scholarly journals Pulmonary aspergilloma on transthoracic ultrasound

Infection ◽  
2021 ◽  
Author(s):  
Lisa C. Ruby ◽  
Rajagopal Kadavigere ◽  
Shubha Sheshadri ◽  
Kavitha Saravu ◽  
Sabine Bélard

Abstract Purpose Pulmonary aspergilloma affects immunocompromised patients but is also a recurrent condition in patients previously treated for pulmonary tuberculosis. Methods and Results We report the case of a 45-year-old patient with a history of cured pulmonary tuberculosis 15 years earlier in whom we visualized pulmonary aspergilloma by transthoracic lung sonography. Sonography of pulmonary aspergilloma demonstrated an oval cavity with hypoechoic contents and an irregular border, measuring a diameter of 4.7 cm; inside the lesion, a roundish structure with an anechoic rim was discernable. Conclusions The sonographic findings corresponded to chest X-ray and computed tomography imaging in this patient and to previously reported sonographic characteristics of mycotic abscesses in other organs. Lung ultrasound may be a tool to identify pulmonary aspergilloma, especially as a point-of-care imaging tool and where other imaging modalities are inaccessible.

2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.


Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-217190
Author(s):  
Rebecca Nightingale ◽  
Beatrice Chinoko ◽  
Maia Lesosky ◽  
Sarah J Rylance ◽  
Bright Mnesa ◽  
...  

RationalePulmonary tuberculosis (PTB) can cause post-TB lung disease (PTLD) associated with respiratory symptoms, spirometric and radiological abnormalities. Understanding of the predictors and natural history of PTLD is limited.ObjectivesTo describe the symptoms and lung function of Malawian adults up to 3 years following PTB-treatment completion, and to determine the evolution of PTLD over this period.MethodsAdults successfully completing PTB treatment in Blantyre, Malawi were followed up for 3 years and assessed using questionnaires, post-bronchodilator spirometry, 6 min walk tests, chest X-ray and high-resolution CT. Predictors of lung function at 3 years were identified by mixed effects regression modelling.Measurement and main resultsWe recruited 405 participants of whom 301 completed 3 years follow-up (mean (SD) age 35 years (10.2); 66.6% males; 60.4% HIV-positive). At 3 years, 59/301 (19.6%) reported respiratory symptoms and 76/272 (27.9%) had abnormal spirometry. The proportions with low FVC fell from 57/285 (20.0%) at TB treatment completion to 33/272 (12.1%), while obstruction increased from and 41/285 (14.4%) to 43/272 (15.8%) at 3 years. Absolute FEV1 and FVC increased by mean 0.03 L and 0.1 L over this period, but FEV1 decline of more than 0.1 L was seen in 73/246 (29.7%). Higher spirometry values at 3 years were associated with higher body mass index and HIV coinfection at TB-treatment completion.ConclusionSpirometric measures improved over the 3 years following treatment, mostly in the first year. However, a third of PTB survivors experienced ongoing respiratory symptoms and abnormal spirometry (with accelerated FEV1 decline). Effective interventions are needed to improve the care of this group of patients.


2015 ◽  
Vol 19 (2) ◽  
pp. 159-162 ◽  
Author(s):  
Rachel Asiniwasis ◽  
Maha T. Dutil ◽  
Scott Walsh

Background/Objectives The clinical and histopathologic findings of a rare simultaneous occurrence of papulonecrotic tuberculid and nodular tuberclid in a patient with active but asymptomatic pulmonary tuberculosis are presented. Papulonecrotic tuberculid was observed at a very early stage, presenting as molluscum-like lesions. This has been described once in the literature. This was observed in conjunction with lesions compatible with the rare clinicopathologic variant of nodular tuberculid. Critical to the diagnosis of active pulmonary tuberculosis was the use of induced sputum testing, which confirmed the diagnosis despite the lack of a cough and a chest x-ray negative for active tuberculosis. Methods/Results A 40-year-old male presented with a 2-week history of fever and a skin eruption consisting of molluscum-like papules on the ears, arms, and abdomen and nodules on his legs. Biopsies from both lesions were consistent with papulonecrotic and nodular tuberculid, respectively. Despite the lack of any respiratory symptoms, induced sputum grew Mycobacterium tuberculosis, and the lesions resolved on antituberculous therapy. Conclusions and Relevance Tuberculids are rare in Western countries but must be considered in the differential diagnosis of eruptions in patients from endemic countries. An active tuberculous focus must be sought out.


2020 ◽  
Vol 4 (3) ◽  
pp. 495-496
Author(s):  
Natasha Tobarran ◽  
Mark Collin

Case Presentation: A 63-year-old male with a past medical history of end stage renal disease presented to the emergency department with painful, lower-extremity necrotic ulcerations. Ultrasound and computed tomography imaging showed concerns for calcium deposits. Biopsy confirmed the diagnosis of calciphylaxis, a rare lethal disease. Discussion: Emergency physicians should keep this disease on their differential due to the high mortality rate.


2019 ◽  
Vol 09 (01) ◽  
pp. e72-e75
Author(s):  
Poonam Jariwala ◽  
Kaarthigeyan Kalaniti ◽  
Neil Wonko ◽  
Sibasis Daspal ◽  
Veronica Mugarab Samedi

Pneumomediastinum (PM), or a mediastinal air leak, is a known morbidity in neonates. Among predisposing factors, the most significant are mixed lung diseases, such as pneumonia or meconium aspiration syndrome, with coexisting atelectasis and airway obstruction. We report an unusual presentation of significant spontaneous pneumomediastinum in a term newborn delivered by elective cesarean section with no history of active resuscitation at birth.Timely diagnosis of SPM is important for both management and prognosis. We believe that lung ultrasound (LUS) is a promising screening tool for early detection of PM in neonates, and could help avoid unnecessary exposure to radiation in delicate neonates. More simultaneous studies comparing chest X-ray (CXR), LUS, and computed tomography (CT) scans may help to prove the utility value of point-of-care ultrasounds as a primary diagnostic tool in identifying this morbidity.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Doina Butcovan ◽  
Veronica Mocanu ◽  
Raluca Ecaterina Haliga ◽  
Dana Baran ◽  
Carmen Ungureanu ◽  
...  

Costal osteocartilaginous exostoses, also known as osteochondromas, are the most common neoplasms of the long bones but are rare tumors of the ribs. Osteochondroma is often asymptomatic and incidentally observed. Tumors typically begin to grow before puberty and continue until bone maturation is reached. Our paper presents the case of a 16-year-old young male who was admitted to the hospital with nonspecific symptoms and having a family history of exostosis. Chest X-ray and computed tomography imaging revealed multiple costosternal exostoses, manifested as mediastinal masses, with protrusion into the thoracic cavity, exerting compressive effects on the ascending aorta and pulmonary parenchyma. Surgery is required in childhood if lesions are painful. But if tumor formation occurs in adulthood, such pathological bony outgrowths should always be resected for avoiding further complications. In this patient, surgical intervention removed the tumoral masses and improved the symptoms. Subsequently, histological exam confirmed the diagnosis of osteocartilaginous exostoses and showed the lack of dysplastic changes.


1980 ◽  
Vol 53 (3) ◽  
pp. 364-368 ◽  
Author(s):  
Rand M. Voorhies ◽  
Narayan Sundaresan ◽  
H. Tzvi Thaler

✓ The role of preoperative diagnostic tests was evaluated in 210 adult patients with single supratentorial lesions demonstrated by computerized tomography. At craniotomy, 59.5% of these patients proved to have primary brain tumors, 36.2% had metastatic tumors, and 4.3% had non-neoplastic lesions. In 23 (11%) of these patients, a single brain metastasis was the first manifestation of a systemic cancer. The primary site of cancer was identified in 14 patients (10 in the lung, three in the kidney, and one in the colon), and in nine patients the primary site could not be established. Using simple conditional probability theory, we established that the probability of a metastatic lesion in patients without a history of previously treated cancer is about 7%, if their chest x-ray film and intravenous pyelogram (IVP) are negative. Extensive preoperative testing to try to establish a primary site is unrewarding if the chest x-ray film and IVP are negative, since these are the only sites likely to be identified in these patients. In patients with a history of previously treated cancer, these tests are justified because they have prognostic value in determining treatment.


2010 ◽  
Vol 01 (02) ◽  
pp. 105-108
Author(s):  
Fahmi Yousef Khan ◽  
Hussain Kamal ◽  
Rania Musa ◽  
Ahmed Hayati

ABSTRACTWe report an unusual association of pulmonary tuberculosis with moyamoya syndrome in a 30-year-old Filipino female who was admitted to our hospital with a 1-week history of fever and cough. Chest X-ray showed widespread bilateral consolidation with cavity, whereas sputum was positive for acid fast bacilli (AFB). Two weeks after starting antituberculous treatment, the patient developed two episodes of loss of consciousness, which were unwitnessed. Urgent brain computed tomography (CT) showed multiple infarctions, suggesting vasculitis. The electroencephalogram showed epileptic discharges. Magnetic resonance angiography showed a picture consistent with moyamoya disease. Brain CT angiography was performed and it showed the same pictures. The patient was diagnosed with pulmonary tuberculosis-associated moyamoya syndrome. On the following days, she was discharged on antituberculous medications, antiepileptic and oral hypoglycemic treatment. After 1 year, the patient was seen in the clinic, she was well and seizure-free.


1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)


2015 ◽  
pp. 12-19
Author(s):  
Thi Ngoc Ha Hoang ◽  
Trong Khoan Le

Background: A pulmonary nodule is defined as a rounded or irregular opacity, well or poorly defined, measuring up to 3 cm in diameter. Early detection the malignancy of nodules has a significant role in decreasing the mortality, increasing the survival time and consider as early diagnosis lung cancer. The main risk factors are those of current or former smokers, aged 55 to 74 years with a smoking history of at least 1 pack-day. Low dose CT: screening individuals with high risk of lung cancer by low dose CT scans could reduce lung cancer mortality by 20 percent compared to chest X-ray. Radiation dose has to maximum reduced but respect the rule of ALARA (As Low as Resonably Archivable). LungRADS 2014: Classification of American College of Radiology, LungRADS, is a newly application but showed many advantages in comparison with others classification such as increasing positive predict value (PPV), no result of false negative and cost effectiveness. Key words: LungRADS, screening lung nodule, low dose CT, lung cancer


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