Infections pulmonary

The most serious and life-threatening complication is recurrent pulmonary infections due to overgrowth of various pathogens in the viscous secretions of the respi-... 

Some members of a community that were exposed to trichloroethylene along with a variety of other solvents in their drinking water complained of respiratory disorders, but the complaints could not be attributed specifically to trichloroethylene (Byers et al. 1988). This effect may have been due to immune system impairment resulting in increased susceptibility to infection. A study in mice in which inhalation exposure to trichloroethylene increased the susceptibility to pulmonary infection with Streptococcus zooepidemicus (Aranyi et al. 1986) provides evidence that trichloroethylene may result in adverse respiratory effects through effects on the immune system. 

Calculate clinical pulmonary infection score (refer to Table 9.4)... 

Clinical Pulmonary Infection Score (CPIS) Calculation... 

White blood cell count with an associated increase in polymorphonuclear (PMN) leukocytes and bands may occur in acute pulmonary infection however, infection may occur without these laboratory abnormalities. 

Gibson RL, Burns JL, Ramsey BW. State of the art pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med 2003 168 918-951. 

RA alone leads to changes in cellular immunity and causes a disproportionate increase in pulmonary infection and sepsis.11 Because medications that alter the immune system are linked to an increased risk of infection, it is difficult to distinguish between an increased risk of infection secondary to RA and the medications used to treat RA. Patients and clinicians must pay close attention to signs and symptoms of infection because of this increased risk.11... 

Luna CM, Blanzaco D, Niederman MS, et al. Resolution of ventilator-associated pneumonia Prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome. Crit Care Med 2003 31 676-682. 

Fluconazole 12 mg/kg/day PO for 6-12 weeks transitioned to itraconazole or fluconazole Corticosteroid therapy should be considered in hypoxic patients with acute pulmonary infection... 

Aspergillus spp. high mortality Pulmonary infection common... 

The use of the aerosol route for delivery of antibiotics for pulmonary infections remains controversial. The majority of pediatric studies have been conducted in children with cystic fibrosis. In these patients distribution of the antibiotic to the desired tissue site is impeded because of the viscosity of the sputum in patients with acute exacerbations of their pulmonary infections [91,92], Long-term studies have demonstrated preventive benefits of aerosolized antibiotics in children with cystic fibrosis who are colonizing Pseudomonas aeruginosa in their lungs but are not acutely ill [93,94], Cyclic administration of tobramycin administered by nebulizer has received FDA approval [95],... 

Pseudomonas aeruginosa membrane protein F Epitope display on cowpea mosaic virus in cowpea leaf Elicited specific antibodies. Immunogenic in mice when delivered parenterally. Mice protected when challenged with model chronic pulmonary infection with P. aeruginosa. 19, 83... 

Table 8.10 Some pathogens (bacterial, fungal and protozoal) whose phagocytic-mediated destruction is impaired in persons suffering from CGD. Administration of IFN-y, in most cases, enhances the phagocyte s ability to destroy these pathogens. These agents can cause hepatic and pulmonary infections, as well as genitourinary tract, joint and other infections...

Infantile, generalized cardiomegalic AMD, or Pompe s disease, usually becomes manifest in the first weeks or months of life, with failure to thrive, poor suck, generalized hypotonia and weakness, also termed floppy infant syndrome. Macroglossia is common, as is hepatomegaly, which, however, is rarely severe. There is massive cardio-megaly, with congestive heart failure. Weak respiratory muscles make these infants susceptible to pulmonary infection death usually occurs before the age of 1 year and invariably before the age of 2 years [6]. 

The clinical picture in male children can closely resemble Duchenne-type muscular dystrophy in adults, it mimics limb-girdle dystrophy or polymyositis. The early and severe involvement of respiratory muscles in most patients with AMD is a distinctive clinical clue. Respiratory failure and pulmonary infection are the most common causes of death. 

Common precipitating factors that may cause a previously compensated patient to decompensate include noncompliance with diet or drug therapy, coronary ischemia, inappropriate medication use, cardiac events (e.g., MI, atrial fibrillation), pulmonary infections, and anemia. 

Some patients with acute pulmonary infection may have a spontaneous cure. Patients with progressive pulmonary disease should be treated... 

Therapy of coccidioidomycosis is difficult, and the results are unpredictable. Only 5% of infected persons require therapy. Candidates for therapy include those with severe primary pulmonary infection or concurrent risk factors (e.g., human immunodeficiency virus infection, organ transplant, or high doses of glucocorticoids), particularly patients with high complement fixation antibody titers in whom dissemination is likely. 

Antibiotic concentrations in respiratory secretions in excess of the pathogen minimum inhibitory concentration (MIC) are necessary for successful treatment of pulmonary infections. 

Prescott, E., Lange, P, and Vestbo, J., Chronic mucus hypersecretion in COPD and death from pulmonary infection, Eur. Respir. J. 8, 8, 1333, 1995. 

It is now recognized that opiates reduce resistance to a variety of infectious agents in both humans and animals. These effects are summarized in Table 30.3 and Table 30.4 and discussed below. For example, pulmonary infections caused by mycobacteria, staphylococci, streptococci, Hemophilus and other common organisms are frequent among opium abusers.23 24 Other infectious diseases caused by microbial pathogens in... 

No studies were located regarding populations that are unusually susceptible to hexachloroethane toxicity. Because the kidney and liver are the primary target tissues, individuals with compromised liver or kidney function would have an increased risk from exposure. Susceptibility to pulmonary infections could be increased by exposure to hexachloroethane vapors and, thus, individuals that suffer from chronic respiratory problems could also have an increased risk from hexachloroethane exposure. 

Caution Both glanders and melioidosis may occur in an acute localized form, as an acute pulmonary infection, or as an acute fulminant, rapidly fatal, sepsis. Combinations of these syndromes may occur in human cases. In addition, melioidosis may remain asymptomatic after initial acquisition, and remain quiescent for decades, but these patients may display active melioidosis years later which is often associated with an immune-compromising state. Aerosol infection produced by a biological weapon containing either glanders (B. mallei) or melioidosis (B. pseudomallei) could produce any of these syndromes... 

Illness from melioidosis can be categorized as acute or localized infection, acute pulmonary infection, acute bloodstream infection, and chronic suppurative infection. Inapparent infections are also possible. The incubation period (time between exposure and appearance of clinical symptoms) is not dearly defined, but may range from 2 days to many years. 

Pulmonary infection This form of the disease can produce a clinical picture of mild bronchitis to severe pneumonia. The onset of pulmonary melioidosis is typically accompanied by a high fever, headache, anorexia, and general muscle soreness. Chest pain is common, but a nonproductive or productive cough with normal sputum is the hallmark of this form of melioidosis. 

Pulmonary infections In pulmonary infections, pneumonia, pulmonary abscesses, and pleural effusion can occur Chest X rays vdl show localized infection in the lobes of the lungs. 

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