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At least 919 records · Page 51Linked to original sources
PubMed1992

Pulmonary zygomycosis: a radiographic and clinical spectrum.

Eight documented cases of pulmonary zygomycosis were analyzed retrospectively with regard to radiographic and clinical features. Predisposing factors were diabetes mellitus in six cases, lymphoblastic lymphoma in one case, and surgery to correct a tracheoesophageal fistula in one case. Two of the patients with diabetes had also undergone renal transplantation for diabetic nephropathy and were immunosuppressed. The more usual radiographic findings of pulmonary zygomycosis represent a spectrum that comprises a normal chest radiograph, a lung abscess, subacute or chronic pneumonia that often evolves into a lung abscess, and rapidly progressive fatal pneumonia. Awareness of the various presentations of pulmonary zygomycosis is important because early diagnosis and appropriate therapy clearly have been shown to improve the survival rate of these patients. Zygomycosis should be included in the differential diagnosis when patients with diabetes mellitus, patients with leukemia or lymphoma, or immunocompromised patients present with or develop perplexing pulmonary abnormalities.

Adolescent↗
PubMed1991

[The clinical efficacy of treating patients with nonspecific lung diseases using low-energy laser irradiation and intrapulmonary drug administration].

Intrapulmonary administration of glucocorticosteroids and antibiotics combined with low-energy laser radiation was employed in the treatment of patients with infection-dependent bronchial asthma in the phase of exacerbation and frequent asphyxia attacks, long medical history and of patients with lung abscesses. The purpose of the work was to study and compare the clinical effectiveness of the method in the gravest group of patients suffering from nonspecific pulmonary diseases: suppurative (acute lung abscess) and infectious allergic (infection-dependent bronchial asthma of medium gravity with frequent attacks, long medical history, tendency towards aggravation of the status and low efficacy of broncholytics). The results of the treatment and follow-up have shown that the use of the combined treatment suggested is most optimal in patients with acute lung abscesses (the percentage of the cured is 94.1). In patients with infection-dependent bronchial asthma, the use of laser therapy combined with intrapulmonary administration of steroids also noticeably improved the clinical, functional and immunological characteristics, prolonged the phase of remission.

Administration, Inhalation↗
PubMed2005

Lung resection in children for infectious pulmonary diseases.

Lung resection is uncommon in children because of its limited indications. We reviewed and analyzed the records of 31 children who underwent pulmonary resection between 1994 and 2001. The mean age was 7 years (range 1.6-12 years), and genders were equal. Bronchiectasis, lung abscess, necrotizing pneumonia, and destroyed lung were seen in 14, 12, 3, and 2 patients, respectively. Bronchial stenosis and inflammation of the bronchus was found endoscopically in four patients, and a foreign body in one patient. The indications for surgery in chronic sepsis were: recurrent respiratory tract infections, severe bronchiectasis, recurrent hemoptysis, destroyed lung parenchyma, and lung abscess, while the indications for surgery in acute infections were: failed medical treatment, or empyema. A lobectomy was done on 15 patients, lobectomy and lingulectomy on 4, lobectomy and decortications on 10, and pneumonectomy on 2 with no operative deaths. Intra-operative and post-operative complications were seen in 2 and 4 patients, respectively. Mean follow-up was 3.9 years (range 1.5-5 years). Twenty-eight patients were asymptomatic and three had improved. Respiratory function remained unchanged in 14 children. Mediastinal shift and lung overinflation occurred after pneumonectomy. These results show that lung resection can be done safely in pulmonary infection refractory to conservative medical therapy. Pulmonary resection does not alter respiratory function since the resected segments do not contribute to ventilation.

Child, Preschool↗
PubMed1980

Bacteriology of aspiration pneumonia in children.

Aspiration pneumonia in adults has been shown to involve anaerobes about 90% of the time. Studies of the bacteriology of aspiration pneumonia in children done in the past have either failed to exclude the oral and upper respiratory tract flora or have not utilized proper anaerobic culture techniques or both. In the present study. 74 institutionalized children with aspiration pneumonia were studied by percutaneous transtracheal aspiration. Their average age was 8 years. Fifty-two patients had pneumonitis, 12, necrotizing pneumonia, and 10, lung abscess. Only one patient (with lung abscess) had a complicating empyema. There was an average of five bacteria isolated per specimen--2.8 anaerobes and 2.2 nonanaerobes. The predominant anaerobic isolates were Gram-positive cocci, Bacteroides melaninogenicus, and fuso-bacteria; there were ten patients who yielded members of the Bacteroides fragilis group. The predominant nonanaerobes were alpha-hemolytic streptococci, Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. Thus, aspiration pneumonia in children, as in adults, commonly involves anaerobic bacteria. When aspiration occurs in a medical institution, nosocomial pathogens which are aerobic or facultative will also often be involved, in both children and adults.

Adolescent↗
PubMed2003

Mixed infections with Porphyromonas gingivalis and Treponema denticola cause excessive inflammatory responses in a mouse pneumonia model compared with monoinfections.

Periodontopathic anaerobes such as Porphyromonas gingivalis are frequently found in aspiration pneumonia and lung abscesses. However, defense mechanisms and responses to these bacterial infections in the lung in vivo remain poorly understood. The coexistence of P. gingivalis with Treponema denticola has been found at higher levels and proportions in periodontally diseased sites. We hypothesized that mixed infections with P. gingivalis and T. denticola can cause severe respiratory disease. In the present study, inflammatory responses to mono- and mixed inoculations with P. gingivalis and T. denticola in the bronchoalveolar lavage (BAL) fluid were investigated. Acute pneumonia and lung abscesses in mice with the mixed infection resulted in a 40% mortality rate within 72 h, compared with only 10% mortality for the respective monoinfections. Pulmonary clearance of P. gingivalis was delayed in the mice with mixed infections with P. gingivalis and T. denticola. Tumor necrosis factor alpha (TNFalpha) interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) levels from BAL fluid of mice with mixed infections at 24 h after inoculation were significantly higher than those after P. gingivalis monoinfection (TNFalpha: P < 0.05, Il-1beta: P < 0.001, IL-6: P < 0.05). The chemokine KC level from BAL fluid of mice at 48 h (P < 0.05) and 72 h after mixed infection was also significantly increased when compared with that after P. gingivalis monoinfection (P < 0.001). The present study demonstrates that a mixed infection of P. gingivalis with T. denticola in mouse causes a marked bronchopneumonia and lung abscess in the mouse model.

Abscess↗
PubMed1994

[A surgical case of achalasia with empyema].

A 57-year-old man who had been complicated with achalasia for thirty years was admitted because of back pain and low grade fever. Chest X-p and Chest CT showed consolidation in the left lower lung field. His respiratory condition was diagnosed as lung abscess preoperatively. After systemic chemotherapy, surgical management was done for both achalasia and this inflammatory respiratory disease. In the operation by left thoracotomy, it was revealed that this case had empyema, not lung abscess. Thus decortication of left lung and esophagomyotomy were performed simultaneously. In the treatment of achalasia, respiratory complications due to aspiration may appear. In addition, it is sometimes difficult to distinguish empyema from lung abscess preoperatively. Therefore much care should be taken during operation in order to treat these respiratory diseases.

Empyema, Pleural↗
PubMed1990

Lung cavities in patients with coeliac disease.

The clinical, radiological and pathological features of 7 patients with coeliac disease (CD) who developed lung abscesses or cavities are described. These patients were seen during a 20-year period during which time approximately 600 coeliacs were seen and 50 died. Six of the coeliac patients with lung abscess died. The patients were middle aged. Staphylococcal infection, Klebsiella pneumoniae, bronchial carcinoma and previous pulmonary tuberculosis accounted for the cavities in 4 patients. In the 3 other patients a definite cause could not be identified. Hyposplenism and malnutrition were common. Next to malignancy pulmonary abscess was the commonest cause of death in the coeliac population. The development of respiratory symptoms should be regarded as a potentially serious and a life-threatening event in the middle-aged coeliac patients. Lung abscess should be added to the list of respiratory diseases associated with coeliac disease.

Adult↗
PubMed1975

Bacteriologic flora of aspiration-induced pulmonary infections.

The role of anaerobic and aerobic microorganisms in the genesis of pneumonia or lung abscess in patients with historical, clinical, and radiologic findings suggestive of aspiration was compared to their role in similar patients without these findings. Bacterial specimens were obtained by transtracheal aspiration or thoracentesis. Anaerobes were isolated in 100% of the patients who were aspiration-prone as contrasted with only 20% of those who were not. Isolation of a single species or no growth was more common in the nonaspiration group, whereas multiple isolates were more common in the aspiration group. Patients with lung abscesses were treated with penicillin and all of them responded clinically, despite occasional recovery from the culture specimen of penicillin-resistant organisms. This suggests that lung abscess may be the result of a synergistic bacterial infection.

Haemophilus influenzae↗
PubMed1982

Thoracic mass lesions in immuno-incompetent patients.

An aggressive surgical approach was used in the diagnosis and treatment of seven immuno-incompetent patients who presented with focal thoracic mass lesions. In five of the seven patients, minor diagnostic procedures had failed to provide a diagnosis. All seven patients were subjected to exploratory thoracotomy with resection and/or drainage of the involved area. Two patients had parenchymal masses, two had lung abscesses, two had empyemas with trapped lung, and one had a bronchial fistula. An accurate diagnosis and full resolution of the intrathoracic process was obtained in all patients. There was little morbidity and no operative mortality in this series. Resection of focal thoracic lesions in immuno-incompetent patients combines accurate diagnosis with precise therapy and is well tolerated in this high risk group of patients.

Adolescent↗
PubMed1992

Thoracic intervention.

The literature of the past year regarding interventional procedures in the thorax covers aspects of transthoracic needle biopsy, drainage of pleural fluid collections, percutaneous management of lung abscess, and thoracic vascular interventions. Topics in transthoracic needle biopsy include a large retrospective series on fluoroscopically guided biopsy of thoracic masses; several reports reviewing experience with diagnosis of anterior mediastinal masses, including four studies describing the use of real-time ultrasound guidance for this procedure; the description of a new automated cutting needle for consistent tissue sampling; and two studies addressing factors affecting pneumothorax and chest tube insertion rates following transthoracic needle biopsy. Reports on percutaneous management of pleural fluid collections are highlighted by a paper reporting the results of ultrasound-guided drainage and sclerosis of malignant pleural effusions. Ultrasound-guided percutaneous aspiration of lung abscess for isolation of causative bacteria is the basis of two recent papers, and successful CT-guided drainage of lung abscesses is described by a group of researchers that has written extensively on a variety of the interventional thoracic procedures that are currently performed. Finally, the failures and complications associated with bronchial and pulmonary arterial embolization procedures have been reviewed.

Biopsy, Needle↗