U N Kumar

Medical College of Wisconsin, Milwaukee, Wisconsin, United States

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Publications (11)113.13 Total impact

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    ABSTRACT: Enzyme immunoassay (EIA), immunodiffusion (ID), and complement fixation (CF) tests for antibody to the A antigen of Blastomyces dermatitidis were assessed in 47 patients in an epidemic of blastomycosis and in 89 control subjects with lower respiratory tract illness. Antibody was detected by EIA, ID, and CF in 77%, 28%, and 9% of the patients, respectively. EIA titers ranged from 1:8-1:512 (median titer, 1:128). Antibody detected by ID or CF was always detectable by EIA. Antibody was detected by EIA 13 days after illness onset, and the peak seroprevalence rate and geometric mean titer occurred 50-70 days after onset. Antifungal therapy produced a significant decline in antibody titer by approximately six months after onset. Seven (8%) control subjects had detectable antibody, six had EIA titers of 1:8, and one had a titer of 1:16. The specificities for EIA, ID, and CF were 92%, 100%, and 100%, respectively. The EIA provides a significant advance in serodiagnostic testing for blastomycosis and can be used in an outbreak setting as an epidemiological tool to identify acute B. dermatitidis infection; titers greater than or equal to 1:32 strongly support the diagnosis, whereas titers of 1:8 or 1:16 are suggestive.
    The Journal of Infectious Diseases 03/1987; 155(2):262-8. DOI:10.1093/infdis/155.2.262 · 6.00 Impact Factor
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    ABSTRACT: In investigating six cases of blastomycosis in two school groups that had separately visited an environmental camp in northern Wisconsin in June 1984, we identified a large outbreak of the disease and isolated Blastomyces dermatitidis from soil at a beaver pond near the camp. Of 89 elementary-school children and 10 adults from the two groups, 48 (51 percent) of the 95 evaluated in September had blastomycosis. Of the cases, 26 (54 percent) were symptomatic (the median incubation period was 45 days; range, 21 to 106 days). No cases were identified in 10 groups that visited the camp two weeks before or after these two groups. A review of camp itineraries, a questionnaire survey, and environmental investigation showed that blastomycosis occurred in two of four groups that visited a beaver pond and in none of eight groups that did not. Walking on the beaver lodge (P = 0.008) and picking up items from its soil (P = 0.05) were associated with illness. Cultures of soil from the beaver lodge and decomposed wood near the beaver dam yielded B. dermatitidis. We conclude that B. dermatitidis in the soil can be a reservoir for human infection.
    New England Journal of Medicine 03/1986; 314(9):529-34. DOI:10.1056/NEJM198602273140901 · 55.87 Impact Factor
  • U Nanda Kumar · Basil Varkey
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    ABSTRACT: Mycobacterium gordonae, a scotochromogenic organism, is considered a saprophyte. In sputum cultures the isolation of this organism or other species belonging to the scotochromogen group is not generally considered clinically significant since they are known to appear as commensals. We report the case of a 50-year-old man with pulmonary infection caused by M. gordonae. The clinical and radiographic findings in this case and the course was outlined. Diagnostic criteria of atypical mycobacterial infections are discussed and previously reported scotochromogenic infections briefly reviewed.
    British Journal of Diseases of the Chest 05/1980; 74(2):189-92. DOI:10.1016/0007-0971(80)90033-9
  • D S Olson · U N Kumar · A Funahashi
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    ABSTRACT: Pulmonary involvement usually is a late manifestation of progressive systemic sclerosis. In the case reported here, dyspnea and pulmonary interstitial fibrosis developed more than a year prior to onset of skin and vascular changes. Open-lung biopsy performed early in the course of the disease failed to yield a definitive diagnosis.
    Postgraduate Medicine 08/1978; 64(1):173-5. · 1.70 Impact Factor
  • B Varkey · U N Kumar
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    ABSTRACT: Exposure to asbestos may occur in any of a large number of occupations, and the latent period from exposure to appearance of clinical or roentgenologic evidence of related disease of the lung or pleura, or both, may be more than 20 years. A complete occupational history is therefore of paramount importance in the detection of asbestos-related diseases. Illustrative cases highlight the features of benign and malignant diseases of the lung and pleura for which a causal relationship to asbestos exposure is probable or established.
    Postgraduate Medicine 07/1978; 63(6):48-66. · 1.70 Impact Factor
  • A Funahashi · U N Kumar · B Varkey
    Postgraduate Medicine 03/1977; 61(2):262-6. · 1.70 Impact Factor
  • U N Kumar · B Varkey
    Postgraduate Medicine 12/1976; 60(5):253-5. · 1.70 Impact Factor
  • Source
    U N Kumar · B Varkey
    Chest 11/1976; 70(4):527-8. DOI:10.1378/chest.70.4.527 · 7.48 Impact Factor
  • U. Nanda Kumar · Basil Varkey
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    ABSTRACT: Bronchogenic carcinoma was suspected in an elderly male smoker who had lost weight and presented with a large solitary pulmonary nodule on the radiograph. On thoracotomy a thoracoabdominal aortic aneurysm was found. The diographic findings in this case and the characteristics of thoracoabdominal aneurysms in general are briefly discussed.
    British Journal of Diseases of the Chest 05/1976; 70(2):117-20. DOI:10.1016/0007-0971(76)90017-6
  • U N Kumar · B Varkey · F B Landis
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    ABSTRACT: Allergic bronchopulmonary aspergillosis is being recognized with increasing frequency in the United States. The characteristics of the disease are recurrent pyrexia, cough, wheezing, sputum plugs containing aspergilli, fleeting pulmonary infiltrates, eosinophilia, dual skin reactions (immediate and late), and antibodies to the fungus in the blood. The pathogenetic mechanism is believed to involve type I and type III hypersensitivity reactions. Adrenal corticosteroids are effective in treating this condition.
    Postgraduate Medicine 12/1975; 58(6):141-5. · 1.70 Impact Factor
  • U N Kumar · B Varkey · G Mathai
    JAMA The Journal of the American Medical Association 12/1975; 234(6):625-6. DOI:10.1001/jama.234.6.625 · 35.29 Impact Factor