1/12. pneumocystis carinii pneumonia with pleurisy, platypnoea and orthodeoxia.We present a patient who collapsed with chest pain and dyspnoea on a transatlantic flight. She was found to have pneumocystis carinii pneumonia (PCP) and human immunodeficiency virus infection. Platypnoea and orthodeoxia, which have not been previously reported in association with PCP, were major features of her illness. The PCP predominantly affected her lung bases and it is likely that gravity increased intrapulmonary blood flow through poorly ventilated lung bases with failure of pulmonary vasoconstriction to increase upper zone perfusion, exacerbating desaturation on sitting up. The partial dna sequence of the infecting P carinii was identical to previously described isolates.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/12. Fatal necrotizing pneumonia caused by group A streptococcus.Group A streptococcus (GAS) causes invasive, non-invasive and non-suppurative diseases. Pneumonia is one of the invasive infections caused by GAS. Although GAS is a significant and serious cause of childhood pneumonia, it is often overlooked clinically. Similarly, the recent literature is surprisingly scant on reports of GAS pneumonia and concentrates mainly on varicella-associated invasive GAS diseases. In this case report, we present a previously healthy 7-year-old child with community-acquired pneumonia that progressed rapidly and resulted in sepsis, respiratory failure and death. In both blood and pleural fluid cultures, streptococcus pyogenes were isolated. On autopsy, macroscopic examination revealed that the lung tissue appeared to have lost its normal architecture. necrosis was present and the lung had a spongy appearance with some solid areas. The light microscopy revealed massive oedema, haemorrhages, intense inflammatory cell infiltration and necrosis. This case report highlights the need for consideration of invasive GAS infection in the event of severe, rapidly progressing pneumonia in children.- - - - - - - - - - ranking = 1.6keywords = pneumonia (Clic here for more details about this article) |
3/12. Clue to fine-needle aspiration diagnosis of pleural pneumocystoma: neovascularization and Langhans' giant cell reaction.Pneumocystis pneumonia is a common component of the acquired immunodeficiency syndrome (AIDS) in the united states. Extrapulmonary pneumocystosis, however, is much less common. Rare cases have been reported in lymph nodes, bone marrow, spleen, pleura, gastrointestinal tract, liver, common bile duct, pancreas, skin, thyroid, and eye. A 39-yr-old man with history of chest wall injuries from gunshot and stabbing presented with multiple pleural masses clinically suspicious of metastatic deposits from an unknown primary. Fine-needle aspiration biopsy of the largest pleural mass revealed extrapulmonary pneumocystis, which led to the diagnosis of AIDS. Similar to the previous reports of pneumocystis mass lesions in extrapulmonary sites, the current case is associated with exuberant vascular proliferation and Langhans' giant cell reaction. Neovascularization and histiocytic influx from the newly formed blood vessels and Langhans' giant cell reaction seem to be a common tissue reaction to the massive deposition of pneumocystis organisms in extrapulmonary sites in patients with AIDS.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
4/12. nocardia asteroides pneumonia complicating low dose methotrexate treatment of refractory rheumatoid arthritis.Low dose methotrexate is used increasingly often in the treatment of rheumatoid arthritis. Severe complications due to toxicity of the lung or bone marrow occur infrequently. This report describes a 71 year old woman with longstanding rheumatoid arthritis who developed pleuritis, a pulmonary infiltrate, and pancytopenia during treatment with low dose methotrexate. Fatal respiratory insufficiency followed, and cultures from the lung after death showed nocardia asteroides.- - - - - - - - - - ranking = 0.8keywords = pneumonia (Clic here for more details about this article) |
5/12. Group C streptococcal pleurisy and pneumonia: a fulminant case and review of the literature.A 30-year-old, previously healthy patient developed a pleurisy and pneumonia due to group C streptococcus, with multiple medical complications, including bilateral empyemas. Eight other reported cases of group C streptococcal pneumonia are reviewed.- - - - - - - - - - ranking = 1.2keywords = pneumonia (Clic here for more details about this article) |
6/12. Explosive pleuritis. Manifestation of group A beta-hemolytic streptococcal infection.Two young adults had clinical and roentgenographic evidence of explosive pleuritis that was caused by group A beta-hemolytic streptococci. Persistent high fever and intense pleuritic pain following severe pharyngitis should suggest streptococcal pleural infection and prompt careful roentgenographic investigation. These cases show that group A beta-hemolytic streptococcal infection can cause explosive pleuritis in the absence of apparent bronchopneumonia.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
7/12. Pleuro-pulmonary manifestations of systemic lupus erythematosus: clinical features of its subgroups. Prognostic and therapeutic implications.Correct identification of the subsets of pulmonary lupus has an unquestioned importance in planning the proper therapeutic regimen in this extremely variegated disease. Asymptomatic pulmonary lupus needs no treatment; however, pulmonary involvement in lupus may be life threatening, in which case prompt and aggressive treatment is mandatory. The different aspects of pulmonary lupus are demonstrated through the clinical histories of patients who suffered from pleuro-pulmonary lupus. The following entities are presented: lupus pneumonitis, lymphocytic interstitial pneumonia, pulmonary hypertension, pulmonary hemorrhage, pulmonary embolism associated with circulating lupus anticoagulant, lupus pleuritis and weakness of the diaphragm.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
8/12. Acute pleurisy in sarcoidosis.A 47-year-old white man with sarcoidosis presented with a six-week history of acute painful pleurisy. On auscultation a loud pleural rub was heard at the left base together with bilateral basal crepitations. The chest radiograph showed hilar enlargement as well as diffuse lung shadowing. A lung biopsy showed the presence of numerous epithelioid and giant-cell granulomata, particularly subpleurally. A patchy interstitial pneumonia was also present. He was given a six-month course of prednisolone, and lung function returned to normal.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
9/12. The clinical spectrum of campylobacter fetus infections: report of five cases and review of the literature.Five cases of extra-intestinal campylobacter fetus infections are described and an additional 242 cases are reviewed from the literature. A variety of clinical syndromes are encountered including endocarditis; thrombophlebitis; meningitis; pneumonia and pleuritis; and infectious arthritis. Thirty-eight per cent of patients presented with bacteremia enteritis. campylobacter fetus demonstrates a preference for endovascular surfaces. The majority of patients are male and have an underlying illness. mortality is increased in patients infected with C. fetus intestinalis. Therapy is based on in vitro antibiotic susceptibility tests although the organism is usually sensitive to an aminoglycoside and chloramphenicol.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
10/12. Infections due to rhodococcus equi in three hiv-infected patients: microbiological findings and antibiotic susceptibility.Infections of rhodococcus equi, a well-known pathogen in animals which causes cavitated pneumonia similar to that caused by mycobacteria, were studied in three hiv-infected patients. This microorganism was isolated in the bronchoalveolar washings of two patients and in the sputum of the third. In two patients, Rh. equi represented the first clinical opportunistic manifestation of hiv disease. One patient died of concomitant Pneumocystis infection. The eradication of the microorganism occurred in two out of three patients. It was found that no isolates were resistant to erythromycin, claritromycin, rifampin, vancomycin, teicoplanin, imipenem, gentamycin or azithromycin (MIC values < or = 0.1 microgram/ml). Moreover, the quinolones (ciprofloxacin and ofloxacin) were found to be less effective, whereas neither the beta-lactam antibiotics nor chloramphenicol were effective therapy for this microrganism. At least two antimicrobial agents should be given contemporaneously to treat these infections for a period of up to several months. Our results suggest that the combinations erythromycin rifampin or imipenem teicoplanin are the most effective treatments in Rh. equi infections.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
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