scholarly journals A case of humidifier lung with a difficult differential diagnosis from COVID-19

2021 ◽  
Vol 2021 (10) ◽  
Author(s):  
Mariko Ono ◽  
Yoko Nagatomo ◽  
Hayato Kinoshita ◽  
Yukihisa Takeda ◽  
Hiroyuki Nakamura ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Ct Scan ◽  
Hypersensitivity Pneumonitis ◽  
Challenge Test ◽  
Respiratory Illnesses ◽  
Rare Phenotype ◽  
Inhalation Challenge ◽  
Ultrasonic Humidifier ◽  
Humidifier Lung ◽  
Chest Ct Scan

ABSTRACT Acute respiratory illnesses that presented with diffuse ground-glass opacities (GGOs) on chest computed tomography (CT) scan suggest the diagnosis of coronavirus disease 2019 (COVID-19). However, many other diseases show similar CT findings, which often offer a difficult differential diagnosis. Here, we report a case of humidifier lung, a rare phenotype of hypersensitivity pneumonitis (HP), which mimicked COVID-19. A 71-year-old man was admitted because of dyspnea and diffuse GGOs found on chest CT scan. Although COVID-19 was initially suspected, his symptoms rapidly improved by the next day. A medical interview revealed that he had started using an ultrasonic humidifier 1 month ago. A high-resolution CT (HRCT) scan showed ill-defined centrilobular nodules and mosaic attenuation, which are typical of HP but atypical of COVID-19. The inhalation challenge test confirmed the diagnosis of humidifier lung. History-taking of humidifier use and a precise HRCT interpretation are helpful to differentiate it from COVID-19.

Inhalation challenge test using pigeon eggs for chronic hypersensitivity pneumonitis

2020 ◽  
Vol 50 (12) ◽  
pp. 1381-1390
Author(s):  
Ryo Okuda ◽  
Tamiko Takemura ◽  
Yu Mikami ◽  
Eri Hagiwara ◽  
Tae Iwasawa ◽  
...  
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Challenge Test ◽  
Inhalation Challenge ◽  
Chronic Hypersensitivity Pneumonitis

Can persulfates cause hypersensitivity pneumonitis? A report of specific inhalation challenge test in 42 hairdressers

2020 ◽  
Author(s):  
Jens-Tore Granslo ◽  
Jorunn Kirkeleit ◽  
Stein Håkon Låstad Lygre ◽  
William Horsnell ◽  
Thomas Blix Grydeland ◽  
...  
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Challenge Test ◽  
Specific Inhalation Challenge ◽  
Inhalation Challenge

Pleural Effusion as a Sign of Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case Report

2020 ◽  
Vol 20 ◽  
Author(s):  
Zahra Ahmadinejad ◽  
Faeze Salahshour ◽  
Omid Dadras ◽  
Hesan Rezaei ◽  
SyyedAhmad Alinaghi
Keyword(s):  
Lung Cancer ◽  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Oxygen Saturation ◽  
Ct Scan ◽  
Chest Ct ◽  
Health Concern ◽  
Lung Involvement ◽  
Diagnosis Of Lung Cancer ◽  
Chest Ct Scan

Background: Recently, COVID-19 infection has become a public health concern. On March 12th, 2020, the World Health Organization (WHO) announced it as a global pandemic. Early diagnosis of atypical cases of COVID-19 infection is critical in reducing the transmission and controlling the present pandemic. In the present report, we described a patient with the chief complaints of dyspnea and dry cough referred to the oncology center at Imam Khomeini Hospital, Tehran with the differential diagnosis of lung cancer who was diagnosed and treated for COVID-19 infection in follow up. Case presentation: A 59-year-old patient complained of fever, dry cough, and dyspnea from two weeks ago. The patient had been referred to this center with the differential diagnosis of lung cancer due to the massive pleural effusion in initial chest CT scan. Dyspnea was the patient’s main complaint at the time of admission in this center and the oxygen saturation was 84%. In the new chest CT scan, similar findings were observed. Due to the severe respiratory distress, a chest tube was placed in the chest cavity to remove the pleural effusion fluid on day one. The patient’s felt relieved immediately after the procedure; however, the oxygen saturation did not raise above 85% despite the oxygen therapy. The cytology of pleural fluid was negative for malignant cells. On day 2, the lymphopenia and high level of CRP suggested the COVID-19 infection. Therefore, a control chest CT scan was conducted and the test for COVID-19 was performed. The CT report indicated the clear pattern of COVID-19’s lung involvement in the absence of pleural effusion. Thus, the treatment for COVID-19 was immediately initiated. On day 4, the test reported positive for COVID-19. Conclusion: Currently, it is important to bear in mind the COVID-19 infection in evaluating the patients with respiratory symptoms. This report indicated how misleading the presentation of chest CT scan could be in clinical judgment. Therefore, we recommend ruling out the COVID-19 infection in all the patients with any pattern of lung involvement to avoid missing the potential cases of this vicious infection.

Clinical and radiological characteristics of ultrasonic humidifier lung and summer-type hypersensitivity pneumonitis

2020 ◽  
Vol 174 ◽  
pp. 106196
Author(s):  
Susumu Sakamoto ◽  
Marie Furukawa ◽  
Hiroshige Shimizu ◽  
Muneyuki Sekiya ◽  
Shion Miyoshi ◽  
...  
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Ultrasonic Humidifier ◽  
Humidifier Lung

scholarly journals Accuracy of Inhalation Challenge Test for Bird-related Fibrotic Hypersensitivity Pneumonitis: a Case Control Study

2021 ◽  
Author(s):  
Ryo Okuda ◽  
Eri Hagiwara ◽  
Tomohisa Baba ◽  
Hideya Kitamura ◽  
Shigeru Komatsu ◽  
...  
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Case Control Study ◽  
Challenge Test ◽  
Case Control ◽  
Histopathological Diagnosis ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
History Of ◽  
Inhalation Challenge ◽  
Control Study

Abstract Background: The inhalation challenge test is considered to be the “gold standard” for diagnosis of hypersensitivity pneumonitis (HP) and identifying the causative antigen in patients with fibrotic HP. However, the inhalation challenge test is not widely used. This study aimed to examine the value of the inhalation challenge test.Methods: This was a single-center, case control study. The patients with fibrotic HP were diagnosed pathologically by surgical lung biopsy or transbronchial lung cryobiopsy, and were assumed to be bird-related fibrotic HP if they had a history of obvious avian exposure. The patients with a histopathological diagnosis of fibrotic HP, no history of bird exposure and negative anti-bird antibodies were assumed to be non-bird-related fibrotic HP.Results: Based on pathological findings and history of avian exposure, 43 of 86 patients were diagnosed with bird-related fibrotic HP. In 43 patients with bird-related fibrotic HP, 15 (35%) were positive for anti-bird IgG antibody, and 36 (81%) were positive for the inhalation challenge test. Patients with both positive inhalation challenge test and anti-bird IgG antibodies had a 2.7% decline in annual FVC before the inhalation (p = 0.029). In patients with positive inhalation challenge test and the negative anti-bird IgG antibodies, the annual FVC decreased by 5.0% (p = 0.047). No significant FVC decline was observed in patients with negative inhalation challenge test and positive anti-bird IgG antibody, and those with both negative tests.Conclusions: The inhalation challenge test for bird-related fibrotic HP was more sensitive than anti-bird IgG antibodies. Furthermore, the inhalation challenge test was able to find a group of patients with FVC decline.

COVID-19: how nuclear medicine can provide a differential diagnosis in very dubious case

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Maria Silvia De Feo ◽  
Viviana Frantellizzi ◽  
Giuseppe De Vincentis
Keyword(s):  
Infectious Disease ◽  
Differential Diagnosis ◽  
Ct Scan ◽  
Imaging Technique ◽  
False Negative ◽  
Clinical Signs ◽  
Negative Results ◽  
Infectious Disease Department ◽  
False Negative Results ◽  
99Mtc Hmpao

Background: We present the case of a 55-year-old woman, admitted to the Infectious Disease Department of Policlinico Umberto I, Rome, in mid-March 2020, with suspicion of COVID-19 infection. Objective: The rRT-PCR was negative and the following CT scan, performed to exclude false-negative results and help diagnosis, was inconclusive. Methods: It was decided to submit the patient to 99mTc-HMPAO-labelled leukocyte scan. Results: This exam led to the diagnosis of infective endocarditis. Conclusion: In the present pandemic scenario, 99mTc-HMPAO-labelled leukocyte scan represents a reliable imaging technique for differential diagnosis with COVID-19 in patients with confusing clinical signs, possible false-negative rRT-PCR results and inconclusive CT scan.

scholarly journals Features of humidifier lung and comparison with summer‐type hypersensitivity pneumonitis

Respirology ◽  
2021 ◽  
Author(s):  
Masafumi Shimoda ◽  
Kozo Morimoto ◽  
Yoshiaki Tanaka ◽  
Koji Furuuchi ◽  
Takeshi Osawa ◽  
...  
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Humidifier Lung

Cancer surgery during the COVID‐19 pandemic: The experience of a comprehensive cancer center performing preoperative screening by RT‐PCR and chest CT scan

2021 ◽  
Vol 123 (4) ◽  
pp. 815-822
Author(s):  
Joanne Guerlain ◽  
Fabienne Haroun ◽  
Alexandra Voicu ◽  
Charles Honoré ◽  
Franck Griscelli ◽  
...  
Keyword(s):  
Ct Scan ◽  
Chest Ct ◽  
Cancer Surgery ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Preoperative Screening ◽  
Rt Pcr ◽  
Chest Ct Scan

scholarly journals A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Ct Scan ◽  
Predictive Value ◽  
Meta Analysis ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Chest Ct Scan

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

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