1/306. Prolonged respiratory failure in chlamydia pneumoniae pneumonia.We describe a 65-year-old man, who had cardiomyopathy and developed acute respiratory failure requiring ventilator treatment. Acute pneumonia caused by chlamydia pneumoniae was diagnosed based on PCR positivity of bronchoalveolar lavage. Gas exchange did not improve in response to appropriate antibiotic therapy, and the patient died.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/306. indium-111 pentetreotide lung uptake in infectious lung disease.Bilateral diffuse lung uptake of In-111 pentetreotide (OCT) was observed during a whole-body scan performed in a 68-year-old woman with Cushing's syndrome and suspected ectopic adrenocorticotropic hormone secretion. A few days later, she was found to have bilateral bacterial pneumonia (of mixed anaerobic origin). Cushing's syndrome was finally proved to be of pituitary origin. The OCT lung uptake in pneumonia probably resulted from tracer binding by somatostatin receptors on the inflammatory leukocytes. Although the rapid wash-out from experimentally induced abscesses does not make OCT a suitable tracer for detecting acute infections, the images and data here reported suggest that infectious lung disease should be excluded before diagnosing lung involvement by neuroendocrine tumors.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
3/306. Acid fast filaments in stool samples from an AIDS patient.The presence of filamentous bacteria morphologically similar to Nocardia in a fresh stool sample from an AIDS patient with pulmonary nocardiosis is here reported. The material was submitted to our laboratory for a parasitologic examination and was stained by the Kinyoun method, revealing numerous delicate, irregularly stained, branching acid-fast filaments. nocardia asteroides had been isolated from sputum samples of this patient. The patient was a 32 year-old hiv female admitted to our center on June 1997 because of productive cough, right-sided thoracic pain and weight loss. Chest X rays showed the presence of right superior lobe excavated pneumonia. This was the first time we had observed filamentous bacteria similar to Nocardia in a stool sample submitted to parasitologic examination. For similar cases, and when its presence was not detected in other specimens collected from the same patient, intestinal endoscopy and biopsy should be performed for eventual lesions and smear examination repeated with Kinyoun stain and cultures for Nocardia.- - - - - - - - - - ranking = 0.1keywords = pneumonia (Clic here for more details about this article) |
4/306. Community acquired pseudomonas aeruginosa pneumonia.pseudomonas aeruginosa is an uncommon cause of community acquired pneumonia in immunocompetent hosts. We report two cases that did well once appropriate and prolonged antimicrobial therapy was initiated. They had no evidence of immune deficiency. The initial consideration was pulmonary tuberculosis in both cases given the subacute presentation, significant weight loss, and findings on chest roentgenogram.- - - - - - - - - - ranking = 0.5keywords = pneumonia (Clic here for more details about this article) |
5/306. Fulminant psittacosis requiring mechanical ventilation and demonstrating serological cross-reactivity between legionella longbeachae and chlamydia psittaci.chlamydia psittaci infection typically causes a mild respiratory illness in humans. Severe respiratory failure requiring mechanical ventilation or intensive care therapy is an uncommon development. The aetiological agents causing severe community acquired pneumonia often remain undetermined. Serological tests may aid in diagnosis. We present two cases of fulminant psittacosis, one demonstrating early cross-reactivity with legionella longbeachae.- - - - - - - - - - ranking = 0.1keywords = pneumonia (Clic here for more details about this article) |
6/306. In-hospital management of adults who have community-acquired pneumonia.The initial in-hospital management of adult patients with community-acquired pneumonia can be divided into five major steps: an early recognition of the patient with presumptive pneumonia, assessment of the severity of illness, establishment of an etiologic diagnosis, supportive therapy, and decision regarding initiation of empirical therapy. In most European recommendations, the empirical antibiotic treatment is directed against "the most likely pathogen," based on epidemiological, clinical, and laboratory data, and on the severity of illness. In contrast, newer North American guidelines have focused on the severity of illness of community-acquired pneumonia. As a consequence, the use of a broader initial antibiotic coverage, including extended-spectrum cephalosporins and combinations, seems to be more common in north america than in europe.- - - - - - - - - - ranking = 0.7keywords = pneumonia (Clic here for more details about this article) |
7/306. Bronchopleural fistula complicating group A beta-haemolytic streptococcal pneumonia. Use of a Fogarty embolectomy catheter for selective bronchial blockade.A 36-year-old woman developed severe group A Streptococcal pneumonia, complicated by a bronchopleural fistula, ARDS and multi-organ failure. We describe the use of selective middle lobe bronchus blockade, with a Fogarty embolectomy catheter, to localise and control the air leak. This allowed effective mechanical ventilation and oxygenation on intensive care and during right middle lobectomy. The patient made a prolonged, but full recovery.- - - - - - - - - - ranking = 0.5keywords = pneumonia (Clic here for more details about this article) |
8/306. A novel type of AmpC beta-lactamase, ACC-1, produced by a klebsiella pneumoniae strain causing nosocomial pneumonia.A klebsiella pneumoniae strain resistant to oxyimino cephalosporins was cultured from respiratory secretions of a patient suffering from nosocomial pneumonia in Kiel, germany, in 1997. The isolate harbors a bla resistance gene located on a transmissible plasmid. An escherichia coli transconjugant produces a beta-lactamase with an isoelectric point of 7.7 and a resistance phenotype characteristic of an AmpC (class 1) beta-lactamase except for low MICs of cephamycins. The bla gene was cloned and sequenced. It encodes a protein of 386 amino acids with the active site serine of the S-X-X-K motif at position 64, as is characteristic for class C beta-lactamases. Multiple alignment of the deduced amino acid sequence with 21 other AmpC beta-lactamases demonstrates only very distant homology, reaching at maximum 52.3% identity for the chromosomal AmpC beta-lactamase of serratia marcescens SR50. The beta-lactamase of K. pneumoniae KUS represents a new type of AmpC-class enzyme, for which we propose the designation ACC-1 (Ambler class C-1).- - - - - - - - - - ranking = 1.1keywords = pneumonia (Clic here for more details about this article) |
9/306. Pseudoaneurysm of the subclavian artery due to xanthomonas pneumonia in a patient with acute myeloid leukemia: its rupture treated by transcatheter coil embolization.A 52-year-old male with acute myeloid leukemia developed pseudoaneurysm of the subclavian artery. Pneumonia due to xanthomonas maltophilia, which was multi-drug resistant, progressed to a lung abscess even under administration of antibiotics. This lung infection contiguous to the left carotid and subclavian arteries was suggested to have caused the pseudoaneurysm of the subclavian artery. The rupture of the aneurysm by penetration to the trachea amounted to about 1,000 ml of bleeding; fortunately the bleeding ceased spontaneously. Nonetheless, an emergency transcatheter coil embolization prevented re-bleeding. Endovascular treatment should be considered especially for aneurysms which develop in patients with underlying diseases.- - - - - - - - - - ranking = 0.4keywords = pneumonia (Clic here for more details about this article) |
10/306. nocardia asteroides pneumonia, subcutaneous abscess and meningitis in a patient with advanced malignant lymphoma: successful treatment based on in vitro antimicrobial susceptibility.nocardia asteroides pneumonia, subcutaneous abscess and meningitis without brain abscesses developed in a patient with advanced non-Hodgkin's lymphoma, who had received corticosteroid therapy and cancer chemotherapy for a long time. At the time of nocardial pneumonia, profound lymphocytopenia and hypogammaglobulinemia was seen. The severely immunosuppressed condition most likely accounted for the uncommon infection, nocardiosis. The organism isolated from the sputum, subcutaneous abscess and cerebrospinal fluid was strongly resistant to cotrimoxazole, which is the recommended standard treatment, but it was susceptible to imipenem (IPM) and erythromycin (EM) in an in vitro antimicrobial susceptibility study. The patient's nocardiosis responded well to chemotherapy including IPM and EM.- - - - - - - - - - ranking = 0.6keywords = pneumonia (Clic here for more details about this article) |
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