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Nihon Kokyuki Gakkai Zasshi. 2002 Nov;40(11):851-5.
[Chronic eosinophilic pneumonia--a follow-up study of 12 cases]

[Article in Japanese]

Mochizuki Y, Kobashi Y, Nakahara Y, Tanaka A, Kawamura T, Sasaki S, Kawanami R.

Department of Pulmonary Medicine, National Himeji Hospital.

In this study, twelve cases of CEP were followed for a mean period of 10.9 years (range 9.3-12.9 years) at National Himeji Hospital. Of the five women and seven men examined, two patients possessed preexisting asthma and one developed asthma during the course of CEP disease. None of the patients exhibited any symptoms of allergic rhinitis. All had dramatic responses to corticosteroid therapy without developing extrathoracic manifestations. During the course of CEP, one patient died from acute myocardial infarction. Relapses, which occurred in six patients, responded as well to the treatment as in the original episode. One patient continued long-term oral corticosteroids (5 mg/day) and steroid inhalants (800 micrograms/day) as treatment for asthma. Another was administered steroid inhalants (800 micrograms/day) to treat both asthma and relapsing CEP; two additional patients received 800-600 micrograms/day to prevent relapse. These data indicate that, with proper treatment, the long-term prognosis for patients with CEP is excellent.

PMID:_12645104 Curr Infect Dis Rep. 2000 Apr;2(2):115-120.
The Role of Chlamydia in Upper Respiratory Tract Infections.

Hammerschlag MR.

Department of Pediatrics and Medicine, State University of New York Health Science Center at Brooklyn, 450 Clarkson Avenue, Brooklyn, NY 11203-2098, USA. E-mail: mhammerschlaol.net

Although Chlamydia pneumoniae and Chlamydia psittaci are well-established causes of community-acquired pneumonia, little is known about the role of Chlamydia species in upper respiratory tract infections. C. pneumoniae may play a role in the pathogenesis of acute otitis media. Although C. pneumoniae has been isolated from the middle-ear fluid of children with otitis, children in whom the organism was isolated from middle-ear fluid improved despite being treated with antibiotics that are not active against C. pneumoniae. Although many patients with community-acquired pneumonia caused by C. pneumoniae have symptoms suggestive of sinusitis, there is only one report of isolation of the organism from the maxillary sinus of a patient with sinusitis. Studies of the association with pharyngitis are all based on serology, which often has a poor correlation with isolation of the organism by culture.

PMID:_11095846 [PubMed - as supplied by publisher] Curr Infect Dis Rep. 2000 Jun;2(3):207-214.
Gram-Positive Pneumonia.

Osiyemi O, Dickinson G.

Medical Service Miami Veterans Affairs Medical Center and University of Miami School of Medicine, 1201 N.W. 16th Street, Miami, FL 33125, USA.

Gram-positive pneumonia is a leading cause of morbidity and mortality throughout the world. Of the gram-positive pathogens that cause pneumonia, Streptococcus pneumoniae and Staphylococcus aureus are the most common. The diagnosis of gram-positive pneumonia remains less than satisfactory, and newer diagnostic techniques such as antibody- and polymerase chain reaction-based antigen detection have yet to prove themselves. Drug resistance among gram-positive organisms is now endemic throughout the world and remains a serious therapeutic problem despite the availability of new antimicrobials. Efforts to control the spread of resistant strains include, in the case of S. aureus, stringent isolation policies and topical treatment to reduce carriage and, for S. pneumoniae, increased use of available vaccines and the develop- ment of more immunogenic vaccines.

PMID:_11095858 [PubMed - as supplied by publisher] Curr Infect Dis Rep. 2000 Jun;2(3):215-223.
Nosocomial or Healthcare Facility-Related Pneumonia in Adults.

Balaguera HU, Mir J, Craven DE.

Section of Infectious Diseases, Boston Medical Center, Dowling Building 3 North, One Boston Medical Center Place, Boston, MA 02118, USA. dcraveu.edu

Nosocomial or hospital-acquired pneumonia (HAP) is a dynamic disease with multiple etiologic agents and a changing natural history. The emergence and spread of multidrug-resistant bacterial pathogens is a current concern. Because of the parallels between HAP and pneumonia occurring in patients in subacute or chronic care facilities, we suggest the use of a more inclusive term for these patients: healthcare facility-related pneumonia. This article focuses on current controversies in the pathogenesis, diagnosis, management, and prevention of bacterial HAP in adults. We endorse early, appropriate antibiotic therapy based on disease severity and the use of strategies to prevent infection, improve patient outcome, and reduce hospital costs.

PMID:_11095859 [PubMed - as supplied by publisher] Curr Infect Dis Rep. 2000 Jun;2(3):231-237.
Pulmonary Infections in Ventilated Patients: Diagnostic and Therapeutic Options.

Dormer AL, Lutwick LI.

Divisions of Pulmonary/Critical Care and Infectious Diseases, Department of Medicine, VA-New York Harbor Health Care System, Brooklyn Campus, 800 Poly Place, Brooklyn, NY 11209, USA. larry.lutwicew-york.va.gov

The diagnosis of pulmonary infections in the ventilated patient has threatened the foundations of medicine. Although the lifesaving techniques of endotracheal intubation (developed for the treatment of diphtheria) and artificial ventilation (developed for the management of poliomyelitis) contribute greatly to medical care, they have resulted in the production of the "progress"-related infection of ventilator-associated pneumonia (VAP). Modern ventilator therapy is a substantial technologic advance from earlier days and, as technology inherently does, has removed some of the human element, the main foundation of Oslerian medical practice. The time-honored clinical diagnosis based on physical examination by an experienced physician has been seriously compromised in the approach to VAP.

PMID:_11095861 [PubMed - as supplied by publisher]

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