Miquel; PORCEL, José M.

    2016-01-01

    Background. The clinical diagnosis of pneumonia is sometimes difficult since chest radiographs are often indeterminate. In this study, we aimed to assess whether serum C-reactive protein (CRP) could assist in identifying patients with pneumonia. Methods. For one winter, all consecutive patients with acute respiratory symptoms admitted to the emergency ward of a single center were prospectively enrolled. In addition to chest radiographs, basic laboratory tests, and microbiology, serum levels o...

  10. Eosinophilic esophagitis

    Anand R Gupte; Peter V Draganov

    2009-01-01

    Eosinophilic esophagitis is increasingly recognized in adults. The diagnosis is based on the presence of both typical symptoms and pathologic findings on esophageal biopsy. Patients usually present with dysphagia, food impaction and/or reflux-like symptoms, and biopsy of the esophagus shows more than 15 eosinophils per high-power field. In addition,it is essential to exclude the presence of known causes of tissue eosinophilia such as gastroesophageal reflux disease, infections, malignancy, collagen vascular diseases, hypersensitivity, and inflammatory bowel disease. There are no standardized protocols for the therapy of eosinophilic esophagitis. A variety of therapeutic approaches including acid suppression, dietary modi f icat ions, topical cor t icosteroids and endoscopic dilation can be used alone or in combination.

  11. X-ray characteristics of acute pneumonia and its outcomes in infants

    The results of an X-ray stUdy of 921 infants of the first 3 years of life with acute pneumonia (focal-669, focal-conflUent-197, destrUctive-55) were analyzed. In 188 patients with the lethal oUtcome the X-ray and pathomorphological data were compared. Repeated examination of 336 children was done 1-2 yrs. later. The specificities of an X-ray and morphological picture of focal, focal-confluent and destructive pnevmonia and outcomes in infants are presented

  12. Present-day concepts in radiodiagnosis of acute pneumonias in children

    An X-ray study of 300 children with pneumonias of various etiology has shown that Pneumococcus is the most frequent cause of pneumonia whereas Hemophilus and Mycoplasma pneumonia are observed less frequently. The most common types are segmental (41%), lobular (30%), focal-confluent (20%) and focal (9%). Pleuritis complicated a course of pneumonia in more than half of the patients. Pulmonary destructive changes were most frequent in pneumococcal pneumonia (20%), less frequent in Hemophilus pneumonia and undetectable in Mycoplasma pneumonia

  13. Eosinophilic oesophagitis

    Nielsen, Rasmus Gaardskjær; Husby, Steffen

    2007-01-01

    , oral steroids, inhaled (swallowed) steroids, and leucotriene receptor antagonists. Detailed information on the eosinophilic inflammatory processes in the oesophageal mucosa was initially obtained from animal models, in particular with regard to the role of interleukin-5 and the chemokine eotaxin-1 in...

  14. Eosinophilic oesophagitis.

    Bancil, Aaron S; Hewett, Rhys; Hayat, Jamal O; Poullis, Andrew

    2016-07-01

    Eosinophilic oesophagitis is a chronic immune-mediated inflammatory disorder of the oesophagus, characterized by symptoms of dysphagia or food bolus obstruction. Diagnosis is supported by typical histological findings. This article covers pertinent aspects of the disease, pathogenic explanations and treatment options. PMID:27388380

  15. Continuous Regional Arterial Infusion Therapy for Acute Necrotizing Pancreatitis Due to Mycoplasma pneumoniae Infection in a Child

    A case of acute necrotizing pancreatitis due to Mycoplasma pneumoniae infection was treated in an 8-year-old girl. She experienced acute pancreatitis during treatment for M. pneumoniae. Contrast-enhanced computed tomographic scan revealed necrotizing pancreatitis. The computed tomographic severity index was 8 points (grade E). A protease inhibitor, ulinastatin, was provided via intravenous infusion but was ineffective. Continuous regional arterial infusion therapy was provided with gabexate mesilate (FOY-007, a protease inhibitor) and meropenem trihydrate, and the pancreatitis improved. This case suggests that infusion therapy is safe and useful in treating necrotizing pancreatitis in children.

  16. Frequency of Streptococcus pneumonia and Haemophilus influenza in acute exacerbation of chronic obstructive airway disease and their sensitivity to levofloxacin

    Objective: To determine the frequency of Streptococcus pneumoniae and Haemophilus influenzae in acute exacerbation of chronic obstructive pulmonary disease and their sensitivity to levofloxacin. Methods: The cross-sectional study was conducted at the Department of Medicine, AbbasiShaheed Hospital, Karachi, between July 2009 and January 2010. Patients already diagnosed with chronic obstructive pulmonary disease and admitted with symptoms of acute exacerbation were included in the study and their sputum samples were sent for microbiological evaluation. SPSS 16 was used for statistical analysis. Results: Of the total 105 patients in the study, 90 (85.17%) were males. Overall mean age at presentation was 62+-10.2 years. S. pneumoniae was isolated from sputum culture of 33 (31.4%) patients, while 13 (12.4%) patients showed growth of H. influenzae. Out of the 33 sputum specimens of S. pneumoniae, 32 (97.0%) were sensitive to levofloxacin, while 1 (3.0%) was resistant. All the 13 isolates of H. influenzae were sensitive to levofloxacin. Conclusion: S. pneumoniae and H. influenzae are still the most prevalent organisms isolated in acute exacerbation of chronic obstructive pulmonary disease in our population. Levofloxacin is still considered a highly sensitive antibiotic against these common micro-organisms in our population, but S. pneumoniae has started developing resistance against levofloxacin. Therefore, intermittent surveillance regarding development of resistance pattern of common micro-organisms against commonly prescribed antibiotics is required. (author)

  17. Radiological Findings in Children with Acute Pneumonia: Age More Important Than Infectious Agent

    Purpose: To evaluate whether radiological findings and healing time in children with pneumonia are correlated to etiologic agent. Material and Methods: A total of 346 children with radiologically verified acute pneumonia, and with accomplished serological tests for bacteria and viruses, were included in the study. Five etiological groups were analysed: children with bacterial etiology only, with viral etiology only, with mixed bacterial and viral etiology, with Mycoplasma only, and children with no etiology. Results: The chest films of each etiological group were analysed and the findings were correlated to the children's age. The radiological findings did not differ between the etiological groups. Radiological findings correlated significantly with the patient's age. The radiological healing frequency at check-up X-ray was found to be significantly lower in children with mixed bacterial and viral etiology compared to children in each of the other groups and to the material as a whole. Conclusion: Conclusions about the etiology could not be drawn from the chest X-ray findings

  18. Radiological Findings in Children with Acute Pneumonia: Age More Important Than Infectious Agent

    Wahlgren, H.; Mortensson, W.; Eriksson, M.; Finkel, Y.; Forsgren, M.; Leinonen, M. [Astrid Lindgren' s Children' s Hospital, Karolinska Hospital, Stockholm (Sweden). Depts. of Pediatric Radiology and Pediatrics

    2005-07-01

    Purpose: To evaluate whether radiological findings and healing time in children with pneumonia are correlated to etiologic agent. Material and Methods: A total of 346 children with radiologically verified acute pneumonia, and with accomplished serological tests for bacteria and viruses, were included in the study. Five etiological groups were analysed: children with bacterial etiology only, with viral etiology only, with mixed bacterial and viral etiology, with Mycoplasma only, and children with no etiology. Results: The chest films of each etiological group were analysed and the findings were correlated to the children's age. The radiological findings did not differ between the etiological groups. Radiological findings correlated significantly with the patient's age. The radiological healing frequency at check-up X-ray was found to be significantly lower in children with mixed bacterial and viral etiology compared to children in each of the other groups and to the material as a whole. Conclusion: Conclusions about the etiology could not be drawn from the chest X-ray findings.

  19. Eosinophil count - absolute

    Eosinophils; Absolute eosinophil count ... the white blood cell count to give the absolute eosinophil count. ... than 500 cells per microliter (cells/mcL). Normal value ranges may vary slightly among different laboratories. Talk ...

  20. Eosinophilic Lung Disorders

    ... You are here: Health Information > Condition Information Eosinophilic Lung Disorders Eosinophilic lung disorders are a category of ... of Programs and Services Doctors Who Treat Eosinophilic Lung Disorders Rohit K. Katial Rafeul Alam Joshua J. ...

  1. High-flow nasal cannula oxygen therapy for acute exacerbation of interstitial pneumonia: A case series.

    Horio, Yukihiro; Takihara, Takahisa; Niimi, Kyoko; Komatsu, Masamichi; Sato, Masako; Tanaka, Jun; Takiguchi, Hiroto; Tomomatsu, Hiromi; Tomomatsu, Katsuyoshi; Hayama, Naoki; Oguma, Tsuyoshi; Aoki, Takuya; Urano, Tetsuya; Takagi, Atsushi; Asano, Koichiro

    2016-03-01

    We report 3 cases (all men, age: 69-81 years) of acute exacerbation of interstitial pneumonia (AEIP) that were successfully treated with a high-flow nasal cannula (HFNC), which delivers heated, humidified gas at a fraction of inspired oxygen (FIO2) up to 1.0 (100%). Oxygenation was insufficient under non-rebreathing face masks; however, the introduction of HFNC with an FIO2 of 0.7-1.0 (flow rate: 40L/min) improved oxygenation and was well-tolerated until the partial pressure of oxygen in blood/FIO2 ratio increased (between 21 and 26 days). Thus, HFNC might be an effective and well-tolerated therapeutic addition to the management of AEIP. PMID:26879483

  2. A case of acute fibrinous and organizing pneumonia during early postoperative period after lung transplantation.

    Alici, I O; Yekeler, E; Yazicioglu, A; Turan, S; Tezer-Tekce, Y; Demirag, F; Karaoglanoglu, N

    2015-04-01

    Acute fibrinous and organizing pneumonia (AFOP) is a distinct histologic pattern usually classified under the term chronic lung allograft dysfunction. We present a 48-year-old female patient who experienced AFOP during the 2nd week of double lung transplantation for pulmonary Langerhans cell histiocytosis and secondary pulmonary hypertension. During the 8th day after transplantation, fever and neutrophilia developed together with bilateral consolidation. Infection markers were elevated. Despite coverage of a full antimicrobial spectrum, the situation progressed. The patient was diagnosed with AFOP with transbronchial biopsy. The infiltration resolved and the patient improved dramatically with the initiation of pulse corticosteroid treatment. AFOP should be suspected when there is a pulmonary consolidation after lung transplantation, even in the very early post-transplantation period. Several causes, such as alveolar damage and drug reactions, should be considered in the differential diagnosis. PMID:25891742

  3. Post-infective transverse myelitis following Streptococcus pneumoniae meningitis with radiological features of acute disseminated encephalomyelitis: a case report

    Williams Thomas

    2012-09-01

    Full Text Available Abstract Introduction Post-infectious autoimmune demyelination of the central nervous system is a rare neurological disorder typically associated with exanthematous viral infections. We report an unusual presentation of the condition and a previously undocumented association with Streptococcus pneumonia meningitis. Case presentation A 50-year-old Caucasian woman presented to our facility with an acute myelopathy three days after discharge following acute Streptococcus pneumoniae meningitis. Imaging studies of the spine ruled out an infective focus and no other lesions were seen within the cord. Diffuse, bilateral white matter lesions were seen within the cerebral hemispheres, and our patient was diagnosed as having a post-infective demyelination syndrome that met the diagnostic criteria for an acute transverse myelitis. Our patient clinically and radiologically improved following treatment with steroids. Conclusions The novel association of a Streptococcus pneumoniae infection with post-infectious autoimmune central nervous system demyelination should alert the reader to the potentially causative role of this common organism, and gives insights into the pathogenesis. The unusual dissociation between the clinical presentation and the location of the radiological lesions should also highlight the potential for the condition to mimic the presentation of others, and stimulates debate on the definitions of acute transverse myelitis and acute disseminated encephalomyelitis, and their potential overlap.

  4. Clinical Risk Factors of Death From Pneumonia in Children with Severe Acute Malnutrition in an Urban Critical Care Ward of Bangladesh

    Mohammod Jobayer Chisti; Mohammed Abdus Salam; Hasan Ashraf; Faruque, Abu S. G.; Pradip Kumar Bardhan; Md Iqbal Hossain; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Sumon Kumar Das; Gazi Imran; Tahmeed Ahmed

    2013-01-01

    BACKGROUND: Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM) as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. METHODS: For this unmatched case-control design, SAM children of either sex, aged 0-59 months, admitted to the Dh...

  5. [Eosinophilic esophagitis].

    Couto, Mariana; Rodrigues, Susana; Piedade, Susana; Gaspar, Ângela; Morais-Almeida, Mário; Macedo, Guilherme

    2011-12-01

    Eosinophilic esophagitis (EE) is an inflammatory disease of the esophagus characterized by significant and isolated infiltration of the esophageal mucosa by eosinophils, associated with clinical symptoms of esophageal dysfunction, affecting children and adults. It is an increasingly frequent cause of symptoms similar to gastroesophageal reflux disease but refractory to anti-acid therapeutic. It is commonly associated with food allergies or other atopic diseases. Since there are no symptoms, signs, serological biomarkers or endoscopic findings pathognomonic of EE, the diagnosis requires a high degree of suspicion; moreover, due to its chronic relapsing nature the potential to cause major esophageal structural changes, its early recognition and close cooperation between gastroenterologists and immunoallergologists is essential for the timely institution of appropriate therapy. The treatment is based on two main strategies: diet and / or pharmacotherapy, depending on the co-existence of sensitization to food allergens. It is our aim to review this issue, considering recent guidelines, as well as propose a diagnostic and therapeutic algorithm. PMID:22863504

  6. An outbreak of acute bovine mastitis caused by Klebsiella pneumoniae in a dairy herd

    Silva N.

    2001-01-01

    Full Text Available An outbreak of coliform mastitis is described in a dairy herd from the State of Rio de Janeiro, Brazil. During a four-month period 14 fatal cases of Klebsiella pneumoniae-related mastitis were observed in a herd of 104 lactating cows. The symptoms included peracute enterotoxemia in which the cows died 6 to 12 h after the detection of mastitis by CMT. Staphylococcus aureus and Streptococcus agalactiae Streptococcus agalactiae were also isolated although could not be associated with cases of acute fatal mastitis. Milking practices were also evaluated. The milking machine was being used correctly and adequate precautions for hygiene and pre-milking and post-milking teat dipping were used. The organism was sensitive to gentamicin. Therapy for acute toxic mastitis required early action for the treatment of infections, involving corticosteroids and fluid therapy. The use of a Klebsiella vaccine produced from the microorganisms isolated from the herd, associated with hygiene measures, resulted in the control of the outbreak.

  7. Pulmonary fibrosis following pneumonia due to acute Legionnaires' disease. Clinical, ultrastructural, and immunofluorescent study.

    Chastre, J; Raghu, G; Soler, P; Brun, P; Basset, F; Gibert, C

    1987-01-01

    During a recent nosocomial outbreak, 20 critically ill patients with acute Legionnaires' disease were admitted to the intensive care unit of Hopital Bichat, Paris. Pulmonary specimens were obtained at surgery or immediately after death in 12 patients and were examined by light, immunofluorescent, and electron microscopy. Five of these 12 patients showed evidence of pulmonary fibrosis. In all of these five patients, infection with Legionella pneumophila was evidenced by bacteriologic methods, and other diseases known to cause fibrosis were excluded. The condition of four patients deteriorated rapidly with respiratory failure, and they died with pulmonary fibrosis. Only one patient finally recovered but was left with pulmonary sequelae. Two distinctive morphologic patterns were observed, one in which interstitial fibrosis was predominant and one in which intra-alveolar organization and fibrosis were also present. The alveolar epithelial lining and the basement membranes were disrupted in all patients, as evidenced by ultrastructural observations and by immunofluorescent studies showing gaps in the distribution of type 4 collagen and laminin. Types 1 and 3 collagen accumulated in areas corresponding to thickened interstitium and intra-alveolar fibrosis. Thus, some patients who survive the acute pneumonia of Legionnaires' disease may develop pulmonary fibrosis, and this process may lead to functional impairment or death despite prompt and appropriate treatment. PMID:3539546

  8. TNF-α Induces Transient Resistance to Fas-induced Apoptosis in Eosinophilic Acute Myeloid Leukemia Cells

    Yimin Qin; Sogyong Auh; Lyubov Blokh; Catherine Long; Isabelle Gagnon; Kimm J. Hamann

    2007-01-01

    Tumor necrosis factor α (TNF-α) has been recognized as an activator of nuclear factor κB (NF-κB), a factor implicated in the protection of many cell types from apoptosis. We and others have presented evidence to suggest that Fas-induced apoptosis may be an important aspect of the resolution of inflammation, and that delayed resolution of inflammation may be directly associated with NF-κB-dependent resistance to Fas. Because TNF-α activates NF-κB in many cell types including inflammatory cells such as eosinophils, we examined effects of TNF-α signaling on the Fas-mediated killing of an eosinophilic cell line AML14. While agonist anti-Fas (CH11) treatment induced apoptosis in AML14 cells, no significant cell death occurred in response to TNF-α alone. Electrophoretic mobility shift assay (EMSA) revealed that TNF-α induced NF-κB transactivation in AML14 cells in a time- and dose-dependent fashion, and subsequent supershift assays indicated that the translocated NF-κB was the heterodimer p65 (RelA)/p50. Pre-treatment of cells with TNF-α dramatically decreased the CH11-induced cell death in a transient fashion, accompanied by suppression of activation of caspase-8 and caspase-3 activation. Inhibition of NF-κB transactivation by inhibitors, BAY 11-7085 and parthenolide, reversed the suppression of Fas-mediated apoptosis by TNF-α. Furthermore, TNF-α up-regulated X-linked inhibitor of apoptosis protein (XIAP) transiently and XIAP levels were correlated with the temporal pattern of TNF-α protection against Fas-mediated apoptosis. This finding suggested that TNF-α may contribute to the prolonged survival of inflammatory cells by suppression of Fas-mediated apoptosis, the process involved with NF-κB transactivation, anti-apoptotic XIAP up-regulation and caspase suppression.

  9. Community-acquired pneumonia and survival of critically ill acute exacerbation of COPD patients in respiratory intensive care units

    Cheng, Yusheng; Lu, Zhiwei; Tu,Xiongwen; Chen, Liang; Chen, Hu; Yang, Jian; Wang, Jinyan; Zhang, Liqin

    2016-01-01

    Zhiwei Lu,* Yusheng Cheng,* Xiongwen Tu, Liang Chen, Hu Chen, Jian Yang, Jinyan Wang, Liqin Zhang Department of Respiratory Medicine, Yijishan Hospital of Wannan Medical College, Wuhu, People’s Republic of China *These authors contributed equally to this work Purpose: The aim of this study was to appraise the effect of community-acquired pneumonia (CAP) on inhospital mortality in critically ill acute exacerbation of COPD (AECOPD) patients admitted to a respiratory intens...

  10. beta-lactamase-producing nontypeable Haemophilus influenzae fails to protect Streptococcus pneumoniae from amoxicillin during experimental acute otitis media

    Westman, E.; Lundin, S.; Hermansson, Ann; Melhus, Åsa

    2004-01-01

    Acute otitis media (AOM) is the most common reason for outpatient antimicrobial therapy. Mixed infections pose a potential problem, since the first-line drug used for the treatment of AOM, amoxicillin, can be neutralized by ß-lactamase-producing pathogens of the upper respiratory tract. To study the effects of a 5-day course of amoxicillin on a mixed middle ear infection, rats were challenged with Streptococcus pneumoniae alone or in combination with ß-lactamase-producing nontypeable Haemophi...

  11. β-Lactamase-Producing Nontypeable Haemophilus influenzae Fails To Protect Streptococcus pneumoniae from Amoxicillin during Experimental Acute Otitis Media

    Westman, Eva; Lundin, Susanne; Hermansson, Ann; Melhus, Åsa

    2004-01-01

    Acute otitis media (AOM) is the most common reason for outpatient antimicrobial therapy. Mixed infections pose a potential problem, since the first-line drug used for the treatment of AOM, amoxicillin, can be neutralized by β-lactamase-producing pathogens of the upper respiratory tract. To study the effects of a 5-day course of amoxicillin on a mixed middle ear infection, rats were challenged with Streptococcus pneumoniae alone or in combination with β-lactamase-producing nontypeable Haemophi...

  12. Eradication of Streptococcus pneumoniae in the Nasopharyngeal Flora of Children with Acute Otitis Media after Amoxicillin-Clavulanate Therapy

    Brook, Itzhak; Gober, Alan E.

    2004-01-01

    Nasopharyngeal cultures were obtained from 60 children with acute otitis media before and after treatment with either 45 or 90 mg of amoxicillin (given as amoxicillin-clavulanate) per kg of body weight per day for 10 days. The number of Streptococcus pneumoniae isolates in the 45-mg/kg group was reduced from 12 to 6 and was reduced from 14 to 1 (P = 0.0261) in the 90-mg/kg group.

  13. Comparison of severe acute respiratory illness (sari) and clinical pneumonia case definitions for the detection of influenza virus infections among hospitalized patients, western Kenya, 2009-2013.

    Makokha, Caroline; Mott, Joshua; Njuguna, Henry N; Khagayi, Sammy; Verani, Jennifer R; Nyawanda, Bryan; Otieno, Nancy; Katz, Mark A

    2016-07-01

    Although the severe acute respiratory illness (SARI) case definition is increasingly used for inpatient influenza surveillance, pneumonia is a more familiar term to clinicians and policymakers. We evaluated WHO case definitions for severe acute respiratory illness (SARI) and pneumonia (Integrated Management of Childhood Illnesses (IMCI) for children aged <5 years and Integrated Management of Adolescent and Adult Illnesses (IMAI) for patients aged ≥13 years) for detecting laboratory-confirmed influenza among hospitalized ARI patients. Sensitivities were 84% for SARI and 69% for IMCI pneumonia in children aged <5 years and 60% for SARI and 57% for IMAI pneumonia in patients aged ≥13 years. Clinical pneumonia case definitions may be a useful complement to SARI for inpatient influenza surveillance. PMID:27219455

  14. [Anesthetic management of posterior lumbar spinal fusion in a patient suspected of having acute exacerbation of chronic interstitial pneumonia].

    Sakai, Mayuko; Takenami, Tamie; Otsuka, Tomohisa; Hayashi, Norito; Yoshino, Kazuhisa; Matsumoto, Shigehiro; Okamoto, Hirotsugu

    2014-02-01

    A patient complicated with interstitial pneumonia required emergency posterior lumbar spinal fusion. The blood gas analysis showed relatively benign values (PaO2 81 torr, PaCO2 44 torr, under room air), but the honeycombing lungs were noted in the bilateral lung fields on CT, and the KL-6 level was high (1,000 U x ml(-1)), for which the acute exacerbation of interstitial pneumonia was suspected. Sivelestat sodium administration was initiated during the surgery and continued postoperatively. During surgery, setting the FIO2 at 0.34, the P/F ratio and intra-airway pressure could be maintained at 500 and 25 mmHg, respectively. To reduce postoperative respiratory complication, anesthesia was maintained with desflurane, which is dissipated easily, and 0.5% ropivacaine 15 ml was subcutaneously injected to the surgical field at the time of wound closure to reduce the total doses of intraoperative fentanyl and postoperative analgesics. After the completion of surgery, the endotracheal tube was removed with head elevated position, and the patient was transported back to the ward. No acute exacerbation occurred thereafter, and the patient was discharged 67 days after surgery. The prediction of acute exacerbation of interstitial pneumonia is difficult. Moreover, there is no established preventive method, although the mortality is high. Therefore, physicians should be thoroughly informed about the currently available evidence, including developmental factors. PMID:24601111

  15. Serum total IgE levels and total eosinophil counts: relationship with treatment response in patients with acute asthma Relação dos níveis séricos de IgE total e das contagens de eosinófilos com a resposta ao tratamento em pacientes com asma aguda

    Ebrahim Razi; Gholam Abbass Moosavi

    2010-01-01

    OBJECTIVE: To determine whether serum total IgE levels and total eosinophil counts have any relationship with the response to routine pharmacological treatment in patients with acute asthma. METHODS: A cross-sectional study involving 162 patients with acute asthma. Serum total IgE levels, peripheral blood cell counts and eosinophil counts were determined. The treatment was adjusted for each patient according to the severity of asthma. Spirometry was performed at baseline and two weeks after t...

  16. Lipid metabolites as potential diagnostic and prognostic biomarkers for acute community acquired pneumonia.

    To, Kelvin K W; Lee, Kim-Chung; Wong, Samson S Y; Sze, Kong-Hung; Ke, Yi-Hong; Lui, Yin-Ming; Tang, Bone S F; Li, Iris W S; Lau, Susanna K P; Hung, Ivan F N; Law, Chun-Yiu; Lam, Ching-Wan; Yuen, Kwok-Yung

    2016-06-01

    Early diagnosis of acute community-acquired pneumonia (CAP) is important in patient triage and treatment decisions. To identify biomarkers that distinguish patients with CAP from non-CAP controls, we conducted an untargeted global metabolome analysis for plasma samples from 142 patients with CAP (CAP cases) and 97 without CAP (non-CAP controls). Thirteen lipid metabolites could discriminate between CAP cases and non-CAP controls with area-under-the-receiver-operating-characteristic curve of >0.8 (P ≤ 10(-9)). The levels of glycosphingolipids, sphingomyelins, lysophosphatidylcholines and L-palmitoylcarnitine were higher, while the levels of lysophosphatidylethanolamines were lower in the CAP cases than those in non-CAP controls. All 13 metabolites could distinguish CAP cases from the non-infection, extrapulmonary infection and non-CAP respiratory tract infection subgroups. The levels of trihexosylceramide (d18:1/16:0) were higher, while the levels of lysophosphatidylethanolamines were lower, in the fatal than those of non-fatal CAP cases. Our findings suggest that lipid metabolites are potential diagnostic and prognostic biomarkers for CAP. PMID:27105773

  17. Acute myocardial infarction versus other cardiovascular events in community-acquired pneumonia

    Stefano Aliberti

    2015-09-01

    Full Text Available The aim of the present study was to define the prevalence, characteristics, risk factors and impact on clinical outcomes of acute myocardial infarction (AMI versus other cardiovascular events (CVEs in patients with community-acquired pneumonia (CAP. This was an international, multicentre, observational, prospective study of CAP patients hospitalised in eight hospitals in Italy and Switzerland. Three groups were identified: those without CVEs, those with AMI and those with other CVEs. Among 905 patients, 21 (2.3% patients experienced at least one AMI, while 107 (11.7% patients experienced at least one other CVE. Patients with CAP and either AMI or other CVEs showed a higher severity of the disease than patients with CAP alone. Female sex, liver disease and the presence of severe sepsis were independent predictors for the occurrence of AMI, while female sex, age >65 years, neurological disease and the presence of pleural effusion predicted other CVEs. In-hospital mortality was significantly higher among those who experienced AMI in comparison to those experiencing other CVEs (43% versus 21%, p=0.039. The presence of AMI showed an adjusted odds ratio for in-hospital mortality of 3.57 (p=0.012 and for other CVEs of 2.63 (p=0.002. These findings on AMI versus other CVEs as complications of CAP may be important when planning interventional studies on cardioprotective medications.

  18. Increased Risk of Acute Kidney Injury following Pneumococcal Pneumonia: A Nationwide Cohort Study

    Lin, Te-Yu; Chen, Yu-Guang; Lin, Cheng-Li; Kao, Chia-Hung

    2016-01-01

    Purpose Pneumococcal disease leads to renal complications ranging from persistent proteinuria to end-stage renal disease. Studies on the association between pneumococcal pneumonia (PP) and acute kidney injury (AKI) are scant. This study assessed the relationship between PP and risk of AKI. Methods This nationwide population-based cohort study examined data from the Taiwan National Health Insurance Research Database for the period 2000–2011. We identified inpatients with newly diagnosed PP according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. In addition, we selected a comparison cohort from inpatient claims without the diagnosis of PP that was randomly frequency-matched with the PP cohort according to age, sex, index year and comorbidities. We analyzed the risks of AKI by using Cox proportional hazards regression models, adjusted for sex, age, and comorbidities. Results A total of 10,069 patients with PP and 10,069 controls were enrolled in this study. After adjustments for age, sex, and comorbidities, patients with PP had a 1.11-fold risk of developing AKI compared with the comparison cohort. Conclusion This study indicates that AKI risks are higher in patients with PP compared with the comparison cohort. Careful follow-up observation and aggressive treatment are necessary for patients with PP to reduce the risk of AKI. PMID:27362355

  19. Recurrent isochromosome 21 and multiple abnormalities in a patient suspected of having acute myeloid leukemia with eosinophilic differentiation-a rare case from South India

    Sangeetha Vijay; Santhi Sarojam; Sureshkumar Raveendran; Vani Syamala; Sreeja Leelakumari; Geetha Narayanan; Sreedharan Hariharan

    2012-01-01

    Acute myeloid leukemia (AML) is a phenotypically heterogeneous disorder.The M4 subtype of AML is frequently associated with the cytogenetic marker inversion 16 and/or the presence of eosinophilia.Blast crisis is the aggressive phase of the triphasic chronic myeloid leukemia (CML),which is a disease with Philadelphia (Ph) chromosome as the major abnormality.In the present study,we report a 76-year-old patient suspected of having AML with eosinophilic differentiation (AML-M4),which in clinical tests resembles CML blast crisis with multiple chromosomal abnormalities.Isochromosome 21 [i(21)(q10)] was the most recurrent feature noted in metaphases with 46 chromosomes.Ring chromosome,tetraploid endoreduplication,recurrent aneuploid clones with loss of X chromosome,monosomy 17,monosomy 7,and structural variation translocation (9;14) were also observed in this patient.Fluorescent in situ hybridization (FISH) confirmed the absence of Ph chromosome.This report shows how cytogenetic analyses revealed atypical structural aberrations in the M4 subtype of AML.

  20. Early warning and prevention of pneumonia in acute leukemia by patient education, spirometry, and positive expiratory pressure

    Møller, Tom; Moser, Claus; Adamsen, Lis;

    2016-01-01

    intervention versus control group (2.17 per 1000 days vs. 6.52 per 1000 days, P = 0.021, respectively). A cross point at 80-76% of the personal FEV1 reference value showed high sensitivity and specificity on pneumonia development. Our data demonstrate the feasibility of educating AML patients in their......Long-lasting neutropenia associated with acute myeloid leukemia (AML) and its treatment gives rise to a high risk of pneumonia. The use of broad-spectrum antibiotic prophylaxis during outpatient management has not completely protected patients against admission due to infections and neutropenic...... fever, emphasizing the need to approach infection protection with complementary efforts. In a randomized controlled design, we examined the applicability of patient-performed daily spirometry [forced expiratory volume in one second (FEV1)] as an early warning tool and explored the effectiveness of...

  1. Immunohistochemical detection of virus through its nuclear cytopathic effect in idiopathic interstitial pneumonia other than acute exacerbation

    G.C. dos Santos

    2013-11-01

    Full Text Available Idiopathic interstitial pneumonias include complex diseases that have a strong interaction between genetic makeup and environmental factors. However, in many cases, no infectious agent can be demonstrated, and these clinical diseases rapidly progress to death. Theoretically, idiopathic interstitial pneumonias could be caused by the Epstein-Barr virus, cytomegalovirus, adenovirus, hepatitis C virus, respiratory syncytial virus, and herpesvirus, which may be present in such small amounts or such configuration that routine histopathological analysis or viral culture techniques cannot detect them. To test the hypothesis that immunohistochemistry provides more accurate results than the mere histological demonstration of viral inclusions, this method was applied to 37 open lung biopsies obtained from patients with idiopathic interstitial pneumonias. As a result, immunohistochemistry detected measles virus and cytomegalovirus in diffuse alveolar damage-related histological patterns of acute exacerbation of idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia in 38 and 10% of the cases, respectively. Alveolar epithelium infection by cytomegalovirus was observed in 25% of organizing pneumonia patterns. These findings were coincident with nuclear cytopathic effects but without demonstration of cytomegalovirus inclusions. These data indicate that diffuse alveolar damage-related cytomegalovirus or measles virus infections enhance lung injury, and a direct involvement of these viruses in diffuse alveolar damage-related histological patterns is likely. Immunohistochemistry was more sensitive than the histological demonstration of cytomegalovirus or measles virus inclusions. We concluded that all patients with diffuse alveolar damage-related histological patterns should be investigated for cytomegalovirus and measles virus using sensitive immunohistochemistry in conjunction with routine procedures.

  2. Risk of pneumonia associated with zero‐degree head positioning in acute ischemic stroke patients treated with intravenous tissue plasminogen activator

    Palazzo, Paola; Brooks, Amy; James, David; Moore, Randy; Andrei V. Alexandrov; Alexandrov, Anne W.

    2016-01-01

    Abstract Introduction In the hyperacute phase of ischemic stroke, a 0° position is recommended to increase cerebral perfusion in nonhypoxic patients able to tolerate lying flat. However, use of 0° positioning is not uniformly applied in clinical practice, most likely due to concerns of aspiration pneumonia. We aimed to determine the risk of pneumonia associated with 0° head of bed positioning in acute stroke patients treated with thrombolytic therapy. Methods A retrospective descriptive study...

  3. Eosinophilic Endotype of Asthma.

    Aleman, Fernando; Lim, Hui Fang; Nair, Parameswaran

    2016-08-01

    Asthma is a heterogeneous disease that can be classified into different clinical endotypes, depending on the type of airway inflammation, clinical severity, and response to treatment. This article focuses on the eosinophilic endotype of asthma, which is defined by the central role that eosinophils play in the pathophysiology of the condition. It is characterized by elevated sputum and/or blood eosinophils on at least 2 occasions and by a significant response to treatments that suppress eosinophilia. Histopathologic demonstration of eosinophils in the airways provides the most direct diagnosis of eosinophilic asthma; but it is invasive, thus, impractical in clinical practice. PMID:27401626

  4. Allergic Airway Inflammation Decreases Lung Bacterial Burden following Acute Klebsiella pneumoniae Infection in a Neutrophil- and CCL8-Dependent Manner

    Dulek, Daniel E.; Newcomb, Dawn C.; Goleniewska, Kasia; Cephus, Jaqueline; Zhou, Weisong; Reiss, Sara; Toki, Shinji; Ye, Fei; Zaynagetdinov, Rinat; Sherrill, Taylor P.; Timothy S. Blackwell; Moore, Martin L.; Boyd, Kelli L.; Kolls, Jay K.; Peebles, R. Stokes

    2014-01-01

    The Th17 cytokines interleukin-17A (IL-17A), IL-17F, and IL-22 are critical for the lung immune response to a variety of bacterial pathogens, including Klebsiella pneumoniae. Th2 cytokine expression in the airways is a characteristic feature of asthma and allergic airway inflammation. The Th2 cytokines IL-4 and IL-13 diminish ex vivo and in vivo IL-17A protein expression by Th17 cells. To determine the effect of IL-4 and IL-13 on IL-17-dependent lung immune responses to acute bacterial infect...

  5. Acute fibrinous and organising pneumonia: a case report and review of the literature

    Tzouvelekis Argyris; Koutsopoulos Anastasios; Oikonomou Anastasia; Froudarakis Marios; Zarogoulidis Pavlos; Steiropoulos Paschalis; Mikroulis Dimitrios; Antoniades Antonis; Bouros Demosthenes

    2009-01-01

    Abstract Introduction Organising pneumonia is a distinct histopathological entity characterized by intra-alveolar buds of granulation tissue, called Masson bodies, which mainly comprise of activated fibroblasts and loose connective tissue. This histopathologic pattern has been described in idiopathic cases, characterizing cryptogenic organising pneumonia as well as in the context of pulmonary infection, drug-induced pneumonitis and following lung transplantation. Although distinct as a clinic...

  6. INTERRELATIONS BETWEEN NEUTRO PHIL ENZYMES AND THEIR INHIBITORS IN PATHOGENESIS OF ACUTE RESPIRATORY DISTRESS SYNDROME ASSOCIATED WITH INFLUENZA PNEUMONIA

    E. V. Prutkina

    2012-01-01

    Full Text Available Abstract. Amounts of several neutrophil enzymes (elastase, myeloperoxidase (MPO, MMP-2 and their local inhibitors, i.e., Clara cell protein (CC16 and HSP-70, have been determined in blood plasma from fifty-two patients with various forms of influenza A/H1N1. Sixteen patients have developed acute respiratory distress syndrome (ARDS. In cases of uncomplicated influenza, elastase and MPO levels were shown to be increased, while MMP-2 levels did not change, along with higher contents of HSP-70 and unchanged CC16 amounts. Upon development of influenza-associated pneumonia, elastase and MPO concentrations became elevated, whereas MMP-2 levels were decreased, along with unchanged amounts of CC16 and HSP-70. In cases of ARDS development, CC16 amounts exhibited a sharp decrease. Meanwhile, contents of other proteins remained at the levels shown for pneumonia patients. It has been shown that increased concentrations of neutrophil elastase and MPO with a relative CC16 deficiency and decreased MMP-2 may represent a mechanism of pneumonia development. Decreased CC16 concentration may serve as a risk predictor of ARDS development.

  7. Update on interstitial pneumonia.

    Wilkins, Pamela A; Lascola, Kara M

    2015-04-01

    Interstitial pneumonias encompass a wide variety of acute and chronic respiratory diseases and include the specific diseases equine multinodular pulmonary fibrosis and acute lung injury and acute respiratory distress. These diseases have been diagnosed in all age groups of horses, and numerous agents have been identified as potential causes of interstitial pneumonia. Despite the varied causes, interstitial pneumonia is uniformly recognized by the severity of respiratory disease and often poor clinical outcome. This article reviews the causal agents that have been associated with the development of interstitial pneumonia in horses. Pathophysiology, clinical diagnosis, and treatment options are discussed. PMID:25770067

  8. Association of Streptococcus pneumoniae nasopharyngeal colonization and other risk factors with acute otitis media in an unvaccinated Indian birth cohort.

    Rupa, V; Isaac, R; Rebekah, G; Manoharan, A

    2016-07-01

    In order to study the epidemiology of acute otitis media (AOM) and Streptococcus pneumoniae nasopharyngeal colonization in the first 2 years of life, we followed up an unvaccinated birth cohort monthly and at visits when sick, with otoscopy to detect AOM and performed nasopharyngeal swabbing to detect S. pneumoniae. Serotyping of positive cultures was also performed. Of 210 babies who were enrolled at birth, 61 (29·05%) experienced 128 episodes of AOM [relative risk 2·63, 95% confidence interval (CI) 1·21-5·75] with maximum incidence in the second half of the first year of life. Episodes ranged from 1 to 7 (mean 2·1 episodes). Most (86·9%) babies with AOM had a positive culture swab giving an odds ratio (OR) of 1·93 (95% CI 1·03-3·62, P = 0·041) for this association. Other risk factors identified for AOM were winter season (OR 3·46, 95% CI 1·56-7·30, P = 0·001), upper respiratory infection (OR 2·43, 95% CI 1·43-4·51, P = 0·005); residents of small households were less likely to develop AOM (OR 0·32, 95% CI 0·17-0·57, P < 0·01). Common S. pneumoniae serotypes isolated during episodes were 19, 6, 15, 35, 7, 23, 9 and 10 which indicated a theoretical coverage for pneumococcal vaccines PCV10 and PCV13 constituent serotypes of 62·8%. We conclude that AOM in Indian infants is often associated with S. pneumoniae colonization of the nasopharynx as well as other risk factors. PMID:26931207

  9. Understanding Pneumonia

    ... and Diseases > Lung Disease Lookup > Pneumonia Learn About Pneumonia 5 Facts You Should Know about Pneumonia Pneumonia ... vaccinated and practicing good health habits What Is Pneumonia? Pneumonia is an infection in one or both ...

  10. Comparison of histological lesions in acute hemorrhagic pneumonia in mink associated with Pseudomonas aeruginosa or Escherichia coli

    Salomonsen, Charlotte Mark; Boye, Mette; Høiby, N.; Jensen, Trine Hammer; Hammer, Anne Sofie

    2013-01-01

    also occurred in farmed mink. The purpose of this study was to compare histological lesions of acute hemorrhagic pneumonia associated with both P. aeruginosa and E. coli in mink, including a description of tissue distribution of pathogens, in an attempt to differentiate between the 2 disease entities...... based on histopathology. The study included material submitted for diagnostic investigation to the National Veterinary Institute in Denmark from 2006 to 2009. Altogether, 19 cases of hemorrhagic pneumonia with a pure lung culture of P. aeruginosa and 18 cases of hemorrhagic pneumonia with a pure lung...... culture of E. coli were examined. Formalin-fixed paraffin-embedded lung tissue obtained from the mink was examined by histology and fluorescence in-situ hybridization (FISH). It was possible to detect a slight histological difference between hemorrhagic pneumonia caused by P. aeruginosa and by E. coli, as...

  11. Interrelationship of interleukin 6, C-reactive protein and Chlamydia pneumoniae IgG antibodies in patients with acute coronary syndromes

    Burazor Ivana; Vojdani Aristo; Burazor Mirko

    2008-01-01

    Background/Aim. Inflammation due to infection could be associated with the development of acute coronary syndromes, clinical manifestations of ongoing atherosclerosis in vessel walls. Our aim was determine whether interleukin 6, C-reactive protein and Chlamydia pneumoniae IgG antibodies are connected with the development of acute coronary syndromes, to evaluate their interrelationship and to examine whether they are predictive of new events and mortality. Methods. This prospective study inclu...

  12. Differential effects of kidney-lung cross-talk during acute kidney injury and bacterial pneumonia

    Singbartl, Kai; Bishop, Jeffery; Wen, Xiaoyan; Murugan, Raghavan; Chandra, Saurabh; Filippi, Marie-Dominique; John A Kellum

    2011-01-01

    Acute kidney injury (AKI) and acute lung injury (ALI) represent serious, complex clinical problems. The combination of AKI and ALI drastically decreases survival. However, detailed knowledge about the interactions between these two organs is scarce.

  13. Zinc for Acute Diarrhea and Amoxicillin for Pneumonia, Do They Work? : Delivered at the AIIMS, IJP Excellence Award for the year 2013 on 7th September 2014.

    Patel, Archana

    2015-08-01

    Acute diarrhea and pneumonia are the two largest killers of under-five children in the world. Zinc, used in management of acute diarrhea and Amoxicillin, used in community acquired pneumonia, feature in the list of 13 Life Saving Commodities for Women's and Children Health by the UN Commission. Zinc has caught wide scientific attention for the conceptual promise it has to offer for prevention, control and treatment of acute diarrhea. This presentation focuses on author's research on the mechanisms by which zinc might contribute to the pathogenesis of acute diarrhea and the degree of success achieved in diarrhea control and treatment by zinc supplementation including its impact on mortality. However, emerging evidence in terms of controlled studies in humans beckons a more complete understanding of the mechanistic basis for zinc supplementation. Current evidence indicates that studies specifically addressing the variability in response to zinc supplementation need to be undertaken to better comprehend these mechanisms. Similarly, the author presented her research that examined the role of oral amoxicillin in community management of severe pneumonia in children and the need to assess its universal efficacy in all children with severe pneumonia. PMID:25731896

  14. Pneumocystis jiroveci pneumonia prophylaxis during maintenance therapy influences methotrexate/6-mercaptopurine dosing but not event-free survival for childhood acute lymphoblastic leukemia

    Levinsen, Mette; Shabaneh, Diana; Bohnstedt, Cathrine;

    2012-01-01

    Trimethoprim-sulfamethoxazole (TMP/SMX) is used in children with acute lymphoblastic leukemia (ALL) to prevent Pneumocystis pneumonia (PCP). We explored to which extent TMP/SMX influenced methotrexate (MTX)/6-mercaptopurine (6MP) dosage, myelosuppression, and event-free survival (EFS) during...

  15. [Angiostrongylosis or eosinophilic meningitis].

    Bourée, Patrice; Dumazedier, Déborah; Dahane, Naïma

    2010-04-20

    Eosinophilic meningitis, or angiostrongyliasis, is a common disease in Asia, in the Caribbean and in the Pacific islands. It is caused by a rat lungworm Angiostrongylus cantonensis. Infection occurs by consumption of raw or undercooked snails. Diagnosis is based on epidemiological criteria, clinical manifestations, elevated count of eosinophils in the cerebrospinal fluid and serological tests. Treatment is symptomatic and supportive. PMID:20465114

  16. Comparison of initial high resolution computed tomography features in viral pneumonia between metapneumovirus infection and severe acute respiratory syndrome

    Objective: To review and compare initial high resolution computed tomography (HRCT) findings in patients with metapneumovirus pneumonia and severe acute respiratory syndrome (SARS-Coronovirus). Materials and methods: 4 cases of metapneumovirus pneumonia (mean age of 52.3 years) in an institutional outbreak (Castle Peak Hospital) in 2008 and 38 cases of SARS-coronovirus (mean age of 39.6 years) admitted to Tuen Mun hospital during an epidemic outbreak in 2003 were included. HRCT findings of the lungs for all patients were retrospectively reviewed by two independent radiologists. Results: In the metapneumovirus group, common HRCT features were ground glass opacities (100%), consolidation (100%), parenchymal band (100%), bronchiectasis (75%). Crazy paving pattern was absent. They were predominantly subpleural and basal in location and bilateral involvement was observed in 50% of patients. In the SARS group, common HRCT features were ground glass opacities (92.1%), interlobular septal thickening (86.8%), crazy paving pattern (73.7%) and consolidation (68%). Bronchiectasis was not seen. Majority of patient demonstrated segmental or lobar in distribution and bilateral involvement was observed in 44.7% of patients. Pleural effusion and lymphadenopathy were of consistent rare features in both groups. Conclusion: Ground glass opacities, interlobular septal thickening and consolidations were consistent HRCT manifestations in both metapneumovirus infection and SARS. The presence of bronchiectasis (0% in SARS) may point towards metapneumovirus while crazy paving pattern is more suggestive of SARS.

  17. Acute respiratory distress syndrome in adenovirus type 4 pneumonia: A case report.

    Narra, R; Bono, P; Zoccoli, A; Orlandi, A; Piconi, S; Grasselli, G; Crotti, S; Girello, A; Piralla, A; Baldanti, F; Lunghi, G

    2016-08-01

    Human adenoviruses (HAdVs) cause a wide spectrum of clinical syndromes, depending on species and types, from mild respiratory infections to deadly pneumonia: in particular, severe infections occur in immunocompromised patients. In this report, we describe the case of a 36 years-old woman admitted to our intensive care unit (ICU) with severe respiratory distress syndrome caused by adenovirus pneumonia, that required invasive respiratory support (mechanical ventilation and extracorporeal membrane oxygenation). Molecular assays detected the virus in respiratory and plasma specimen and sequencing procedure identified HAdV type 4. Patient improved after cidofovir administration. Leukopenia and subsequent bacterial infection occurred, but the patient recovered completely and was discharged from the hospital after 54days. PMID:27354307

  18. An outbreak of acute bovine mastitis caused by Klebsiella pneumoniae in a dairy herd

    Silva N.; Costa G.M.

    2001-01-01

    An outbreak of coliform mastitis is described in a dairy herd from the State of Rio de Janeiro, Brazil. During a four-month period 14 fatal cases of Klebsiella pneumoniae-related mastitis were observed in a herd of 104 lactating cows. The symptoms included peracute enterotoxemia in which the cows died 6 to 12 h after the detection of mastitis by CMT. Staphylococcus aureus and Streptococcus agalactiae Streptococcus agalactiae were also isolated although could not be associated with cases of ac...

  19. Mycoplasma pneumonia

    Mycoplasma pneumonia is an infection of the lungs by the bacteria Mycoplasma pneumoniae (M. pneumoniae) . This type of pneumonia is ... Mycoplasma pneumonia usually affects people younger than 40. People who live or work in crowded areas such ...

  20. Pseudozyma aphidis fungaemia with invasive fungal pneumonia in a patient with acute myeloid leukaemia: case report and literature review.

    Joo, Hyonsoo; Choi, Yeon-Geun; Cho, Sung-Yeon; Choi, Jae-Ki; Lee, Dong-Gun; Kim, Hee-Je; Jo, Irene; Park, Yeon-Joon; Lee, Kyo-Young

    2016-01-01

    Pseudozyma species rarely cause invasive diseases in humans, which are usually isolated from plants. There have been anecdotal reports regarding Pseudozyma species infections in patients with underlying diseases or in neonates. However, clinical data and the pathogenicity in humans are still insufficient. We experienced a case of Pseudozyma aphidis fungaemia with invasive fungal pneumonia that developed during reinduction chemotherapy in a 51-year-old male with acute myeloid leukaemia (AML). P. aphidis was suspected based on the morphology of the yeast isolated from the blood and was confirmed via rDNA gene sequencing analysis. The patient successfully underwent stem cell transplantation with continuing antifungal treatment and finally completely recovered from both the AML and infectious complications. Here, we report a case of P. aphidis infection that developed during neutropenia in an AML patient and review the global literature. PMID:26608844

  1. Ultraviolet blood irradiation in acute exogeneus poisoming for the prevention and treatment of pneumonia

    Possibility of therapeutic application of UV irradiation (UVI) of blood and the mechanism of its medical effect has been studied in 111 patients with intoxication by psychotropic drugs and organic phosphorus insecticides with poisonings by cautering substances and by alcohol in patients with pneumonia. UVI has been carried out by means of MD-73M ''Izol'da'' device with the DRB-8 mercury lamp. The procedure permits to reduce lethality and cases of pneumonia development more than two times as well as to decrease periods of treatment. To achieve the best effect, the radiation energy should be not less than 100 J and not more than 15 J. Early application (in 1-2 days before poisoning or pneumonia development) of UVI in 100-150 J dose per a period of treatment is most effective. It is established that the mechanism of medical UVI effect in blood is mainly related to stimulation of a cell unit of immunity as well as to improvement of rheologic properties of blood and a qualitative composition of erythrocytes, that favours the strengthening of redox and desintoxication processes in an organism

  2. Non-typeable Haemophilus influenzae and Streptococcus pneumoniae as primary causes of acute otitis media in colombian children: a prospective study

    Castrejon Maria M

    2011-01-01

    Full Text Available Abstract Background Acute otitis media (AOM is one of the most frequently encountered bacterial infections in children aged Streptococcus pneumoniae (S. pneumoniae and non-typeable Haemophilus influenzae (NTHi are historically identified as primary AOM causes. Nevertheless, recent data on bacterial pathogens causing AOM in Latin America are limited. This prospective study aimed to identify and characterize bacterial etiology and serotypes of AOM cases including antimicrobial susceptibility in Methods From February 2008 to January 2009, children ≥3 months and Results Of the 106 enrolled children, 99 were included in the analysis. Bacteria were cultured from 62/99 (63% of samples with S. pneumoniae, H. influenzae, or S. pyogenes. The most commonly isolated bacteria were H. influenzae in 31/99 (31% and S. pneumoniae in 30/99 (30% of samples. The majority of H. influenzae episodes were NTHi (27/31; 87%. 19F was the most frequently isolated pneumococcal serotype (10/30; 33%. Of the 30 S. pneumoniae positive samples, 8/30 (27% were resistant to tetracycline, 5/30 (17% to erythromycin and 8/30 (27% had intermediate resistance to penicillin. All H. influenzae isolates tested were negative to beta-lactamase. Conclusions NTHi and S. pneumoniae are the leading causes of AOM in Colombian children. A pneumococcal conjugate vaccine that prevents both pathogens could be useful in maximizing protection against AOM.

  3. [Eosinophilic cellulitis (Wells' syndrome)].

    Cerri, D; Carabelli, A; Bertani, E; Portaluppi, F; Novi, C; Gianotti, R; Gelmetti, C

    1990-09-01

    The Authors report a case of eosinophilic cellulitis (Wells' syndrome). The patient was a 61 year old woman, diabetic, with a cardio-respiratory insufficiency and a maniaco-depressive psycosis. She presented, on the upper arms and trunk, a cutaneous eruption of erythematous-urticarial plaques, that histopathologically were characterized by a dermic leukocyte population, with a prevalence of eosinophils, distributed in the perivascular site. Laboratory tests revealed eosinophilia and circulating immune complexes. The etiopathogenesis of the disease is discussed as is the possible role of immune complexes in eosinophilic cellulitis. PMID:2079351

  4. Acute interstitial pneumonia in mink kits inoculated with defined isolates of Aleutian mink disease parvovirus

    Alexandersen, Søren; Larsen, S; Aasted, B; Uttenthal, Åse; Bloom, M. E.; Hansen, M

    1994-01-01

    , interstitial edema, and hyaline membrane formation was experimentally reproduced in mink kits infected as newborns with five different isolates of ADV. Four hundred forty-nine newborn mink kits were included in the study, of which 247 were necropsied. The lesions caused by the different isolates were...... cells, including plasma cells in lung, liver, spleen, kidney, mesenteric lymph node, and intestine. Surviving kits also had hypertrophy of the bronchus-associated lymphoid tissue and focal subpleural, intraalveolar accumulations of large cells with foamy cytoplasm, so-called lipid pneumonia....

  5. Eosinophilic activation in cystic fibrosis.

    Koller, D. Y.; Götz, M.; Eichler, I; Urbanek, R

    1994-01-01

    BACKGROUND--The neutrophil is a potent contributor to pulmonary destruction in cystic fibrosis. Since eosinophils also possess destructive potential the involvement of eosinophils in cystic fibrosis has been investigated. METHODS--Eosinophil numbers and levels of eosinophil cationic protein (ECP), a marker of eosinophil activation, were determined in the serum of 42 patients with cystic fibrosis and in the sputum of 10 of them. To determine neutrophil activation levels of myeloperoxidase (MPO...

  6. [Critical evaluation and predictive value of clinical presentation in out-patients with acute community-acquired pneumonia].

    Mayaud, C; Fartoukh, M; Prigent, H; Parrot, A; Cadranel, J

    2006-01-01

    Diagnostic probability of community-acquired pneumonia (CAP) depends on data related to age and clinical and radiological findings. The critical evaluation of data in the literature leads to the following conclusions: 1) the prevalence of CAP in a given population with acute respiratory disease is 5% in outpatients and 10% in an emergency care unit. This could be as low as 2% in young people and even higher than 40% in hospitalized elderly patients; 2) the collection of clinical data is linked to the way the patient is examined and to the expertise of the clinician. The absolute lack of "vital signs" has a good negative predictive value in CAP; presence of unilateral crackles has a good positive predictive value; 3) there is a wide range of X-ray abnormalities: localized alveolar opacities; interstitial opacities, limited of diffused. The greatest radiological difficulties are encountered in old people with disorders including chronic respiratory or cardiac opacities and as a consequence of the high prevalence of bronchopneumonia episodes at this age; 4) among patients with lower respiratory tract (LRT) infections, the blood levels of leukocytes, CRP and procalcitonine are higher in CAP patients, mainly when their disease has a bacterial origin. Since you have not a threshold value reliably demonstrated in large populations with LRT infections or acute respiratory disease, presence or absence of these parameters could only be taken as a slight hint for a CAP diagnosis. PMID:17084571

  7. Bronchitis and Pneumonia

    ... What is the difference between bronchitis and pneumonia? Bronchitis is most often a bacte- rial or viral infection that causes swelling of the tubes (bronchioles) leading to the lungs. Pneumonia is an acute or chronic disease marked by inflammation of the ...

  8. Aspiration pneumonia

    Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis ... The type of bacteria that caused the pneumonia depends on: Your ... facility, for example) Whether you were recently hospitalized ...

  9. The Eosinophil in Infection.

    Ravin, Karen A; Loy, Michael

    2016-04-01

    First described by Paul Ehrlich in 1879, who noted its characteristic staining by acidophilic dyes, for many years, the eosinophil was considered to be an end-effector cell associated with helminth infections and a cause of tissue damage. Over the past 30 years, research has helped to elucidate the complexity of the eosinophil's function and establish its role in host defense and immunity. Eosinophils express an array of ligand receptors which play a role in cell growth, adhesion, chemotaxis, degranulation, and cell-to-cell interactions. They play a role in activation of complement via both classical and alternative pathways. Eosinophils synthesize, store and secrete cytokines, chemokines, and growth factors. They can process antigen, stimulate T cells, and promote humoral responses by interacting with B cells. Eosinophils can function as antigen presenting cells and can regulate processes associated with both T1 and T2 immunity. Although long known to play a role in defense against helminth organisms, the interactions of eosinophils with these parasites are now recognized to be much more complex. In addition, their interaction with other pathogens continues to be investigated. In this paper, we review the eosinophil's unique biology and structure, including its characteristic granules and the effects of its proteins, our developing understanding of its role in innate and adaptive immunity and importance in immunomodulation, and the part it plays in defense against parasitic, viral, fungal and bacterial infections. Rather than our worst enemy, the eosinophil may, in fact, be one of the most essential components in host defense and immunity. PMID:26690368

  10. Comparative Study of ELISA and IIFT in Detecting Chlamydia Pneumoniae Specific IgG Antibodies in Patients of Acute Coronary Syndrome (ACS

    Bhuva S P, Bhuva P J, Javdekar T B, Jain M R, Mulla S A

    2012-01-01

    Full Text Available Background: Chlamydia pnaumoniae is reported to be associated with coronary heart disease (CHD. Efficacy of available serologic tests for detecting C.pneumoniae antibodies has been debated. The aim of present study was to compare Enzyme Linked Immunosorbant Assay (ELISA and Indirect Immunofluorescent Test (IIFT for detecting specific antichlamydial antibodies in patients of Acute Coronary Syndrome (ACS. Materials and Methods: Serum samples from 100 patients of ACS and 90 healthy controls were tested for the presence of Chlamydial IgG antibodies using ELISA and IIFT. To assess agreement between ELISA and IIFT, we used ‘nominal scale variables”. Agreement analysis was done using sensitivity, specificity, positive and negative predictive values (PPV and NPV and diagnostic accuracy of the test. Results: The ELISA and IIFT detected C.pneumoniae IgG antibodies in 66% and 48% respectively in patients of ACS, and 29% and 20% respectively of healthy controls. In patients of ACS, sensitivity and specificity of ELISA as compared to IIFT were 70.8% and 38.4% respectively. The PPV of ELISA for C.pneumoniae was 51.5% and NPV was 58.8%. The diagnostic accuracy of ELISA for C.pneumoniae was 54.6%. The two tests correlated in 54% of samples with a moderate agreement of =0.51. Conclusions: The results of present study indicate that ELISA test was inferior to IIFT in detecting C.pneumoniae antibodies in patients of ACS.

  11. Klebsiella pneumoniae related community-acquired acute lower respiratory infections in Cambodia: Clinical characteristics and treatment

    2012-01-01

    Background In many Asian countries, Klebsiella pneumoniae (KP) is the second pathogen responsible for community-acquired pneumonia. Yet, very little is known about KP etiology in ALRI in Cambodia, a country that has one of the weakest medical infrastructures in the region. We present here the first clinico-radiological description of KP community-acquired ALRI in hospitalized Cambodian patients. Methods Through ALRI surveillance in two provincial hospitals, KP was isolated from sputum and blood cultures, and identified by API20E gallery from patients ≥ 5 years-old with fever and respiratory symptoms onset ≤14 days. Antibiotics susceptibility testing was provided systematically to clinicians when bacteria were isolated. We collected patients' clinical, radiological and microbiological data and their outcome 3 months after discharge. We also compared KP-related with other bacteria-related ALRI to determine risk factors for KP infection. Results From April 2007 to December 2009, 2315 ALRI patients ≥ 5 years-old were enrolled including 587 whose bacterial etiology could be assigned. Of these, 47 (8.0%) had KP infection; their median age was 55 years and 68.1% were females. Reported prior medication was high (42.5%). Patients' chest radiographs showed pneumonia (61.3% including 39% that were necrotizing), preexisting parenchyma lesions (29.5%) and pleural effusions alone (4.5%) and normal parenchyma (4.5%). Five patients had severe conditions on admission and one patient died during hospitalization. Of the 39 patients that were hospital discharged, 14 died including 12 within 1 month after discharge. Only 13 patients (28%) received an appropriate antibiotherapy. Extended-spectrum beta-lactamases (ESBL) - producing strains were found in 8 (17.0%) patients. Female gender (Odds ratio (OR) 2.1; p = 0.04) and diabetes mellitus (OR 3.1; p = 0.03) were independent risk factors for KP-related ALRI. Conclusions KP ALRI in Cambodia has high fatality rate, are more

  12. Klebsiella pneumoniae related community-acquired acute lower respiratory infections in Cambodia: Clinical characteristics and treatment

    Rammaert Blandine

    2012-01-01

    Full Text Available Abstract Background In many Asian countries, Klebsiella pneumoniae (KP is the second pathogen responsible for community-acquired pneumonia. Yet, very little is known about KP etiology in ALRI in Cambodia, a country that has one of the weakest medical infrastructures in the region. We present here the first clinico-radiological description of KP community-acquired ALRI in hospitalized Cambodian patients. Methods Through ALRI surveillance in two provincial hospitals, KP was isolated from sputum and blood cultures, and identified by API20E gallery from patients ≥ 5 years-old with fever and respiratory symptoms onset ≤14 days. Antibiotics susceptibility testing was provided systematically to clinicians when bacteria were isolated. We collected patients' clinical, radiological and microbiological data and their outcome 3 months after discharge. We also compared KP-related with other bacteria-related ALRI to determine risk factors for KP infection. Results From April 2007 to December 2009, 2315 ALRI patients ≥ 5 years-old were enrolled including 587 whose bacterial etiology could be assigned. Of these, 47 (8.0% had KP infection; their median age was 55 years and 68.1% were females. Reported prior medication was high (42.5%. Patients' chest radiographs showed pneumonia (61.3% including 39% that were necrotizing, preexisting parenchyma lesions (29.5% and pleural effusions alone (4.5% and normal parenchyma (4.5%. Five patients had severe conditions on admission and one patient died during hospitalization. Of the 39 patients that were hospital discharged, 14 died including 12 within 1 month after discharge. Only 13 patients (28% received an appropriate antibiotherapy. Extended-spectrum beta-lactamases (ESBL - producing strains were found in 8 (17.0% patients. Female gender (Odds ratio (OR 2.1; p = 0.04 and diabetes mellitus (OR 3.1; p = 0.03 were independent risk factors for KP-related ALRI. Conclusions KP ALRI in Cambodia has high fatality rate

  13. Diagnosing pneumonia, influenza and obstructive pulmonary diseases in adult patients presenting to primary care with acute cough: a multinomial logistic regression analysis

    Mesiri, Pavlina

    2015-01-01

    The objective of this report is to assess the diagnostic value of signs and symptoms and added value of bio markers, e.g. C-Reactive Protein, of adult patients from 16 primary care networks from 12 European countries who presented to primary care with acute cough for GRACE studies in the diagnosis of pneumonia, influenza and obstructive pulmonary diseases treating the diagnoses in parallel rather than in series.

  14. Use of an oscillatory PEP device to enhance bronchial hygiene in a patient of post-H1NI pneumonia and acute respiratory distress syndrome with pneumothorax

    Narula, Deepali; Nangia, Vivek

    2014-01-01

    A 26-year-old, 14 week pregnant woman was admitted to our hospital with pneumonia with acute respiratory distress syndrome in an intubated and mechanically ventilated state. She was diagnosed to have polymicrobial infection and left-sided pneumothorax and was put on a ventilator for 2 weeks. Postextubation, she found it difficult to clear her respiratory secretions despite aggressive routine chest physiotherapy. She was planned to undergo a mini-tracheostomy for tracheobronchial toileting. Ho...

  15. Pneumonia Atipik

    Dr. Dian Dwi Wahyuni

    2009-01-01

    Abstrak : Pneumonia atipik adalah pneumonia yang memberikan gambaran klinis dan radiologis yang berbeda dengan bentuk pneumonia tipikal. gambaran klinis dan radiologis yang khas dari pneumonia tipikal adalah berupa munculnya demam tiba-tiba disertai menggigil, nyeri pleura dan batuk berdahak berwarna seperti karat (rust colored sputum) dan disertai gambaran radiologis berupa konsolidasi segmental ataupun lobular. Penyebab paling sering pneumonia atipik ini adalah Mycoplasma pneumoniae,...

  16. Clinical risk factors of death from pneumonia in children with severe acute malnutrition in an urban critical care ward of Bangladesh.

    Mohammod Jobayer Chisti

    Full Text Available BACKGROUND: Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. METHODS: For this unmatched case-control design, SAM children of either sex, aged 0-59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b during April 2011 to July 2012 with radiological pneumonia were studied. The SAM children with pneumonia who had fatal outcome constituted the cases (n = 35, and randomly selected SAM children with pneumonia who survived constituted controls (n = 105. RESULTS: The median (inter-quartile range age (months was comparable among the cases and the controls [8.0 (4.9, 11.0 vs. 9.7 (5.0, 18.0; p = 0.210]. In logistic regression analysis, after adjusting for potential confounders, such as vomiting, abnormal mental status, and systolic hypotension (<70 mm of Hg in absence of dehydration, fatal cases of severely malnourished under-five children with pneumonia were more often hypoxemic (OR = 23.15, 95% CI = 4.38-122.42, had clinical dehydration (some/severe (OR = 9.48, 95% CI = 2.42-37.19, abdominal distension at admission (OR = 4.41, 95% CI = 1.12-16.52, and received blood transfusion (OR = 5.50, 95% CI = 1.21-24.99 for the management of crystalloid resistant systolic hypotension. CONCLUSION AND SIGNIFICANCE: We identified hypoxemia, clinical dehydration, and abdominal distension as the independent predictors of death in SAM children with pneumonia. SAM children with pneumonia who required blood transfusion for the management of crystalloid resistant systolic hypotension were also at risk for death. Thus, early identification and prompt management of these simple clinically

  17. Ultrasound in Rheumatologic Interstitial Lung Disease: A Case Report of Nonspecific Interstitial Pneumonia in Rheumatoid Arthritis

    Laria, A.; Lurati, A; Scarpellini, M.

    2015-01-01

    According to the American Thoracic Society (ATS)/European Respiratory Society consensus classification, idiopathic interstitial pneumonias (IIPs) include several clinic-radiologic-pathologic entities: idiopathic pulmonary fibrosis (IPF), usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), cryptogenic organizing pneumonia, acute interstitial pneumonia, respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia, and lymphoid interstitial pneumonia. ...

  18. Metabolomics Investigation Reveals Metabolite Mediators Associated with Acute Lung Injury and Repair in a Murine Model of Influenza Pneumonia

    Cui, Liang; Zheng, Dahai; Lee, Yie Hou; Chan, Tze Khee; Kumar, Yadunanda; Ho, Wanxing Eugene; Chen, Jian Zhu; Tannenbaum, Steven R.; Ong, Choon Nam

    2016-01-01

    Influenza virus infection (IVI) can cause primary viral pneumonia, which may progress to acute lung injury (ALI) and respiratory failure with a potentially fatal outcome. At present, the interactions between host and influenza virus at molecular levels and the underlying mechanisms that give rise to IVI-induced ALI are poorly understood. We conducted a comprehensive mass spectrometry-based metabolic profiling of serum, lung tissue and bronchoalveolar lavage fluid (BALF) from a non-lethal mouse model with influenza A virus at 0, 6, 10, 14, 21 and 28 days post infection (dpi), representing the major stages of IVI. Distinct metabolite signatures were observed in mice sera, lung tissues and BALF, indicating the molecular differences between systematic and localized host responses to IVI. More than 100 differential metabolites were captured in mice sera, lung tissues and BALF, including purines, pyrimidines, acylcarnitines, fatty acids, amino acids, glucocorticoids, sphingolipids, phospholipids, etc. Many of these metabolites belonged to pulmonary surfactants, indicating IVI-induced aberrations of the pulmonary surfactant system might play an important role in the etiology of respiratory failure and repair. Our findings revealed dynamic host responses to IVI and various metabolic pathways linked to disease progression, and provided mechanistic insights into IVI-induced ALI and repair process. PMID:27188343

  19. Eosinophilic inflammation in allergic asthma

    IolandaFátima Lopes CalvoTibério; CarlaMáximoPrado

    2013-01-01

    Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL)-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR)3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modu...

  20. Eosinophilic Inflammation in Allergic Asthma

    Possa, Samantha S.; Leick, Edna A; Carla M. Prado; Martins, Mílton A.; Tibério, Iolanda F. L. C.

    2013-01-01

    Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL)-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR)3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modu...

  1. Sinusitis with eosinophilic otitis media

    Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

  2. Clinical Features of Eosinophilic Bronchitis

    Joo, Jae Hak; Park, Sang Joon; Park, Sung Woo; Lee, June Hyuk; Kim, Do Jin; Uh, Soo Taek; Kim, Yong Hoon; Park, Choon Sik

    2002-01-01

    Background Eosinophilic inflammation of the airway is usually associated with airway hyper-responsiveness in bronchial asthma. However, there is a small group of patients which has the eosinophilic inflammation in the bronchial tree with normal spirometry and no evidence of airway hyper-responsiveness, which was named eosinophilic bronchitis. The objectives of this study are 1) to investigate the incidence of eosinophilic bronchitis in the chronic cough syndrome and 2) to evaluate the clinica...

  3. Early warning and prevention of pneumonia in acute leukemia by patient education, spirometry, and positive expiratory pressure: A randomized controlled trial.

    Møller, Tom; Moser, Claus; Adamsen, Lis; Rugaard, Grith; Jarden, Mary; Bøtcher, Tina S; Wiedenbein, Liza; Kjeldsen, Lars

    2016-03-01

    Long-lasting neutropenia associated with acute myeloid leukemia (AML) and its treatment gives rise to a high risk of pneumonia. The use of broad-spectrum antibiotic prophylaxis during outpatient management has not completely protected patients against admission due to infections and neutropenic fever, emphasizing the need to approach infection protection with complementary efforts. In a randomized controlled design, we examined the applicability of patient-performed daily spirometry [forced expiratory volume in one second (FEV1)] as an early warning tool and explored the effectiveness of positive expiratory pressure (PEP) in preventing pneumonia among 80 AML patients. Twenty-five incidences of pneumonia were detected among 23 patients (6 interventions, 17 controls), giving a prevalence of 28.75% during 5420 days of observation. We found a significant difference in incidence between intervention versus control group (2.17 per 1000 days vs. 6.52 per 1000 days, P = 0.021, respectively). A cross point at 80-76% of the personal FEV1 reference value showed high sensitivity and specificity on pneumonia development. Our data demonstrate the feasibility of educating AML patients in their continuous daily measurement of FEV1 and use of PEP. Daily measures of FEV1 may be an important early warning tool for assessment of pulmonary deterioration during critical phases of neutropenia. We suggest that strategic patient education in the use of spirometry and PEP should be part of standard of care for AML patients undergoing induction chemotherapy. PMID:26661344

  4. Olanzapine-induced eosinophilic pleuritis

    Matthew Evison

    2015-01-01

    Eosinophilic pleural fluid is not a marker of non-malignant aetiology and eosinophilic pleural effusions require a careful and systematic diagnostic work-up. This is the second case report to identify olanzapine as a causative agent in eosinophilic pleural effusion.

  5. Bronchiolitis obliterans organizing pneumonia: Pathogenesis, clinical features, imaging and therapy review

    Al-Ghanem Sara

    2008-01-01

    Full Text Available Bronchiolitis obliterans organizing pneumonia (BOOP was first described in the early 1980s as a clinicopathologic syndrome characterized symptomatically by subacute or chronic respiratory illness and histopathologically by the presence of granulation tissue in the bronchiolar lumen, alveolar ducts and some alveoli, associated with a variable degree of interstitial and airspace infiltration by mononuclear cells and foamy macrophages. Persons of all ages can be affected. Dry cough and shortness of breath of 2 weeks to 2 months in duration usually characterizes BOOP. Symptoms persist despite antibiotic therapy. On imaging, air space consolidation can be indistinguishable from chronic eosinophilic pneumonia (CEP, interstitial pneumonitis (acute, nonspecific and usual interstitial pneumonitis, neoplasm, inflammation and infection. The definitive diagnosis is achieved by tissue biopsy. Patients with BOOP respond favorably to treatment with steroids.

  6. Equine eosinophilic enterocolitis.

    Kostiuk, D

    2000-01-01

    A 4-year-old Morgan stallion was presented with a 9-week history of diarrhea. Biopsy of nodules in the rectal mucosa yielded a diagnosis of eosinophilic enterocolitis. Treatment with steroids was instituted and the feces firmed within 2 days. Continued treatment with oral prednisone kept the feces at a normal consistency for 4 months.

  7. Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia

    Pneumonia is a common illness in all parts of the world and is considered as a major cause of death among all age groups. Nevertheless, only about 5% of patients referring to their primary care physicians with acute respiratory symptoms will develop pneumonia. This study was performed to derive practical criteria for performing chest radiographs for the evaluation of community-acquired pneumonia (CAP). A total of 420 patients with acute respiratory symptoms and positive findings on chest radiograph were evaluated from December 2008 to December 2009. The subjects were referred to outpatient clinics or emergency departments of Birjand's medical university hospitals, Iran, and were enrolled as positive cases. A checklist was completed for each patient including their demographic information, clinical signs and symptoms (cough, sputum production, dyspnea, chest pain, fever, tachycardia, and tachypnea), abnormal findings in pulmonary auscultation and laboratory findings (erythrocyte sedimentation rate, C-reactive protein levels, and white blood cell count). An equal number of age-matched individuals with acute respiratory symptoms, but insignificant findings on chest radiography, were included as the control group. Finally, the diagnostic values of different findings were compared. The data showed that vital signs and physical examination findings are useful screening parameters for predicting chest radiograph findings in outpatient settings. Therefore, by implementing a prediction rule, we would be able to determine which patients would benefit from a chest X-Ray (sensitivity, 94% and specificity, 57%). This study's findings suggest that requesting chest radiographs might not be necessary in patients with acute respiratory symptoms unless the vital signs and/or physical examination findings are abnormal. Considering the 94% sensitivity of this rule for predicting CAP, a chest radiograph is required for patients with unreliable follow-ups or moderate to high

  8. Rapidly progressive Bronchiolitis Obliterans Organising Pneumonia presenting with pneumothorax, persistent air leak, acute respiratory distress syndrome and multi-organ dysfunction: a case report

    Chakravorty Indranil

    2008-05-01

    Full Text Available Abstract Introduction Bronchiolitis Obliterans Organising Pneumonia (BOOP may often present initially as a recurrent spontaneous pneumothorax and then develop multi-system complications. Case presentation A 17-year-old boy presented with a pneumothorax, which developed into rapidly progressive Bronchiolitis Obliterans Organising Pneumonia (BOOP. He developed multi-organ dysfunction (including adult respiratory distress syndrome, oliguric renal failure, acute coronary syndrome, cardiac failure and a right atrial thrombus which necessitated prolonged intensive care. Diagnosis was confirmed on open lung biopsy and he responded well to treatment with corticosteroids. Conclusion BOOP is exquisitely sensitive to oral corticosteroids but if the diagnosis is not considered in such patients and appropriate treatment instituted early, BOOP may often lead to prolonged hospital admission with considerable morbidity.

  9. Comparison of histological lesions in acute hemorrhagic pneumonia in mink associated with Pseudomonas aeruginosa or Escherichia coli

    Salomonsen, Charlotte Mark; Boye, Mette; Høiby, N.;

    2013-01-01

    culture of E. coli were examined. Formalin-fixed paraffin-embedded lung tissue obtained from the mink was examined by histology and fluorescence in-situ hybridization (FISH). It was possible to detect a slight histological difference between hemorrhagic pneumonia caused by P. aeruginosa and by E. coli, as...... also occurred in farmed mink. The purpose of this study was to compare histological lesions of acute hemorrhagic pneumonia associated with both P. aeruginosa and E. coli in mink, including a description of tissue distribution of pathogens, in an attempt to differentiate between the 2 disease entities...... P. aeruginosa was most often found surrounding blood vessels and lining the alveoli, while E. coli showed a more diffuse distribution in the lung tissue. Furthermore, P. aeruginosa often elicited a very hemorrhagic response in the lung, while infection with E. coli was associated with a higher...

  10. Eosinophilic colitis in infants

    Adriana Chebar Lozinsky

    2014-01-01

    Full Text Available OBJECTIVE: To review the literature for clinical data on infants with allergic or eosinophilic colitis. DATA SOURCE: MEDLINE search of all indexes was performed using the words ''colitis or procto-colitis and eosinophilic'' or ''colitis or proctocolitis and allergic'' between 1966 and February of 2013. All articles that described patients' characteristics were selected. DATA SYNTHESIS: A total of 770 articles were identified, of which 32 met the inclusion criteria. The 32 articles included a total of 314 infants. According to the available information, 61.6% of infants were male and 78.6% were younger than 6 months. Of the 314 patients, 49.0% were fed exclusively breast milk, 44.2% received cow's milk protein, and 6.8% received soy protein. Diarrheal stools were described in 28.3% of patients. Eosinophilia was found in 43.8% (115/263 of infants. Colonic or rectal biopsy showed infiltration by eosinophils (between 5 and 25 perhigh-power field in 89.3% (236/264 of patients. Most patients showed improvement with theremoval of the protein in cow's milk from their diet or the mother's diet. Allergy challenge tests with cow's milk protein were cited by 12 of the 32 articles (66 patients. CONCLUSIONS: Eosinophilic colitis occurs predominantly in the first six months of life and in males. Allergy to cow's milk was considered the main cause of eosinophilic colitis. Exclusion of cow'smilk from the diet of the lactating mother or from the infant's diet is generally an effective therapeutic measure.

  11. Desquamative interstitial pneumonia: A case report

    Lovrenski Aleksandra; Eri Živka; Tegeltija Dragana; Kašiković-Lečić Svetlana; Panjković Milana

    2014-01-01

    Introduction. Desquamative interstitial pneumonia is one of the rarest idiopathic interstitial pneumonias and the rarest form of smoking-related interstitial lung diseases. It was first described by Liebow in 1965. Histologically, it is characterized by the presence of eosinophilic macrophages uniformly filling airspaces which often contain a finely granular light-brown pigment that does not stain for hemosiderin. The alveolar walls are usually mildly thick...

  12. Eosinophilic infiltration in Korea: idiopathic?

    Lim, Jae Hoon; Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2006-03-15

    Eosinophilia is defined as the presence of more than 500 eosinophils/{mu}L in the peripheral blood, and may be accompanied by eosinophil infiltration in tissues. Focal eosinophilic infiltration in the lungs and liver is relatively common and is often associated with a parasitic infection, drug hypersensitivity, allergic diseases, collagen vascular diseased, and internal malignancies such as Hodgkin's disease, as well as cancer of the lung, stomach, pancreas or ovary. An eosinophilic abscess refers to a lesion of massive eosinophil infiltration and associated destroyed tissue, and an eosinophilic granuloma refers to a lesion consisting of central necrosis and mixed inflammatory cell infiltrates with numerous eosinophils, a number of neutrophils and lymphocytes, and a palisade of epithelioid histiocytes and/or giant cells.

  13. Mycoplasma pneumoniae Pneumonia Associated With Methemoglobinemia and Anemia: An Overlooked Association?

    Khoury, Tawfik; Abu Rmeileh, Ayman; Kornspan, Jonathan David; Abel, Roy; Mizrahi, Meir; Nir-Paz, Ran

    2015-01-01

    We report a case of acute methemoglobinemia and anemia in a patient with Mycoplasma pneumoniae pneumonia. We suggest that M. pneumoniae secretes a putative protein that can induce methemoglobin in red blood cells. Thus, Mycoplasma pneumoniae may induce methemoglobinemia in patients who have low oxygen saturation and anemia.

  14. 急性脑卒中并发肺炎的预测量表评定%The application value of predication scale of pneumonia after acute stroke

    刘奇龙

    2015-01-01

    Objective:To evaluate the accuracy and validity of predication scale of pneumonia after acute stroke. Methods:The scores of 312 patients with acute stroke during the admission to hospital were evaluated using the predication scale of pneumonia, and the number of patients infected with pneumonia were observed in the duration of hospital. The accuracy of the predication scale was analyzed using the receiver operating characteristic,the sensitivity,specificity,positive predictive value,negative predictive value,negative likely ratio and positive likely ratio of the predication scale were used to validate its validity. Results:The occurrence rate of pneumonia was 18. 9%,which was significantly positive correlation with the score of scale(P0.50,以取3分值为最佳,其敏感度69.5%、阳性预测值52.7%及阳性似然比3.663,而特异度81.0%、阴性预测值89.7%及阴性似然比0.377。该量表的准确性达83.6%。结论:急性脑卒中并发肺炎预测量表在检出急性脑卒中并发肺炎的发生能力有一定的局限性,但对于排除急性脑卒中并发肺炎的能力较强;在基层医院临床工作中,对急性脑卒中并发肺炎的初步预测有一定的实际应用价值。

  15. Pneumonia - weakened immune system

    ... immunocompromised host." Related conditions include: Hospital-acquired pneumonia Pneumocystis jirovecii (previously called Pneumocystis carinii) pneumonia Pneumonia - cytomegalovirus Pneumonia ...

  16. Pneumonia in the immunocompetent patient.

    Reynolds, J H; McDonald, G; Alton, H; Gordon, S B

    2010-12-01

    Pneumonia is an acute inflammation of the lower respiratory tract. Lower respiratory tract infection is a major cause of mortality worldwide. Pneumonia is most common at the extremes of life. Predisposing factors in children include an under-developed immune system together with other factors, such as malnutrition and over-crowding. In adults, tobacco smoking is the single most important preventable risk factor. The commonest infecting organisms in children are respiratory viruses and Streptoccocus pneumoniae. In adults, pneumonia can be broadly classified, on the basis of chest radiographic appearance, into lobar pneumonia, bronchopneumonia and pneumonia producing an interstitial pattern. Lobar pneumonia is most commonly associated with community acquired pneumonia, bronchopneumonia with hospital acquired infection and an interstitial pattern with the so called atypical pneumonias, which can be caused by viruses or organisms such as Mycoplasma pneumoniae. Most cases of pneumonia can be managed with chest radiographs as the only form of imaging, but CT can detect pneumonia not visible on the chest radiograph and may be of value, particularly in the hospital setting. Complications of pneumonia include pleural effusion, empyema and lung abscess. The chest radiograph may initially indicate an effusion but ultrasound is more sensitive, allows characterisation in some cases and can guide catheter placement for drainage. CT can also be used to characterise and estimate the extent of pleural disease. Most lung abscesses respond to medical therapy, with surgery and image guided catheter drainage serving as options for those cases who do not respond. PMID:21088086

  17. Focus on JNJ-Q2, a novel fluoroquinolone, for the management of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections.

    Jones, Travis M; Johnson, Steven W; DiMondi, V Paul; Wilson, Dustin T

    2016-01-01

    JNJ-Q2 is a novel, fifth-generation fluoroquinolone that has excellent in vitro and in vivo activity against a variety of Gram-positive and Gram-negative organisms. In vitro studies indicate that JNJ-Q2 has potent activity against pathogens responsible for acute bacterial skin and skin structure infections (ABSSSI) and community-acquired bacterial pneumonia (CABP), such as Staphylococcus aureus and Streptococcus pneumoniae. JNJ-Q2 also has been shown to have a higher barrier to resistance compared to other agents in the class and it remains highly active against drug-resistant organisms, including methicillin-resistant S. aureus, ciprofloxacin-resistant methicillin-resistant S. aureus, and drug-resistant S. pneumoniae. In two Phase II studies, the efficacy of JNJ-Q2 was comparable to linezolid for ABSSSI and moxifloxacin for CABP. Furthermore, JNJ-Q2 was well tolerated, with adverse event rates similar to or less than other fluoroquinolones. With an expanded spectrum of activity and low potential for resistance, JNJ-Q2 shows promise as an effective treatment option for ABSSSI and CABP. Considering its early stage of development, the definitive role of JNJ-Q2 against these infections and its safety profile will be determined in future Phase III studies. PMID:27354817

  18. Eosinophilic bioactivities in severe asthma.

    Carr, Tara F; Berdnikovs, Sergejs; Simon, Hans-Uwe; Bochner, Bruce S; Rosenwasser, Lanny J

    2016-01-01

    Asthma is clearly related to airway or blood eosinophilia, and asthmatics with significant eosinophilia are at higher risk for more severe disease. Eosinophils actively contribute to innate and adaptive immune responses and inflammatory cascades through the production and release of diverse chemokines, cytokines, lipid mediators and other growth factors. Eosinophils may persist in the blood and airways despite guidelines-based treatment. This review details eosinophil effector mechanisms, surface markers, and clinical outcomes associated with eosinophilia and asthma severity. There is interest in the potential of eosinophils or their products to predict treatment response with biotherapeutics and their usefulness as biomarkers. This is important as monoclonal antibodies are targeting cytokines and eosinophils in different lung environments for treating severe asthma. Identifying disease state-specific eosinophil biomarkers would help to refine these strategies and choose likely responders to biotherapeutics. PMID:27386041

  19. Glomerulonefritis aguda post-infecciosa asociada a neumonía neumocócica Acute post infectious glomerulonephritis associated to pneumococcal pneumonia

    S. Fernández de Miguel

    2009-01-01

    Full Text Available

    Presentamos un niño de 6 años con insuficiencia renal aguda secundaria a glomerulonefritis asociada a neumonía neumocócica. El paciente presentó en primer lugar un síndrome nefrítico con hematuria, proteinuria, oliguria, edemas y deterioro de la función renal, siendo diagnosticado a continuación de neumonía con derrame pleural. La función renal se normalizó tras 72 horas, persistiendo una hipertensión arterial que precisó tratamiento en la fase aguda. El cuadro se resolvió sin secuelas. Asimismo, revisamos la información
    publicada previamente sobre casos similares en la literatura científica. El caso sirve para reforzar el concepto de que otros microorganismos además del Streptococcus pyogenes pueden desencadenar una glomerulonefritis post-infecciosa y deben considerarse en el diagnóstico diferencial de cualquier niño que presente glomerulonefritis aguda y hallazgos respiratorios.
    La presentación del cuadro nefrítico suele ser concomitante o con poca latencia respecto al cuadro infeccioso. A nivel analítico se encontró un descenso de la fracción C3 del complemento y un aumento del título de antiestreptolisinas, como se ha descrito en otras publicaciones. La etiología se confirmó mediante detección del antígeno neumocócico en orina y líquido pleural. La evolución del cuadro nefrítico suele ser buena, como en nuestro caso, y es excepcional que se precise algún método de depuración extrarrenal.

    We report a 6 year old boy, evolving acute renal failure due to acute glomerulonephritis associated with pneumonia. The patient firstly presented a nephritic syndrome with abnormal urinalysis, hypertension, azotemia and oliguria, being diagnosed afterwards of pneumonia. Renal function was normal past 72 hours. He presented arterial hypertension that required treatment only in acute phase.
    This case was resolved with no after-effects. Previously released information about similar cases in

  20. The History of Mycoplasma pneumoniae Pneumonia.

    Saraya, Takeshi

    2016-01-01

    In the United States in the 1930s, although the pathogen was not known, atypical pneumonia was clinically distinguished from pneumococcal pneumonia by its resistance to sulfonamides. Reimann (1938) reported seven patients with an unusual form of tracheo bronchopneumonia and severe constitutional symptoms. He believed the clinical picture of this disease differed from that of the disease caused by influenza viruses or known bacteria and instead suspected "primary atypical pneumonia." For many years, the responsible infectious agent was tentatively classified as a filterable virus that could pass through a Seitz filter to remove bacteria and was reported to be a psittacosis-like or new virus. After that, Eaton et al. (1942, 1944, 1945) identified an agent that was the principal cause of primary atypical pneumonia using cotton rats, hamsters, and chick embryos. Eaton et al. (1942, 1944, 1945) did not perform an inoculation study in human volunteers. During the 1940s, there were three groups engaged in discovering the etiology of the primary atypical pneumonia. (1) Commission on Acute Respiratory Diseases Diseases directed by John Dingle, (2) Dr. Monroe Eaton's group, the Virus Research Laboratory of the California State Public Health Department, (3) The Hospital of the Rockefeller Institute for Medical Research directed by Horsfall. During 1940s, the members of the Commission on Acute Respiratory Diseases concluded that the bacteria-free filtrates obtained from the patients, presumably containing a virus, could induce primary atypical pneumonia in human volunteers via Pinehurst trials. During 1950s, serological approaches for identification of the Eaton agent developed such as Fluorescent-Stainable Antibody, and at the beginning of the1960s, the Eaton agent successfully grew in media, and finally accepted as a cause of primary atypical pneumonia. Thus, technical difficulties with visualizing the agent and failure to recognize the full significance of the Pinehurst

  1. An improved method to visualize eosinophils in eosinophilic esophagitis.

    Rubio, C A; Glaessgen, A

    2006-01-01

    We previously found in Giemsa-stained colorectal sections from IBD patients that eosinophilic granulocytes turned fluorescent when excited with indirect fluorescent light, while other inflammatory cells were non-fluorescent. We now studied with that method, the frequency of eosinophilic granulocytes in sections from patients with eosinophilic esophagitis (EE). Cell counting was done in consecutive sections stained with Giemsa stain using indirect fluorescence light (G-IFL setting) and with hematoxylin-eosin using transmitted light (HE-TL setting) in 5 cases of EE and in 10 consecutive cases of reflux esophagitis (RE) grade 2. In EE 45.0 eosinophils/case (range 39-51) were recorded with the G-IFL setting but only 33.4 eosinophils/case (range 28-39) with the HE-TL setting (p cell counting is not necessary. PMID:17091778

  2. [Eosinophilic esophagitis: an "emerging disease"].

    Collardeau-Frachon, Sophie; Hervieu, Valérie; Scoazec, Jean-Yves

    2007-12-01

    Eosinophilic esophagitis is a recently identified disease. The histological examination of esophageal biopsies is essential for its diagnosis, which is made with steadily increasing frequency. Eosinophilic esophagitis is an anatomoclinical entity, involving both children and adults, characterized by a dense and isolated infiltration of the esophageal mucosa by eosinophils, revealed by clinical symptoms of upper digestive tract origin and resistant to anti-acid treatment with IPP at high doses. Eosinophilic esophagitis is currently interpreted as an allergic disease, even though its pathogenesis remains unclear. The disease has a chronic course with persistent or relapsing symptoms, present with symptoms similar to those of gastro-esophageal reflux or with dysphagia. Endoscopic examination shows the presence of characteristic, but not pathognomonic, lesions (stenoses, strictures, circular rings, reduction of calibre, white specks, granularity of the mucosa). The histological diagnosis requires multiple biopsies taken all along the esophagus. The main sign is the presence of a dense eosinophilic infiltrate of the mucosa: a peak density of more than 15 eosinophils in at least one x400 field is the minimal criteria required for diagnosis. Associated lesions correspond to tissue damage and repair secondary to eosinophil activation (basal hyperplasia, microabscesses, fibrosis of the lamina propria). The treatment is based on dietary measures (allergen exclusion) and on the use of anti-inflammatory drugs, mainly corticoids. In conclusion, eosinophilic esophagitis is an emerging disease, important to identify, since it requires a specific treatment, different from that of reflux esophagitis. PMID:18554551

  3. CNS Complications of Mycoplasma Pneumoniae

    J Gordon Millichap

    2004-08-01

    Full Text Available Three cases of acute central nervous system disease occurring subsequent to infection with M pneumoniae are reported from University College, Institute of Child Health, and Great Ormond Street Hospital, London, UK.

  4. Eosinophilic inflammation in allergic asthma

    Samantha Souza Possa

    2013-04-01

    Full Text Available Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modulation of immune response, induction of airway hyperresponsiveness and remodeling, characteristic features of asthma. Various types of promising treatments for reducing asthmatic response are related to reduction in eosinophil counts both in human and experimental models of pulmonary allergic inflammation, showing that the recruitment of these cells really plays an important role in the pathophysiology of allergic diseases such asthma.

  5. The clinical characteristics of the radiation pneumonia

    Objective: To analyse the clinical characteristics of the radiation pneumonia, sum the experience and the basis of the radiation pneumonia for its prevention and treatment. Method: Twenty three cases with radiation pneumonia from 1991 to 1998 were retrospectively analysed. Its clinical manifestation, chest X-ray, thoracic CT and blood routine were evaluated. Result: The acute manifestation was fever, cough, dyspnea, and the chronic manifestation was cough and insufficiency of pulmonary function. Conclusion: The prevention of radiation pneumonia is more important, high dose cortical steroids and antibiotics were prescribed during the acute stage and the chronic radiation pneumonia is irreversible

  6. Lipoid pneumonia: An uncommon entity

    Khilnani G; Hadda V

    2009-01-01

    Lipoid pneumonia is a rare form of pneumonia caused by inhalation or aspiration of fat-containing substances like petroleum jelly, mineral oils, certain laxatives, etc. It usually presents as an insidious onset, chronic respiratory illness simulating interstitial lung diseases. Rarely, it may present as an acute respiratory illness, especially when the exposure to fatty substance(s) is massive. Radiological findings are diverse and can mimic many other diseases including carcinoma, acute or c...

  7. Prevention of hospital-acquired pneumonia with Yupingfeng Powder in patients with acute cerebral vascular diseases: a randomized controlled trial

    Li YAN

    2010-01-01

    Full Text Available Background: An increase in the incidence rate of hospital-acquired pneumonia (HAP has a direct influence on prognosis and survival of patients with acute cerebral vascular diseases (ACVD, and how to prevent HAP is a growing concern to clinicians.Objective: To study the efficacy of Yupingfeng Powder, a compound traditional Chinese herbal medicine, in preventing HAP in patients with ACVD.Design, setting, participants and interventions: Sixty ACVD patients with lung qi deficiency syndrome without concurrent infections were randomly divided into prevention group (28 cases and control group (32 cases. The 60 cases were all from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. Tough measures were taken to prevent cross-infection based on treatment of the primary diseases, well nutrition and support therapy. Yupingfeng Powder was used in the prevention group to prevent HAP. The patients were treated for 10 days.Main outcome measures: The clinical symptoms, physical signs, body temperature, and chest X-ray were observed. The changes of blood immunoglobulin A (IgA, immunoglobulin G (IgG, immunoglobulin M (IgM and interleukin-6 (IL-6 were detected before and after treatment.Results: The total response rate in the prevention group was higher than that in the control group (P<0.05, and the total response rates were 78.57% (22/28 and 31.25% (10/32 respectively. The incidence rate of HAP in the prevention group was lower than that in the control group. There were no significant differences in white blood cell count, neutrophilic granulocyte count, and the levels of IgA, IgG, IgM and IL-6 between the two groups before treatment. The white blood cell count and neutrophilic granulocyte count in the control group increased after treatment, and there was a significant difference between the two groups (P<0.05. There was no significant difference in IgA level in the two groups after treatment, and the IgM levels in the two groups

  8. Lipoid pneumonia presenting as non resolving community acquired pneumonia: a case report

    Hadda, Vijay; Gopi C Khilnani; Ashu S Bhalla; Mathur, Sandeep

    2009-01-01

    Introduction Lipoid pneumonia is a rare form of pneumonia caused by inhalation or aspiration of fat containing substances like, petroleum jelly, mineral oils, few laxatives etc. It usually presents as insidious onset chronic respiratory illness simulating interstitial lung diseases. Rarely, it may present as an acute respiratory illness, specially, when exposure to fatty substance is acute and/or massive. Radiologically, it may mimic carcinoma, acute or chronic pneumonia, ARDS, or a localized...

  9. The Role and Immunobiology of Eosinophils in the Respiratory System: a Comprehensive Review.

    Eng, Stephanie S; DeFelice, Magee L

    2016-04-01

    The eosinophil is a fully delineated granulocyte that disseminates throughout the bloodstream to end-organs after complete maturation in the bone marrow. While the presence of eosinophils is not uncommon even in healthy individuals, these granulocytes play a central role in inflammation and allergic processes. Normally appearing in smaller numbers, higher levels of eosinophils in the peripheral blood or certain tissues typically signal a pathologic process. Eosinophils confer a beneficial effect on the host by enhancing immunity against molds and viruses. However, tissue-specific elevation of eosinophils, particularly in the respiratory system, can cause a variety of short-term symptoms and may lead to long-term sequelae. Eosinophils often play a role in more commonly encountered disease processes, such as asthma and allergic responses in the upper respiratory tract. They are also integral in the pathology of less common diseases including eosinophilic pneumonia, allergic bronchopulmonary aspergillosis, hypersensitivity pneumonitis, and drug reaction with eosinophilia and systemic symptoms. They can be seen in neoplastic disorders or occupational exposures as well. The involvement of eosinophils in pulmonary disease processes can affect the method of diagnosis and the selection of treatment modalities. By analyzing the complex interaction between the eosinophil and its environment, which includes signaling molecules and tissues, different therapies have been discovered and created in order to target disease processes at a cellular level. Innovative treatments such as mepolizumab and benralizumab will be discussed. The purpose of this article is to further explore the topic of eosinophilic presence, activity, and pathology in the respiratory tract, as well as discuss current and future treatment options through a detailed literature review. PMID:26797962

  10. 64 Effect of Formoterol on Eosinophil Trans-Basement Migration Induced by Interleukin-8-Stimulated Neutrophils

    KAWASHIMA, Akiko; Nishihara, Fuyumi; Kobayashi, Takehito; Nakagome, Kazuyuki; Nagata, Makoto

    2012-01-01

    Background Neutrophils are often increased in the airways of either chronic severe disease or acute exacerbation of asthma. Neutrophils migrated in response to interleukin-8 (IL-8) may lead eosinophils to accumulate in the airways of asthma and possibly aggravate this disease. In this study, we investigated whether formoterol modify the trans-basement membrane migration (TBM) of eosinophils stimulated with neutrophils and IL-8. Methods Neutrophils and eosinophils were isolated from peripheral...

  11. Genome Sequence of Klebsiella pneumoniae Urinary Tract Isolate Top52

    Johnson, Jeremiah G.; Spurbeck, Rachel R.; Sandhu, Sukhinder K.; Matson, Jyl S.

    2014-01-01

    Klebsiella pneumoniae is a significant cause of nosocomial infections, including ventilator-associated pneumonias and catheter-associated urinary tract infections. K. pneumoniae strain TOP52 #1721 (Top52) was isolated from a woman presenting with acute cystitis and subsequently characterized using various murine models of infection. Here we present the genome sequence of K. pneumoniae Top52.

  12. Focus on JNJ-Q2, a novel fluoroquinolone, for the management of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections

    Jones TM

    2016-06-01

    Full Text Available Travis M Jones,1,2 Steven W Johnson,1,3 V Paul DiMondi,1,4 Dustin T Wilson,1,2 1Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, 2Department of Pharmacy, Duke University Hospital, Durham, 3Department of Pharmacy, Forsyth Medical Center, Novant Health, Winston-Salem, 4Department of Pharmacy, Durham VA Medical Center, Durham, NC, USA Abstract: JNJ-Q2 is a novel, fifth-generation fluoroquinolone that has excellent in vitro and in vivo activity against a variety of Gram-positive and Gram-negative organisms. In vitro studies indicate that JNJ-Q2 has potent activity against pathogens responsible for acute bacterial skin and skin structure infections (ABSSSI and community-acquired bacterial pneumonia (CABP, such as Staphylococcus aureus and Streptococcus pneumoniae. JNJ-Q2 also has been shown to have a higher barrier to resistance compared to other agents in the class and it remains highly active against drug-resistant organisms, including methicillin-resistant S. aureus, ciprofloxacin-resistant methicillin-resistant S. aureus, and drug-resistant S. pneumoniae. In two Phase II studies, the efficacy of JNJ-Q2 was comparable to linezolid for ABSSSI and moxifloxacin for CABP. Furthermore, JNJ-Q2 was well tolerated, with adverse event rates similar to or less than other fluoroquinolones. With an expanded spectrum of activity and low potential for resistance, JNJ-Q2 shows promise as an effective treatment option for ABSSSI and CABP. Considering its early stage of development, the definitive role of JNJ-Q2 against these infections and its safety profile will be determined in future Phase III studies. Keywords: JNJ-Q2, fluoroquinolone, ABSSSI, CABP, MRSA

  13. Pneumonia (image)

    Pneumonia is an inflammation of the lungs caused by an infection. Many different organisms can cause it, including bacteria, viruses, and fungi. Pneumonia is a common illness that affects millions of ...

  14. Mycoplasma pneumonia

    ... this page: //medlineplus.gov/ency/article/000082.htm Mycoplasma pneumonia To use the sharing features on this page, please enable JavaScript. Mycoplasma pneumonia is an infection of the lungs by ...

  15. Amount of Pneumocystis carinii and degree of acute lung inflammation in HIV-associated P carinii pneumonia

    Vestbo, Jørgen; Nielsen, T L; Junge, Jette; Lundgren, Jens Dilling

    1993-01-01

    Correlations between semiquantitative amounts of Pneumocystis carinii (PC), the degree of inflammation, and the severity of pneumonia were analyzed in 58 patients with PC pneumonia (PCP). Material from both transbronchial biopsies (TBBs; n = 39) and bronchoalveolar lavage fluid (BALF; n = 57) was...... examined. In the TBB the amount of PC correlated strongly with overall inflammation in the interstitium (Kendall correlation coefficient [Kcc] = 0.59; p < 0.0001), type 2 pneumocyte proliferation, and edema formation. The amount of PC in the TBB also correlated with interstitial accumulation of neutrophils...... (Kcc = 0.54; p = 0.0001), lymphocytes, and macrophages. In BALF the amount of PC correlated with edema formation and type 2 pneumocyte proliferation in the TBB but not with the percentage of neutrophils, lymphocytes, or macrophages in BALF. The amount of PC in the BALF and the percentage of neutrophils...

  16. Influence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study

    Yone Eric Walter

    2012-08-01

    Full Text Available Abstract Background The impact of HIV infection on the evolution of acute community-acquired pneumonia (CAP is still controversial. The aim of this study was to investigate possible differences in the clinical presentation and in-hospital outcomes of patients with CAP with and without HIV infection in a specialised service in Yaounde. Methods Medical files of 106 patients (51 men aged 15 years and above, admitted to the Pneumology service of the Yaounde Jamot Hospital between January 2008 and May 2012, were retrospectively studied. Results Sixty-two (58.5% patients were HIV infected. The median age of all patients was 40 years (interquartile range: 31.75-53 and there was no difference in the clinical and radiological profile of patients with and without HIV infection. The median leukocyte count (interquartile range was 14,600/mm3 (10,900-20,600 and 10,450/mm3 (6,400-16,850 respectively in HIV negative and HIV positive patients (p = 0.002. Median haemoglobin level (interquartile range was 10.8 g/dl (8.9-12 in HIV negative and 9.7 g/dl (8–11.6 in HIV positive patients (p = 0.025. In-hospital treatment failure on third day (39.5% vs. 25.5.1%, p = 0.137 and mortality rates (9% vs. 14.5%, p = 0.401 were similar between HIV negative and HIV positive patients. Conclusion Clinical and radiological features as well as response to treatment and in hospital fatal outcomes are similar in adult patients hospitalised with acute community-acquired pneumonia in Yaounde. In contrast, HIV infected patients tend to be more anaemic and have lower white cell counts than HIV negative patients. Larger prospective studies are needed to consolidate these findings.

  17. EoE (Eosinophilic Esophagitis)

    ... EoE commonly have other allergic diseases such as rhinitis, asthma, and/or eczema. Certain families may have ... swallowed from an asthma inhaler or mixture to control inflammation and suppress the eosinophils. Systemic corticosteroids such ...

  18. Eosinophil-Associated Gene Pathways but not Eosinophil Numbers are Differentially Regulated between Synchrotron Microbeam Radiation Treatment and Synchrotron Broad-Beam Treatment by 48 Hours Postirradiation.

    Ibahim, M J; Yang, Y; Crosbie, J C; Stevenson, A; Cann, L; Paiva, P; Rogers, P A

    2016-01-01

    Synchrotron microbeam radiation treatment (MRT) is a preclinical radiotherapy technique with considerable clinical promise, although some of the underlying radiobiology of MRT is still not well understood. In recently reported studies, it has been suggested that MRT elicits a different tumor immune profile compared to broad-beam treatment (BB). The aim of this study was to investigate the effects of synchrotron MRT and BB on eosinophil-associated gene pathways and eosinophil numbers within and around the tumor in the acute stage, 48 h postirradiation. Balb/C mice were inoculated with EMT6.5 mouse mammary tumors and irradiated with microbeam radiation (112 and 560 Gy) and broad-beam radiation (5 and 9 Gy) at equivalent doses determined from a previous in vitro study. After tumors were collected 24 and 48 h postirradiation, RNA was extracted and quantitative PCR performed to assess eosinophil-associated gene expression. Immunohistochemistry was performed to detect two known markers of eosinophils: eosinophil-associated ribonucleases (EARs) and eosinophil major basic protein (MBP). We identified five genes associated with eosinophil function and recruitment (Ear11, Ccl24, Ccl6, Ccl9 and Ccl11) and all of them, except Ccl11, were differentially regulated in synchrotron microbeam-irradiated tumors compared to broad-beam-irradiated tumors. However, immunohistochemical localization demonstrated no significant differences in the number of EAR- and MBP-positive eosinophils infiltrating the primary tumor after MRT compared to BB. In conclusion, our work demonstrates that the effects of MRT on eosinophil-related gene pathways are different from broad-beam radiation treatment at doses previously demonstrated to be equivalent in an in vitro study. However, a comparison of the microenvironments of tumors, which received MRT and BB, 48 h after exposure showed no difference between them with respect to eosinophil accumulation. These findings contribute to our understanding of the

  19. [Drug induced eosinophilic pleural effusion].

    Vasilescu, Raluca

    2014-01-01

    The hypersensitivity reactions induced by drugs, some widely used, like central nervous system medication, can have various presentations. The lung is a frequent target for such events. We present the case of 40-year-old male patient, non-smoker, with infant encephalopaty, seizures since age of 6 with polimorphic crisis (mainly absences), with anticonvulsivant treatment since 2011 (carbamazepine, sodium valproate, levetiracetam), with no respiratory medical history. Current symptoms started two weeks before, with chest pain, dry cough. He received no antibiotics. Chest X-ray and thoracic CT scan (27 June 2013) showed a left pleral effusion. Left exploratory thoracocentesis extracted 20 ml reddish pleural fluid: eosinophilic exsudate (60%) with normal adenosin deaminase. He also presents moderate blood eosinophilia (13.7%-1780/mm3). Pulmonary infarction with secondary pleurisy, thoracic trauma, acute pancreatitis with secondary pleurisy were excluded. No Loeffler transient infiltrates were documented, serology for Toxocara is IgG positive (historical) and not significant for current episode, no symptoms suggestive for toxocarosis (characteristic to young children, patient had no liver enlargement etc.), no hidatidosis or trichinelosis were found. As an exclusion diagnosis, a hypersensitivity reaction to anticonvulsivant medication was considered (mentioned in literature) carbamazepine and sodium valproate (even if medication was taken for a longer time), with blood and pleural eosinophilia. Together with the neurologist, the mentioned drugs were stopped and he was started on lamotrigine 2 tb/day and levetiracetam 1 tb/day, well tolerated, no absences were noticed. Total remission of blood eosinophilia and partial remission of pleural effusion were noticed. Subsequent follow-ups confirm favourable evolution, with healing of pleurisy and normal blood cell count, which are stable at 7 months after changing anticonvulsivant treatment. PMID:25241560

  20. Colonização e resistência antimicrobiana de Streptococcus pneumoniae isolado em nasofaringe de crianças com rinofaringite aguda Nasopharyngeal colonization and antimicrobial resistance of Streptococcus pneumoniae isolated in children with acute rinofaringitis

    Lêda Lúcia M. Ferreira

    2001-06-01

    ças com infecção respiratória alta podem ser usados na vigilância da resistência antimicrobiana numa determinada comunidade.OBJECTIVE: to determine the prevalence and risk factors for nasopharyngeal colonization by, and to evaluate antimicrobial susceptibility of Streptococcus pneumoniae strains in children with acute rhinopharyngitis. METHODS: we collected nasopharyngeal swab specimens from 400 children aged 3 months to 5 years and with clinical status of acute rhinopharyngitis from June 16, 1997 to May 20, 1998 at the outpatient clinics of two hospitals in the city of São Paulo. Nasopharyngeal specimens were collected pernasally using a calcium alginate swab and plated immediately after collection onto trypticose soy agar with 5% sheep blood and garamicin 5 mcg/ml. Penicillin susceptibility was determined by oxacillin 1 mcg disk screening test and the minimal inhibitory concentration by the E-test. RESULTS: Pneumococci were recovered from 139 children, indicating a colonization prevalence of 35%. The risk factors analyzed indicated that the colonization was more prevalent in children attending day-care centers, children with siblings younger than 5 years, and children with recent use of antimicrobial agents. The prevalence of penicillin non-susceptible strains was of 16 % (20 strains. All strains were intermediately resistant (0.1mcg/ ml < MIC < 1.0 mcg/ ml. Out of the penicillin intermediately resistant strains, 7 (37% showed intermediate resistance to cotrimoxazol and 2 (11% full resistance to trimethoprim-sulfamethoxazole. No strains were resistant to ceftriaxone, amoxicillin, clarithromicin, or chloramphenicol. CONCLUSIONS: our findings indicate that the prevalence of nasopharyngeal colonization by Streptococcus pneumoniae in children with upper respiratory infections was of 34.8%. Children attending day-care centers and children with younger siblings showed higher levels of colonization The results of prevalence of bacterial resistance were similar to those

  1. Viral pneumonia

    ... off infection. Vaccines may help prevent pneumonia in children, the elderly, and people with diabetes, asthma, emphysema , HIV, cancer, or other chronic conditions. A drug called palivizumab ( ...

  2. Insuficiência respiratória aguda causada por pneumonia em organização secundária à terapia antineoplásica para linfoma não Hodgkin Acute respiratory failure caused by organizing pneumonia secondary to antineoplastic therapy for non-Hodgkin's lymphoma

    Adriell Ramalho Santana

    2012-12-01

    Full Text Available Doenças difusas do parênquima pulmonar pertencem a um grupo de doenças de evolução geralmente subaguda ou crônica, mas que podem determinar insuficiência respiratória aguda. Paciente masculino, 37 anos, em terapia para linfoma não Hodgkin, admitido com tosse seca, febre, dispneia e insuficiência respiratória aguda hipoxêmica. Iniciadas ventilação mecânica e antibioticoterapia, porém houve evolução desfavorável. Tomografia computadorizada de tórax mostrava opacidades pulmonares em "vidro fosco" bilaterais. Devido ao paciente ter feito uso de três drogas relacionadas à pneumonia em organização (ciclofosfamida, doxorrubicina e rituximabe e quadros clínico e radiológico serem sugestivos, iniciou-se pulsoterapia com metilprednisolona com boa resposta. Pneumonia em organização pode ser idiopática ou associada a colagenoses, drogas e neoplasias, e geralmente responde bem a corticoterapia. O diagnóstico é anatomopatológico, mas condições clínicas do paciente não permitiam a realização de biópsia pulmonar. Pneumonia em organização deve ser diagnóstico diferencial em pacientes com aparente pneumonia de evolução desfavorável ao tratamento antimicrobiano.Interstitial lung diseases belong to a group of diseases that typically exhibit a subacute or chronic progression but that may cause acute respiratory failure. The male patient, who was 37 years of age and undergoing therapy for non-Hodgkin's lymphoma, was admitted with cough, fever, dyspnea and acute hypoxemic respiratory failure. Mechanical ventilation and antibiotic therapy were initiated but were associated with unfavorable progression. Thoracic computed tomography showed bilateral pulmonary "ground glass" opacities. Methylprednisolone pulse therapy was initiated with satisfactory response because the patient had used three drugs related to organizing pneumonia (cyclophosphamide, doxorubicin and rituximab, and the clinical and radiological symptoms were

  3. Pneumonia in the immunocompetent patient

    Reynolds, J. H.; McDonald, G; Alton, H; Gordon, S B

    2010-01-01

    Pneumonia is an acute inflammation of the lower respiratory tract. Lower respiratory tract infection is a major cause of mortality worldwide. Pneumonia is most common at the extremes of life. Predisposing factors in children include an under-developed immune system together with other factors, such as malnutrition and over-crowding. In adults, tobacco smoking is the single most important preventable risk factor. The commonest infecting organisms in children are respiratory viruses and Strepto...

  4. Atypical presentations of eosinophilic fasciitis

    Tulin Ergun

    2016-01-01

    Full Text Available Eosinophilic fasciitis is an uncommon connective tissue disease that may mimic and overlap with other sclerosing disorders such as morphea and lichen sclerosus. Herein, we report four patients (two men and two women, aged 16-64 yeas with eosinophilic fasciitis. There was overlap with both morphea and lichen sclerosus in 2 patients and with morphoea alone in 1 patient. Magnetic resonance imaging (MRI was used for diagnosis in three patients and for assessing treatment response in one patient. Eosinophilic fasciitis may co-exist with morhoea and lichen sclerosus. In view of the overlapping clinical and histopathological features of these disorders, MRI may be helful in delineating the conditions by detecting involvement of fascia.

  5. The identification of eosinophilic gastroenteritis in prednisone-dependent eosinophilic bronchitis and asthma

    Nair Parameswaran; Ochkur Sergei I; Protheroe Cheryl; Simms Elizabeth; Lee Nancy A; Lee James J

    2011-01-01

    Abstract This case reports the unique association of eosinophilic gastrointestinal disease with eosinophilic bronchitis, asthma and chronic rhinosinusitis and some features of lymphocytic hypereosinophilic syndrome, describes a diagnostic protocol for patients with asthma and persistent eosinophilic bronchitis, and suggests that the use of a novel EPX-mAb provides a reliable method to identify eosinophilic inflammation.

  6. Possible Prevalence and Transmission of Acute Respiratory Tract Infections Caused by Streptococcus pneumoniae and Haemophilus influenzae among the Internally Displaced Persons in Tsunami Disaster Evacuation Camps of Sri Lanka

    Watanabe, Hiroshi; Batuwanthudawe, Ranjith; Thevanesam, Vasanthi; Kaji, Chiharu; Qin, Liang; Nishikiori, Nobuyuki; Saito, Wakana; Saito, Mariko; Watanabe, Kiwao; Oishi, Kazunori; Abeysinghe, Nihal; Kunii, Osamu

    2007-01-01

    Objective The objective of this prospective study was to investigate the status of acute respiratory tract infections caused by Haemophilus influenzae and Streptococcus pneumoniae in tsunami disaster evacuation camps. Methods Nasopharyngeal swabs (NP) of 324 internally displaced persons (IDP) in 3 different tsunami disaster evacuation camps of Sri Lanka were collected between March 18th and 20th, 2005, and analyzed for MIC, β-lactamase production, serotypes, PCR and pulsed-field gel electroph...

  7. Fasciola hepatica induces eosinophil apoptosis in the migratory and biliary stages of infection in sheep.

    Escamilla, A; Bautista, M J; Zafra, R; Pacheco, I L; Ruiz, M T; Martínez-Cruz, S; Méndez, A; Martínez-Moreno, A; Molina-Hernández, V; Pérez, J

    2016-01-30

    The aim of the present work was to evaluate the number of apoptotic eosinophils in the livers of sheep experimentally infected with Fasciola hepatica during the migratory and biliary stages of infection. Four groups (n=5) of sheep were used; groups 1-3 were orally infected with 200 metacercariae (mc) and sacrificed at 8 and 28 days post-infection (dpi), and 17 weeks post-infection (wpi), respectively. Group 4 was used as an uninfected control. Apoptosis was detected using immunohistochemistry with a polyclonal antibody against anti-active caspase-3, and transmission electron microscopy (TEM). Eosinophils were identified using the Hansel stain in serial sections for caspase-3, and by ultrastructural features using TEM. At 8 and 28 dpi, numerous caspase-3(+) eosinophils were mainly found at the periphery of acute hepatic necrotic foci. The percentage of caspase -3(+) apoptotic eosinophils in the periphery of necrotic foci was high (46.1-53.9) at 8 and 28 dpi, respectively, and decreased in granulomas found at 28 dpi (6%). Transmission electron microscopy confirmed the presence of apoptotic eosinophils in hepatic lesions at 8 and 28 dpi. At 17 wpi, apoptotic eosinophils were detected in the infiltrate surrounding some enlarged bile ducts containing adult flukes. This is the first report of apoptosis induced by F. hepatica in sheep and the first study reporting apoptosis in eosinophils in hepatic inflammatory infiltrates in vivo. The high number of apoptotic eosinophils in acute necrotic tracts during the migratory and biliary stages of infection suggests that eosinophil apoptosis may play a role in F. hepatica survival during different stages of infection. PMID:26801599

  8. Eosinophilic Gastritis Presenting as Tissue Necrosis

    Jo, Yong Min; Jang, Jin Seok; Han, Seung Hee; Kang, Sang Hyun; Kim, Woo Jae; Jeong, Jin Sook

    2015-01-01

    Eosinophilic gastroenteritis is very rare disorder that is characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of any definite causes of eosinophilia. It is associated with various clinical gastrointestinal manifestations, and depends on the involved layer and site. We report a case of eosinophilic gastritis presenting with severe necrosis. The symptoms disappeared immediately after beginning steroid treatment, and the eosinophil count decreased to the refe...

  9. Eosinophil-Mediated Cholinergic Nerve Remodeling

    Durcan, Niamh; Costello, Richard W; McLean, W. Graham; Blusztajn, Jan; Madziar, Beata; Fenech, Anthony G; Hall, Ian P; Gleich, Gerard J.; McGarvey, Lorcan; Walsh, Marie-Therese

    2006-01-01

    Eosinophils are observed to localize to cholinergic nerves in a variety of inflammatory conditions such as asthma, rhinitis, eosinophilic gastroenteritis, and inflammatory bowel disease, where they are also responsible for the induction of cell signaling.Wehypothesized that a consequence of eosinophil localization to cholinergic nerves would involve a neural remodeling process. Eosinophil co-culture with cholinergic IMR32 cells led to increased expression of the M2 muscar...

  10. Eosinophilic esophagitis: diagnosis and management.

    Lieberman, Jay A; Chehade, Mirna

    2012-02-01

    Eosinophilic esophagitis is a clinicopathologic disease that can present with a constellation of upper gastrointestinal symptoms and endoscopic findings in conjunction with significant infiltration of the esophageal tissue with eosinophils. Clinical and histologic resolution of the disease can be seen with dietary restriction therapies and systemic and topical corticosteroids. Because most patients have an atopic background and the disease seems to have an underlying T-helper type 2 pathogenesis, allergists and gastroenterologists need to be familiar with the diagnosis and management of this disease. In this review, clinical characteristics, endoscopic and histologic findings, and available therapy options are discussed. PMID:22244233

  11. Eosinophilic Endomyocarditis: A Rare Case of Neonatal Mortality

    Allison J. Pollock

    2015-10-01

    Full Text Available Background - Eosinophilic endomyocarditis (EEM is a rare diagnosis that is extremely uncommon in newborns. This case report aimed to present a case of neonatal mortality from acute cardiac failure due to EEM. Case - Our report presents a term male neonate with minor complications in the immediate postnatal course, who was discharged at 48 hours of life, but who developed unexpected respiratory distress, followed by cardiac arrest and death at 3 days of life. One day after discharge, the infant developed respiratory distress and cool skin, and then developed cardiac arrest at the pediatrician's office, undergoing resuscitation with intravenous fluid, cardiopulmonary resuscitation, epinephrine, atropine, and failed intubation. Autopsy revealed EEM, an inflammatory infiltrative process involving the endomyocardium. Pathology - Pathogenesis involves three stages: (1 myocarditis with an acute eosinophilic inflammatory infiltrate followed by (2 myocyte necrosis and eventually (3 fibrosis in the final stage of the disease. Discussion - The cause of death was acute cardiac failure due to intense eosinophilic infiltration and degranulation with early subendocardial myocyte necrosis but before development of extensive myocyte necrosis. This case appears to be the youngest patient reported with EEM.

  12. Eosinophilic Endomyocarditis: A Rare Case of Neonatal Mortality.

    Pollock, Allison J; Hitt, Stacy L; Stier, Michael A; Houser, Laura M

    2015-10-01

    Background Eosinophilic endomyocarditis (EEM) is a rare diagnosis that is extremely uncommon in newborns. This case report aimed to present a case of neonatal mortality from acute cardiac failure due to EEM. Case Our report presents a term male neonate with minor complications in the immediate postnatal course, who was discharged at 48 hours of life, but who developed unexpected respiratory distress, followed by cardiac arrest and death at 3 days of life. One day after discharge, the infant developed respiratory distress and cool skin, and then developed cardiac arrest at the pediatrician's office, undergoing resuscitation with intravenous fluid, cardiopulmonary resuscitation, epinephrine, atropine, and failed intubation. Autopsy revealed EEM, an inflammatory infiltrative process involving the endomyocardium. Pathology Pathogenesis involves three stages: (1) myocarditis with an acute eosinophilic inflammatory infiltrate followed by (2) myocyte necrosis and eventually (3) fibrosis in the final stage of the disease. Discussion The cause of death was acute cardiac failure due to intense eosinophilic infiltration and degranulation with early subendocardial myocyte necrosis but before development of extensive myocyte necrosis. This case appears to be the youngest patient reported with EEM. PMID:26495174

  13. Eosinophilic Esophagitis (EE) or (EoE)

    ... EoE evaluation. Eosinophilic Esophagitis: Food Allergies Adverse immune responses to food are the main cause of EoE ... empiric elimination diets for eosinophilic esophagitis in adults » Eosinophilic Esophagitis in black children: An overlooked ... Academy of Allergy Asthma & Immunology 555 East Wells Street Suite 1100, Milwaukee , ...

  14. Severe Eosinophilic Endometritis Following Diagnostic Curettage

    Desai SR

    2010-07-01

    Full Text Available Severe Eosinophilic Endometritis appears after injury from a preoperative diagnostic procedure. It is an unusual and distinctive inflammatory uterine disease process, in response to eosinophil chemotactic substances. We report this case of a 55-year-old lady who developed severe eosinophilic endometritis following a diagnostic curettage

  15. Severe Eosinophilic Endometritis Following Diagnostic Curettage

    Desai SR; Shweta A. Shinagare

    2010-01-01

    Severe Eosinophilic Endometritis appears after injury from a preoperative diagnostic procedure. It is an unusual and distinctive inflammatory uterine disease process, in response to eosinophil chemotactic substances. We report this case of a 55-year-old lady who developed severe eosinophilic endometritis following a diagnostic curettage.

  16. Management guidelines of eosinophilic esophagitis in childhood

    Papadopoulou, A; Koletzko, S; Heuschkel, R;

    2014-01-01

    OBJECTIVES: Eosinophilic esophagitis (EoE) represents a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. With few exceptions, 15 eosinophils per high-power field (p...

  17. Eosinophilic cholecystitis caused by Ascaris lumbricoides

    Montiel-Jarquín Alvaro

    2008-01-01

    Eosinophilic cholecystitis is caused by the accumulation of eosinophils in the gallbladder wall and diagnosis is usually made based on histopahologic studies.The purpose of this paper is to comment on a case report published in Wodd J Gastroenterol 2007 luly;13 (27):3760-3762,about eosinophilic cholecystitis along with pericarditis without histopathological studies,which are considered necessary for its diagnosis.

  18. Emerging roles of eosinophils and eosinophil-derived lipid mediators in the resolution of inflammation

    Yosuke eIsobe

    2012-08-01

    Full Text Available Acute inflammation and its resolution are essential processes for tissue protection and homeostasis. Once thought to be a passive process, the resolution of inflammation is now shown to involve active biochemical programs that enable inflamed tissues to return to homeostasis. The mechanisms by which acute inflammation is resolved are of interest, and research in recent years has uncovered new endogenous anti-inflammatory and pro-resolving lipid mediators (i.e. lipoxins, resolvins, protectin, and maresin generated from polyunsaturated fatty acids (PUFAs. This review presents new insights into the cellular and molecular mechanisms of inflammatory resolution, especially the roles of eosinophils, and a series of omega-3 PUFA derived anti-inflammatory lipid mediators that they generate.

  19. Murine eosinophil differentiation factor. An eosinophil-specific colony- stimulating factor with activity for human cells

    1986-01-01

    A purified murine lymphokine, eosinophil differentiation factor (EDF), was found to be a selective stimulus for the clonal proliferation and differentiation of murine eosinophil progenitor cells, establishing it as the murine eosinophil colony-stimulating factor (Eo-CSF). EDF was also active on human eosinophil progenitors and mature blood eosinophils, but had no effect on neutrophil or macrophage precursor cells, nor on blood neutrophils. In culture of human bone marrow cells, EDF stimulated...

  20. Childhood pneumonia and vitamin A

    Farhad Heidarian

    2014-04-01

    Full Text Available One of the major causes of mortality in children younger than 5 years old is acute lower respiratory tract infections (ALRI. ALRI clinical features are cough, tachypnea, fever, coryza, chest retraction, crackles and wheeze. Increased white blood cell count with left shift might happen in pneumonia. C-reactive protein (CRP and erythrocyte sedimentation rate (ESR might rise in children with respiratory tract infections. Vitamin A deficiency is associated with severe childhood infections. The effect of vitamin A supplementation in childhood pneumonia depends on the prevalence and the level of vitamin A deficiency in the population. Some studies confirmed that retinol levels were significantly higher after recovery from acute pneumonia compared to acute phase. But there were no significant association between serum retinol level and the clinical manifestation.

  1. Lipoid Pneumonia in a Gas Station Attendant

    Gladis Isabel Yampara Guarachi; Valeria Barbosa Moreira; Angela Santos Ferreira; Selma M. De A. Sias; Rodrigues, Cristovão C.; Graça Helena M. do C. Teixeira

    2014-01-01

    The exogenous lipoid pneumonia, uncommon in adults, is the result of the inhalation and/or aspiration of lipid material into the tracheobronchial tree. This is often confused with bacterial pneumonia and pulmonary tuberculosis due to a nonspecific clinical and radiologic picture. It presents acutely or chronically and may result in pulmonary fibrosis. We describe here a case of lipoid pneumonia in a gas station attendant who siphoned gasoline to fill motorcycles; he was hospitalized due to pr...

  2. Viral pneumonia

    More serious infections can result in respiratory failure, liver failure, and heart failure. Sometimes, bacterial infections occur during or just after viral pneumonia, which may lead to more serious forms ...

  3. Hydrocarbon pneumonia

    Pneumonia - hydrocarbon ... Coughing Fever Shortness of breath Smell of a hydrocarbon product on the breath Stupor (decreased level of ... Most children who drink or inhale hydrocarbon products and develop ... hydrocarbons may lead to rapid respiratory failure and death.

  4. The Pneumonia Severity Index as a Predictor of In-Hospital Mortality in Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

    Guoping Hu

    Full Text Available To determine whether the pneumonia severity index (PSI can predict in-hospital mortality for AECOPD patients and compare its usefulness with the CURB65 and BAP65 indexes to predict mortality.Demographics, clinical signs and symptoms, comorbidities, and laboratory and radiographic findings of hospitalized AECOPD patients were obtained. Univariate and multiple logistic regression analyses were used to identify the risk factors for in-hospital mortality. The PSI, CURB65 and BAP65 scores were calculated. Receiver operating characteristic (ROC curve analysis was used to identify the PSI, CURB65 and BAP65 scores that could discriminate between non-survivors and survivors. To control for the confounding factor of invasive mechanical ventilation (IMV regarding the mortality of AECOPD, subgroup analysis was performed when excluded patients who had met the criteria of IMV but who had not received the cure of IMV according to their wishes.During the in-hospital period, 73 patients died and 679 patients recovered. Age, PaO2<60 mmHg, pH < 7.35, PaCO2≥50 mmHg, nursing home residency, congestive heart failure, liver disease, sodium<130 mmol/L, lower FEV1% and altered mental status were risk factors for in-hospital mortality. The areas under the ROC curves (AUCs of the PSI for death were 0.847 (95% CI: 0.799-0.895. The cut-off value was 116.5 with a sensitivity of 82.2% and a specificity of 77.6%. However, the AUCs of the CURB65 and BAP65 for death were only 0.744 (95% CI: 0.680-0.809 and 0.665 (95% CI: 0.594-0.736, respectively. Subgroup analysis also showed that the PSI score could predict the mortality of AECOPD patients with an AUC = 0.857 (95% CI: 0.802-0.913, with exclusion of the patients who met the criteria of IMV but who did not receive the cure of IMV.The PSI score may be used to predict in-hospital mortality for hospitalized AECOPD patients, with a prognostic capacity superior to CURB65 and BAP65.

  5. Transverse myelitis associated with Mycoplasma pneumoniae infection.

    MacFarlane, P I; Miller, V

    1984-01-01

    A case of acute transverse myelitis associated with respiratory infection by Mycoplasma pneumoniae is described. Circulating antibodies to myelin were detected suggesting that mycoplasma related neurological damage is mediated by producing an immunological myelopathy.

  6. Exogenous lipid pneumonia

    Exogenous lipid pneumonia (ELP) is caused by the aspiration of animal, vegetal or, more often, mineral oils. Even though it may also be acute, ELP is most frequently a chronic disease, affecting people with predisposing factors, such as neuromuscular disorders, structural abnormalities and so on; very often exogenous lipid pneumonia is found in tracheotomized patients. The pathology of lipid pneumonia is a chronic inflammatory process evolving in foreign-body-like reaction, and eventually in ''end-stage lung'' condition. Clinically, most patients are asymptomatic; few cases only present with cough, dyspnea and chest pain. Eight cases of ELP, studied over the past 3 years, are described in this paper. All the patients were examined by chest radiographs and standard tomograms; 3 patients underwent CT. X-ray features were mono/bilateral consolidation of the lower zones, with air bronchogram and variable reduction in volume. CT density was not specific for fat tissue. In all cases the diagnosis was confirmed at biopsy. In 5 patients, followed for at least one year, clinical-radiological features showed no change. Thus, complications of ELP (especially malignant evolution) could be excluded. The authors conclude that lipid pneumonia must be considered in differential diagnosis of patients with history of usage of oils and compatible X-ray findings. The usefulness of an accurate follow-up is stressed

  7. How Is Pneumonia Treated?

    ... page from the NHLBI on Twitter. How Is Pneumonia Treated? Treatment for pneumonia depends on the type ... can go back to their normal routines. Bacterial Pneumonia Bacterial pneumonia is treated with medicines called antibiotics. ...

  8. Eosinophilic granuloma of temporal bone

    Sachin Gupta

    2016-01-01

    Full Text Available Eosinophilic granuloma is an uncommon granulomatous disease which can affect the temporal bone. Also known as Langerhans cell histiocytosis, the lesion is characterized by uncontrolled proliferation of Langerhans cells. Although initially silent, the disease may erode the mastoid cortex, destroy the tegmen, and extend into the cranial vault, as well as erode the semicircular canals or cochlea. These lesions almost always become infected and can be confused with chronic otomastoiditis. Equally important, temporal bone involvement may represent only one manifestation of a multifocal disease. This report describes a case of 40-year-old male with eosinophilic granuloma involving the right temporal bone extending into midbrain region causing focal compression and displacement of part of the temporal lobe.

  9. MR findings of eosinophilic granuloma

    To describe the MR findings for the three phases of eosinophilic granuloma, as defined by Mirra's conventional radiographic criteria. Eighteen lesions in 14 patients with proven eosinophilic granuloma were retrospectively analyzed. Among this total, three vertebral lesions were excluded, and the remaining is were classified as early, middle, or late phase on the basis of Mirra's radiographic criteria. For each phase, we compared MR findings with regard to signal intensity, homogeneity, contrast enhancement, perilesional marrow edema, and soft tissue change. For the three vertebral lesions excluded because the application of radiographic criteria was difficult, MR findings for paravertebral soft tissue reaction and degree of cord compression were compared. Of the fifteen cases classified, eight were early phase, five were mid phase, and two were late phase. During each phase, all lesions except one, as seen on T1-weighted images(T1WI), showed iso-signal intensity. On T2WI, all lesions showed high signal intensity. Contrast study demonstrated marked contrast enhancement. Thus, no remarkable differences were found in the signal intensity degree of contrast enhancement of each phase. With regard to heterogeneity, this was demonstrated in most early phase lesions, reflecting necrosis and hemorrhage of those lesions. Soft tissue swelling was more severe during the early phase than the mid or late phase, but marrow edema was similar in each of the three phase. One of three patients with vertebraplana showed para-vertebral soft tissue swelling and cord compression, but this was not seen in the two other cases. For evalvating the extent of eosinophilic granuloma and its relationship with surrounding structures, MRI was superior to conventional radiography. During the early phase of the disease, lesions showed greater inhomogeneity and more aggressive soft tissue reaction than during the mid and late phase.The use of MRI for the evalvation of eosinophilic granuloma can help

  10. Eosinophilic airway inflammation in COPD

    Saha, Shironjit; Brightling, Christopher E.

    2006-01-01

    Chronic obstructive pulmonary disease is a common condition and a major cause of mortality. COPD is characterized by irreversible airflow obstruction. The physiological abnormalities observed in COPD are due to a combination of emphysema and obliteration of the small airways in association with airway inflammation. The predominant cells involved in this inflammatory response are CD8+ lymphocytes, neutrophils, and macrophages. Although eosinophilic airway inflammation is usually considered a f...

  11. Eosinophilic fasciitis after parasite infection.

    Oliveira, Marta; Patinha, Fabia; Marinho, Antonio

    2016-01-01

    Eosinophilic fasciitis is a systemic inflammatory disease characterized by symmetrical swelling and skin induration of the distal portions of the arms and/or legs, evolving into a scleroderma-like appearance, accompanied by peripheral blood eosinophilia. It is a rare disease with a poorly understood etiology. Corticosteroid treatment remains the standard therapy, either taken alone or in association with an immunosuppressive drug. This paper presents a case of a male patient with palpebral edema and marked eosinophilia, diagnosed with intestinal parasitic infection in October 2006. He was treated with an antiparasitic drug, but both the swelling and the analytical changes remained. This was followed by a skin and muscle biopsy, which turned out to be compatible with eosinophilic fasciitis. There was progressive worsening of the clinical state, with stiffness of the abdominal wall and elevated inflammatory parameters, and the patient was referred to the Immunology Department, medicated with corticosteroids and methotrexate. Over the years there were therapeutic adjustments and other causes were excluded. Currently the patient continues to be monitored, and there is no evidence of active disease. The case described in this article is interesting because of the diagnosis of eosinophilic fasciitis probably associated/coexisting with a parasite infection. This case report differs from others in that there is an uncommon cause associated with the onset of the disease, instead of the common causes such as trauma, medication, non-parasitic infections or cancer. PMID:27407276

  12. Gemifloxacin for the treatment of community-acquired pneumonia and acute exacerbation of chronic bronchitis: a meta-analysis of randomized controlled trials

    ZHANG Lei; WANG Rui; Falagas E. Matthew; CHEN Liang-an; LIU You-ning

    2012-01-01

    Background Gemifloxacin is a fluoroquinolone antibiotic with broad spectrum of antibacterial activity.The aim of the study was to evaluate the comparative effectiveness and safety of gemifloxacin for the treatment of patients with community-acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB).Methods We performed a meta-analysis of randomized controlled trials (RCTs) comparing gemifloxacin with other approved antibiotics.The PubMed,EMBASE,Chinese Biomedical Literature Database and the Cochrane Central Register of Controlled Trials were searched,with no language restrictions.Results Ten RCTs,comparing gemifloxacin with other quinolones (in 5 RCTs) and β-lactams and/or macrolides (in 5 RCTs),involving 3940 patients,were included in this meta-analysis.Overall,the treatment success was higher for gemifloxacin when compared with other antibiotics (odds ratio 1.39,95% confidence interval 1.15-1.68 in intention-to-treat patients,and 1.33,1.02-1.73 in clinically evaluable patients).There was no significant difference between the compared antibiotics regarding microbiological success (1.19,0.84-1.68) or all-cause mortality (0.82,0.41-1.63).The total drug related adverse events were similar for gemifloxacin when compared with other quinolones (0.89,0.56-1.41),while lower when compared with β-lactams and/or macrolides (0.71,0.57-0.89).In subgroup analyses,administration of gemifloxacin was associated with fewer cases of diarrhoea and more rashes compared with other antibiotics (0.66,0.48-0.91,and 2.36,1.18-4.74,respectively).Conclusions The available evidence suggests that gemifloxacin 320 mg oral daily is equivalent or superior to other approved antibiotics in effectiveness and safety for CAP and AECB.The development of rash represents potential limitation of gemifloxacin.

  13. 3 Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: Initial results in comparison to HRCT

    Attenberger, U.I., E-mail: ulrike.attenberger@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany); Morelli, J.N. [Scott and White Hospital, Texas A and M Health Sciences Center, Temple (United States); Henzler, T. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany); Buchheidt, D. [Department of Hematology and Oncology, University Medical Center Mannheim (Germany); Fink, C. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany); Department of Radiology, AKH Celle, Celle (Germany); Schoenberg, S.O.; Reichert, M. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany)

    2014-01-15

    Purpose: To evaluate the diagnostic accuracy of 3 Tesla proton MRI for the assessment of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia. Material and methods: In a prospective study, 3 Tesla MRI was performed in 19 febrile neutropenic patients (5 women, 14 men; mean age 61 years ± 14.2; range 23–77 years). All patients underwent high-resolution CT less than 24 h prior to MRI. The MRI protocol (Magnetom Tim Trio, Siemens) included a T2-weighted HASTE sequence (TE/TR: 49 ms/∞, slice thickness 6 mm) and a high-resolution 3D VIBE sequence with an ultra-short TE < 1 ms (TE/TR 0.8/2.9 ms, slice thickness 2 mm). The VIBE sequence was examined before and after intravenous injection of 0.1 mmol/kg gadoterate meglumine (Dotarem, Guerbet). The presence of pulmonary abnormalities, their location within the lung, and lesion type (nodules, consolidations, glass opacity areas) were analyzed by one reader and compared to the findings of HRCT, which was evaluated by a second independent radiologist who served as the reference standard. The findings were compared per lobe in each patient and rated as true positive (TP) findings if all three characteristics (presence, location, and lesion type) listed above were concordant to HRCT. Results: Pulmonary abnormalities were characterized by 3 Tesla MRI with a sensitivity of 82.3% and a specificity of 78.6%, resulting in an overall accuracy of 88% (NPV/PPV 66.7%/89.5%). In 51 lobes (19 of 19 patients), pulmonary abnormalities visualized by MR were judged to be concordant in their location and in the lesion type identified by both readers. In 22 lobes (11 of 19 patients), no abnormalities were present on either MR or HRCT (true negative). In 6 lobes (5 of 19 patients), ground glass opacity areas were detected on MRI but were not visible on HRCT (false positives). In 11 lobes (7 of 19 patients), MRI failed to detect ground glass opacity areas identified by HRCT. However, since the abnormalities were

  14. 3 Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: Initial results in comparison to HRCT

    Purpose: To evaluate the diagnostic accuracy of 3 Tesla proton MRI for the assessment of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia. Material and methods: In a prospective study, 3 Tesla MRI was performed in 19 febrile neutropenic patients (5 women, 14 men; mean age 61 years ± 14.2; range 23–77 years). All patients underwent high-resolution CT less than 24 h prior to MRI. The MRI protocol (Magnetom Tim Trio, Siemens) included a T2-weighted HASTE sequence (TE/TR: 49 ms/∞, slice thickness 6 mm) and a high-resolution 3D VIBE sequence with an ultra-short TE < 1 ms (TE/TR 0.8/2.9 ms, slice thickness 2 mm). The VIBE sequence was examined before and after intravenous injection of 0.1 mmol/kg gadoterate meglumine (Dotarem, Guerbet). The presence of pulmonary abnormalities, their location within the lung, and lesion type (nodules, consolidations, glass opacity areas) were analyzed by one reader and compared to the findings of HRCT, which was evaluated by a second independent radiologist who served as the reference standard. The findings were compared per lobe in each patient and rated as true positive (TP) findings if all three characteristics (presence, location, and lesion type) listed above were concordant to HRCT. Results: Pulmonary abnormalities were characterized by 3 Tesla MRI with a sensitivity of 82.3% and a specificity of 78.6%, resulting in an overall accuracy of 88% (NPV/PPV 66.7%/89.5%). In 51 lobes (19 of 19 patients), pulmonary abnormalities visualized by MR were judged to be concordant in their location and in the lesion type identified by both readers. In 22 lobes (11 of 19 patients), no abnormalities were present on either MR or HRCT (true negative). In 6 lobes (5 of 19 patients), ground glass opacity areas were detected on MRI but were not visible on HRCT (false positives). In 11 lobes (7 of 19 patients), MRI failed to detect ground glass opacity areas identified by HRCT. However, since the abnormalities were

  15. Eosinophilic gastroenteritis with ascites and hepatic dysfunction

    Hai-Bo Zhou; Jin-Ming Chen; Qin Du

    2007-01-01

    Eosinophilic gastroenteritis is a rare gastrointestinal disorder with eosinophilic infiltration of the gastrointestinal wall and various gastrointestinal dysfunctions. Diagnosis requires a high index of suspicion and exclusion of various disorders that are associated with peripheral eosinophilia.We report a case of eosinophilic gastroenteritis, which had features of the predominant subserosal type presenting with ascites and hepatic dysfunction, and which responded to a course of low-dose steroid.

  16. Eosinophil Apoptosis and Clearance in Asthma

    Walsh, Garry M

    2013-01-01

    Asthma is an increasingly common respiratory condition characterized by reversible airway obstruction, bronchial hyper-responsiveness and airway inflammation with a clear unmet need for more effective therapy. Eosinophilic asthma is a phenotype of the condition that features increased blood or sputum eosinophils whose numbers correlate with disease severity. Several lines of evidence are now emerging, which implicate increased persistence of eosinophils in the lungs of patients with asthma as...

  17. Severe Aplastic Anemia Associated With Eosinophilic Fasciitis

    de Masson, Adèle; Bouaziz, Jean-David; de Latour, Régis Peffault; Benhamou, Ygal; Moluçon-Chabrot, Cécile; Bay, Jacques-Olivier; Laquerrière, Annie; Picquenot, Jean-Michel; Michonneau, David; Leguy-Seguin, Vanessa; Rybojad, Michel; Bonnotte, Bernard; Jardin, Fabrice; Lévesque, Hervé; Bagot, Martine

    2013-01-01

    Abstract Diffuse eosinophilic fasciitis (Shulman disease) is a rare sclerodermiform syndrome that, in most cases, resolves spontaneously or after corticosteroid therapy. It has been associated with hematologic disorders, such as aplastic anemia. The clinical features and long-term outcomes of patients with eosinophilic fasciitis and associated aplastic anemia have been poorly described. We report the cases of 4 patients with eosinophilic fasciitis and associated severe aplastic anemia. For 3 ...

  18. Roles of integrin activation in eosinophil function and the eosinophilic inflammation of asthma

    Barthel, Steven R; Johansson, Mats W.; McNamee, Dawn M.; Deane F Mosher

    2007-01-01

    Eosinophilic inflammation is a characteristic feature of asthma. Integrins are highly versatile cellular receptors that regulate extravasation of eosinophils from the postcapillary segment of the bronchial circulation to the airway wall and airspace. Such movement into the asthmatic lung is described as a sequential, multistep paradigm, whereby integrins on circulating eosinophils become activated, eosinophils tether in flow and roll on bronchial endothelial cells, integrins on rolling eosino...

  19. Tropical Pulmonary Eosinophilia with Eosinophilic Leukemoid Reaction

    Manish Kumar

    2016-03-01

    Full Text Available A 7 year-old male presented with recurrent fever, cough and respiratory distress for over last 2 years. Based on extremely high eosinophil count, high Immunoglobulin E, increase in eosinophilic precursors in bone marrow, and positive antigen test for Wuchereria bancrofti, a diagnosis of Tropical Pulmonary Eosinophilia with Eosinophilic Leukemoid Reaction was made. Complete recovery was achieved with Diethylcarbamazine for 3 weeks. We are reporting this case as the first case of Tropical pulmonary eosinophilia with eosinophilic leukemoid reaction in a child.

  20. [Eosinophilic esophagitis: a rare cause of dysphagia].

    Billot, D; Pernin, M; Pillot, C; Bredin, C; Hoeffler, P; Graffin, B; Rey, P

    2010-12-01

    Eosinophilic esophagitis is an unrecognized and emerging entity. Its incidence increases with allergic disorders. A 29-year-old man presented with a 4-year history of intermittent and paroxysmal dysphagia. The triad including allergy, young age, and impaction of foreign bodies, combined with a chronic dysphagia is almost pathognomonic of eosinophilic esophagitis. Endoscopic esophageal features can be diverse, so systematic esophageal biopsies are required. Diagnosis is established with the demonstration of an eosinophilic infiltrate with a cell count exceeding 15 eosinophils per high power field (×400). First line therapy includes swallowed topical corticosteroids and removal of an allergic cause, when it could be identified. PMID:20605659

  1. Treatments and the choice of opportunity in treating pedo-pneumonia with acute pyothorax%小儿肺炎合并急性脓胸治疗方法及时机的选择

    王永连; 王忠民; 王毅; 陈志军; 赵宝生; 李汉臣

    2009-01-01

    Objective To explore the different treatments and the choice of opportunity in treating pedo-pneumonia with acute pyothorax.Methods Forty-eight cases of pedo-pneumonia with acute pyothorax from Sep.2003 to Oct.2007 were selected in our study.We analysed the dates of their diagnoses,treatment and therapeutic effect retrospectively.Results Forty-seven cases were healed,1 case was dead.There were 6 eases treated with antibiotics,supportive treatment and thoracentesis,19 cases treated with antibiotics,supportive treatment and closed drainage,23 cases treated with antibiotic,supportive treatment and operation in the cured cases.Conclusions Suitable therapy and opportunity of chose are important to treat pedo-pneumonia with acute pyothorax.%目的 探讨小儿肺炎合并急性脓胸不同的治疗方法及时机的选择.方法 回顾性分析我科自2003年9月至2007年10月收治的48例小儿肺炎合并急性脓胸的诊断、治疗及疗效.结果 48例小儿肺炎合并急性脓胸治愈47例,死亡1例.抗生素治疗+支持治疗+胸腔穿刺治愈6例,抗生素+支持治疗+胸腔闭式引流治愈19例,抗生素+支持治疗+开胸手术治愈23例.结论 对小儿肺炎合并急性脓胸的治疗要选择合适的方法,并且运用时机要恰当.

  2. Infección por Mycoplasma pneumoniae: tres casos con complicaciones neurológicas

    Cunha, J.; Madalena, C.; Guimarães, P.; Sousa, A.; Temudo, T.

    2002-01-01

    Summary. Introduction. Mycoplasma pneumoniae infection has been associated with severe central nervous system diseases. The pathogenesis of these disorders is unknown and the treatment uncertain. Case reports. The authors present three cases of central nervous system diseases: acute transverse myelitis, cerebellitis and encephalomyelitis associated with M. pneumoniae infection. Conclusions. M. pneumoniae infection should be considered in all cases of severe acute central nervous s...

  3. Prevent Pneumonia

    2015-08-06

    CDC’s Matthew Westercamp explains what pneumonia is, its symptoms, and how to prevent it.  Created: 8/6/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Respiratory Diseases Branch (RDB).   Date Released: 8/6/2015.

  4. Atypical pneumonia

    ... America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis . 2007;44:S27-S72. PMID: 17278083 ... by: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy and Critical Care, Perelman ...

  5. An outbreak of acute bovine mastitis caused by Klebsiella pneumoniae in a dairy herd Descrição de um surto de mamite aguda produzida por Klebsiella pneumoniae em bovinos leiteiros

    Silva, N.; G.M. Costa

    2001-01-01

    An outbreak of coliform mastitis is described in a dairy herd from the State of Rio de Janeiro, Brazil. During a four-month period 14 fatal cases of Klebsiella pneumoniae-related mastitis were observed in a herd of 104 lactating cows. The symptoms included peracute enterotoxemia in which the cows died 6 to 12 h after the detection of mastitis by CMT. Staphylococcus aureus and Streptococcus agalactiae Streptococcus agalactiae were also isolated although could not be associated with cases of ac...

  6. 异丙托溴铵、布地奈德雾化吸入加用口服急支糖浆辅助治疗小儿肺炎支原体肺炎的临床观察%Ipratropium Bromide Nebulized Budesonide Inhalation Plus Oral Acute Bronchitis Syrup Auxiliary Treatment of Mycoplasma Pneumoniae Pneumonia Clinical Observation

    王丽珍; 李飞平; 罗芳; 张梅娟

    2012-01-01

    Objective; To study the budesonide, ipratropium bromide Stock aerosol inhalation plus oral acute bronchitis syrup efficacy of mycoplasma pneumonia in children. Method; from May 2011 to May 2012 in our hospital diagnosed with pneumonia, mycoplasma pneumonia, aged 3 to 14 years old, 69 cases of hospitalized children, 35 cases were randomly divided into a control group and a test group of 34 patients. Test group application budesonide, ipratropium bromide atomizing inhalation plus oral acute bronchitis syrup, observation and comparison of the two groups on the basis of given antibiotics. Experimental group, children with cough disappeared time, of pulmonary rales disappear and hospitalization time there was significantly shorter (P<0.01) than the control group, the total effective rate in the test group than the control group (P<0. 01). Conclusion:Budesonide, ipratropium bromide oxygen drive to the aerosol inhalation plus oral acute bronchitis syrup can be used as auxiliary treatment of mycoplasma pneumonia treatment.%目的:研究布地奈德、异丙托溴铵联合雾化吸入加用口服急支糖浆对小儿支原体肺炎的疗效.方法:将2011年5月-2012年5月在我院诊断为肺炎支原体肺炎,年龄3~14岁的69例住院患儿,随机分为对照组35例与试验组34例.在给予抗感染的基础上试验组应用布地奈德、异丙托溴铵氧气驱动雾化吸入加用口服急支糖浆,观察比较两组疗效.结果:试验组患儿咳嗽消失时间、肺部罗音消失时间及住院时间均比对照组有极显著缩短(P<0.01),试验组总有效率比对照组高(P<0.01).结论:布地奈德、异丙托溴铵氧气驱动雾化吸入加用口服急支糖浆可以作为治疗小儿支原体肺炎的辅助治疗方式.

  7. Eosinophils in hereditary and inflammatory myopathies.

    Schröder, Thomas; Fuchss, Johann; Schneider, Ilka; Stoltenburg-Didinger, Gisela; Hanisch, Frank

    2013-12-01

    It is not known whether eosinophilic myositis is a specific histopathological feature of limb girdle muscular dystrophy 2A (LGMD2A). Number and location of eosinophils in skeletal muscle biopsies (n=100) was analysed by Giemsa and modified hematoxylin/eosin staining in patients with genetically confirmed myopathies (LGMD2A, LGMD2B, LGMD2L, facioscapulohumeral muscular dystrophy, dystrophinopathy), histologically confirmed idiopathic inflammatory myopathies (sporadic inclusion body myositis (sIBM), dermatomyositis (DM), polymyositis), amyotrophic lateral sclerosis (neurogenic control), and normal controls. The number of eosinophils/mm² was significantly higher in LGMD2A, PM, DM, and sIBM compared to controls but not significantly higher than other myopathies. A large overlap in the number of eosinophils/mm2 between all groups was seen. In all disease groups eosinophils were mainly found endomysially (46- 88%) and intra- and perivascularly (4-37%). There was no correlation between the numbers of eosinophils/mm² and (i) age at biopsy and (ii) the duration of the disease. The extent of myopathic, fibrotic, and inflammatory changes did not differ in samples with high and low eosinophil count. Eosinophils seem to represent an unspecific histological finding in hereditary and inflammatory myopathies, but also amyotrophic lateral sclerosis. PMID:24803842

  8. Coxiella burnetii pneumonia.

    Marrie, T J

    2003-04-01

    This report reviews the pulmonary and extrapulmonary manifestation of infections due to Coxiella burnetii. Q fever, a zoonosis, is due to infection with C. burnetii. This spore-forming microorganism is a small gram-negative coccobacillus that is an obligate intracellular parasite. The most common animal reservoirs are goats, cattle, sheep, cats, and occasionally dogs. The organism reaches high concentrations in the placenta of infected animals. Aerosolisation occurs at the time of parturition and infection follows inhalation of this aerosol. There are three distinct clinical syndromes of the acute form of the illness: nonspecific febrile illness, pneumonia, and hepatitis. The chronic form of Q fever is almost always endocarditis, but occasionally it is manifest as hepatitis, osteomyelitis or endovascular infection. The pneumonic form of the illness can range from very mild-to-severe pneumonia requiring assisted ventilation. Multiple round opacities are a common finding on chest radiography. Treatment with doxycycline or a fluoroquinolone is preferred. Susceptibility to macrolides is variable. In conclusion, Coxiella burnetii pneumonia should be considered when there is a suitable exposure history and when outbreaks of a pneumonic illness are being investigated. PMID:12762362

  9. The Pathophysiology of Eosinophilic Esophagitis

    Daniel Avi Lemberg

    2014-05-01

    Full Text Available Eosinophilic Esophagitis (EoE is an emerging disease characterised by esophageal eosinophilia (>15eos/hpf, lack of responsiveness to acid-suppressive medication and is managed by allergen elimination and anti-allergy therapy. Although the pathophysiology of EoE is currently unsubstantiated, evidence implicates food and aeroallergen hypersensitivity in genetically predisposed individuals as contributory factors. Genome-wide expression analyses have isolated a remarkably conserved gene-expression profile irrespective of age and gender, suggesting a genetic contribution. EoE has characteristics of mainly TH2 type immune responses but also some TH1 cytokines, which appear to strongly contribute to tissue fibrosis, with esophageal epithelial cells providing a hospitable environment for this inflammatory process. Eosinophil-degranulation products appear to play a central role in tissue remodeling in EoE. This remodeling and dysregulation predisposes to fibrosis. Mast cell-derived molecules such as histamine may have an effect on enteric nerves and may also act in concert with TGF-β to interfere with esophageal musculature. Additionally, the esophageal epithelium may facilitate the inflammatory process under pathogenic contexts such as in EoE. This article aims to discuss the contributory factors in the pathophysiology of EoE.

  10. Eosinophilic esophagitis: trials and tribulations.

    Allen, Katrina J; Heine, Ralf G

    2011-08-01

    Eosinophilic esophagitis (EE) is a recently recognized form of pan-esophagitis, which is characterized by the presence of at least 15 eosinophils per high power field on esophageal histology. EE is closely associated with atopic disorders and occurs predominantly in male patients. Young children are more likely to be sensitized to food allergens whilst aeroallergen sensitization predominates in older children and adults--a pattern reminiscent of the "atopic march". EE presents with a diverse range of gastrointestinal symptoms, including regurgitation, vomiting, feeding difficulties or refusal in infancy, in addition to dysphagia and food bolus impaction in older children and adults. The diagnosis may also be ascertained incidentally in patients undergoing gastroscopy for other suspected gastrointestinal conditions, such as gastroesophageal reflux disease or celiac disease. Complications mainly relate to subepithelial remodeling and fibrosis which may result in dysmotility, dysphagia and esophageal strictures. The proportion of EE patients at risk of these complications is unknown due to a paucity of data on the natural history of EE. There are only few randomized controlled trials assessing the efficacy of treatment modalities for EE, which currently either involve food allergen elimination or use of swallowed aerosolized corticosteroids. This article aims to discuss the complex issues of the diagnosis and long-term management that confront clinicians who care for children with EE. PMID:21415771