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Of 30 patients with pneumonia due to Haemophilus influenzae, 26 had infection due to nontypable and 4 due to typable organisms. Biotype I isolates were implicated with surprising frequency. Blood cultures were positive in six patients. An additional 14 patients, all with nontypable H. influenzae infection, had febrile purulent tracheobronchitis that was clinically indistinguishable from pneumonia except for the absence of a radiographic infiltrate; none were bacteremic. Penicillin susceptibility was shown for 95% of isolates, and response to ampicillin was prompt. Patients had high serum levels of bactericidal antibody on admission but had lower levels of serum opsonizing activity against their own organism than did uninfected carriers with chronic bronchitis; 2 to 3 weeks later, levels of opsonizing antibody had risen to equal those of carriers. Deficient opsonizing activity may have contributed to susceptibility to infection. These findings identify both host and bacterial factors that may cause susceptibility to pulmonary infection from H. influenzae.

The 1938 article by Dr H. A. Reimann, a Philadelphia physician from Jefferson Medical College, 1 published inThe Journal, became widely quoted and popularized the term atypical pneumonia . Dr Reimann described the presence of a pneumonia syndrome with findings quite different from the lobar consolidation of classic pneumococcal pneumonia and stressed a possible viral etiology. His cases varied from afebrile upper respiratory tract illness to a severe, prolonged pneumonia associated with encephalopathy. Headaches and symptoms of tracheobronchitis often preceded the signs of pneumonia. Retrospectively, one might question why this article had such a substantial effect in subsequent years. Neither the syndrome nor the name atypical pneumonia originated with Dr Reimann. There were many reports from Europe in the early 1920s of an unusual acute pneumonia syndrome of unknown cause. Similar syndromes had been described in army troops, school academies, and colleges in the United States between 1931 and 1936.

The tracheobronchial histopathologic findings in 7 healthy cats used with high frequency oscillation ventilation (HFOV) were compared with those in 6 cats used with conventional mechanical ventilation (CMV). 4-point, 9-variable scoring system was used to evaluate the injury in the trachea, right & left main bronchi and parenchyme. The following results were obtained ; 1) The tracheobronchial tree received HFOV had no significant damage compared with CMV (P>0.05). 2) Intraepithelial mucus loss and emphysema were s lightly more prominent in CMV groups. As above results ; the tracheobronchial histopathologic difference was not prominent between CMV and HFOV groups received with relatively short period, however, the cellular function and barotrauma may be more prominent in CMV groups. From now on, as causes of tracheobronchial injury in HFV, interaction between humidification and mechanical trauma considers further study.

Acute infections of the upper respiratory tract, whether manifested as coryza, acute rhinitis, pharyngitis, or tracheobronchitis, are of the commonest incidence. A "cold," the grip, influenza nostras, catarrhal fever, acute bronchitis, are common terms used to designate such attacks. The infectious nature of the disease is almost universally accepted, although the identity of the infecting agent is not established. Walter's investigations 1 are of practical interest. He shows that the Bacillus segmentosus of Cautley and the Micrococcus catarrhalis are probably sometimes causative of acute rhinitis and infections of the middle ear and accessory nasal sinuses. A cold may cause as much suffering and incapacity as many diseases considered more serious. Often the illness is prolonged from the usual few days to ten days or two weeks. These infections are only too frequently the starting-point of complications that are a life-long menace to well-being. Among such complications and sequelae are a

Surgical treatment of tracheobronchial deformities permits conservation of undamaged lung tissue distal to bronchial lesions, and provides a means of treating obstructive tracheal lesions heretofore considered insurmountable. Two methods in this immature surgical field have been used with gratifying success. The first is resection and anastomosis, 1 the second is plastic reconstruction with wire-supported dermal grafts. 2 The first method is useful for small localized lesions, and the second suitable for more extensive deformities. The case described here afforded a severe test for tracheobronchial reconstruction. The relatively new surgical method used provided a solution to a clinical problem in which the distribution of healed lesions of tuberculous tracheobronchitis (which created the problem) was unique. In this case strangulating asphyxiation was gradually progressive for two years until finally an incredible degree of airway obstruction resulted that involved the thoracic trachea as well as both bronchi. Developing rapidly, a similar degree of

A typical attack of influenza usually begins as a rhinitis and spreads from the nasal mucosa throughout the respiratory tract. As the chief symptoms are produced by the involvement of the bronchial tree, attention is naturally directed to the lungs and bronchi as the most important foci for the infection. However, in studying acute cases one is often impressed by the fact that the severity of the disease, best evidenced by the general prostration of the patient, is out of all proportion to the physical signs. Tracheobronchitis with abundant mucopurulent sputum, a particularly distressing and often spasmodic cough, and moist râles uniformly present in both lungs, almost exhaust the positive findings for the respiratory tract. It becomes difficult to understand why a vigorous, previously healthy young adult, should succumb to an infection which in many cases appears to be almost wholly confined to the tracheobronchial mucosae. It might even be

Excerpt Articles have frequently appeared in the medical literature concerning pseudomembranous enterocolitis appearing as a complication of antibiotic therapy and caused by the development of bact...

It is no longer felt that atypical (viral) pneumonia is always as innocuous as it was originally described. Many patients have experienced recurring episodes of this disease over a period of several years. In some the symptoms have continued unabated; a productive cough has developed, and the presence of bronchiectasis has been confirmed by bronchographic examination. Other patients have had residual ulcerative tracheobronchitis associated with hemoptysis and production of sputum. These patients may show roentgenographic evidence of bronchial and bronchiolar dilatation and occlusion, atelectasis or obstructive emphysema. In others the convalescence has been prolonged and characterized by neurasthenia, chronic cough, production of sputum, pain in the chest, generalized weakness, easy fatigability, occasional hemoptysis, loss of weight or failure to regain previous weight lost, elevated sedimentation rate and low grade fever. Twenty-nine of 150 patients having bronchoscopic examinations during the first six months of 1944 were found to have ulcerative lesions

DERMATITIS caused by beryllium compounds is one of the principal occupational hazards in beryllium-extraction plants. Gelman 1 cited Pack as having observed a papulovesicular dermatitis on the exposed surfaces of workers engaged in the extraction of beryllium. Ulcers resembling those caused by chromates and dichromates occurred on the fingers of these workers. De Nardi 2 reported 202 cases of dermatitis, 131 cases of tracheobronchitis, and 57 cases of pneumonitis from two beryllium-extraction plants near Cleveland during the period from 1940 to Jan. 17, 1950. Of the 202 cases of dermatitis, De Nardi lists 156 as due to beryllium fluoride (BeF 2 ) and 45 as due to beryllium sulfate (BeSO 4 ). 3 Many of the workers who acquired the dermatitis also acquired conjunctivitis and rhinopharyngitis. Van Ordstrand and De Nardi and associates 4 observed that the skin and mucous membrane symptoms occurred in about 25% of the new employees

Ventilator associated- respiratory infections (VARI) are the most prevalent in the ICU. The differential diagnosis of pneumonia (VAP) and tracheobronchitis (TAV) is overlapping.

Introduction Herpes simplex virus (HSV) type 1 was identified in respiratory specimens from a cluster of eight patients on a surgical intensive care unit within 8 weeks. Six of these patients suffered from HSV-related tracheobronchitis and one from HSV-related pneumonia only. Our outbreak investigation aimed to determine the clinical relevance of and risk factors associated with HSV-related tracheobronchitis or pneumonia in critically ill patients, and to investigate whether the cluster was caused by nosocomial transmission. Methods A retrospective cohort study was performed to identify risk factors for the outcomes of HSV-related tracheobronchitis or pneumonia and death using univariable analysis as well as logistic regression analysis. Viruses were typed by molecular analysis of a fragment of the HSV type 1 glycoprotein G. Results The cohort of patients covering the outbreak period comprised 53 patients, including six patients with HSV-related tracheobronchitis and one patient with pneumonia only. HSV-related tracheobronchitis or pneumonia was associated with increased mortality (100% in patients with versus 17.8% in patients without HSV-related tracheobronchitis or pneumonia; P < 0.0001). The interaction of longer duration of ventilation and tracheotomy was associated with HSV-related tracheobronchitis or pneumonia in multivariable analysis. Identical HSV type 1 glycoprotein G sequences were found in three patients and in two patients. The group of three identical viral sequences belonged to a widely circulating strain. The two identical viral sequences were recovered from bronchoalveolar lavages of one patient with HSV-related tracheobronchitis and of one patient without clinical symptoms. These viral sequences showed unique polymorphisms, indicating probable nosocomial transmission. Conclusion HSV-related tracheobronchitis or pneumonia is associated with increased mortality in critically ill patients. Care should be taken to avoid nosocomial transmission and early diagnosis should be attempted.