scholarly journals Unusual Radiographic Presentation of Pneumocystis Pneumonia in a Patient with AIDS

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Brian L. Block ◽  
Tejas Mehta ◽  
Gabriel M. Ortiz ◽  
Sean P. Ferris ◽  
Thienkhai H. Vu ◽  
...  

Pneumocystis jirovecii pneumonia (PCP) typically presents as an interstitial and alveolar process with ground glass opacities on chest computed tomography (CT). The absence of ground glass opacities on chest CT is thought to have a high negative predictive value for PCP in individuals with AIDS. Here, we report a case of PCP in a man with AIDS who presented to our hospital with subacute shortness of breath and a nonproductive cough. While his chest CT revealed diffuse nodular rather than ground glass opacities, bronchoscopy with bronchoalveolar lavage and transbronchial biopsies confirmed the diagnosis of PCP and did not identify additional pathogens. PCP was not the expected diagnosis based on chest CT, but it otherwise fit well with the patient’s clinical and laboratory presentation. In the era of combination antiretroviral therapy, routine prophylaxis for PCP, and increased use of computed tomography, it may be that PCP will increasingly present with nonclassical chest radiographic patterns. Clinicians should be aware of this presentation when selecting diagnostic and management strategies.

2021 ◽  
Vol 104 (5) ◽  
pp. 866-871

Background: Recent evidence has demonstrated the high sensitivity of chest computed tomography (CT) in coronavirus disease 2019 (COVID-19) case detection. However, considering the cost and infection control issues, the experience of chest CT for COVID-19 diagnosis in Thailand is still limited. Objective: To present the characteristics of chest CT findings in COVID-19 patients at Siriraj Hospital and compare them with other reports. Materials and Methods: The authors retrospectively reviewed the COVID-19 patients’ medical records between April and May 2020. All cases with the presence of chest CT performed during admission were recruited. Clinical data were retrieved from the patients’ medical records. All chest imaging results were reported by consensus between the authors. Results: From 103 cases, four cases with a chest CT scan during the admission were recruited. Consistent with previous reports, the common chest CT findings included a ground-glass opacity and consolidation with bilateral involvement. A round-shaped ground-glass opacity or consolidation was evidenced in half of the cases. The only case with the presence of chest CT scan, which was done 77 days after the onset of COVID-19 symptoms, revealed resolution of the abnormal findings. Conclusion: Chest CT findings in four COVID-19 cases at Siriraj Hospital are consistent with previous reports. Common findings include bilateral ground-glass opacity and consolidation. Keywords: COVID-19, SARS-CoV-2, Computed tomography, Case series


2020 ◽  
pp. 028418512092480
Author(s):  
Shan Hu ◽  
Zhen Li ◽  
Xu Chen ◽  
Chang-Hong Liang

Background The recent outbreak of pneumonia cases in Wuhan, PR China, was caused by a novel beta coronavirus, the 2019 novel coronavirus (COVID-19). Purpose To summarize chest computed tomography (CT) manifestations of the early stage of COVID-19 infection and provide a piece of reliable imaging evidence for initial screening and diagnosis. Material and Methods From 10 January 2020 to 10 February 2020, we continuously observed chest CT imaging of 14 patients with clinically suspected new coronavirus infection in the two weeks after onset of symptoms. Ground-glass opacity (GGO), consolidation, reticular pattern, and ground-glass mimic nodules in each patient’s chest CT image were recorded. Results We enrolled 14 patients, of which nine patients had the infection confirmed by reverse transcription polymerase chain reaction (RT-PCR). Five patients were highly suspected of infection. All cases had epidemiological evidence. GGO was a dominant imaging manifestation in the initial days of infection. GGO performance accounts for 40% in 1– 2 days, 90% in 3– 6 days, and 85% in 7– 10 days. With disease progression, consolidation appeared on follow-up CT. Consolidation performance accounts for 0% in 1– 2 days, 40% in 3– 6 days, and 71% in 7– 10 days. The lesions are mostly near the pleura. The number of lesions and the extent of the lesions increased as the disease progressed. Conclusion Patients with novel coronavirus pneumonia have characteristic CT features in the initial stage of infection, which can be used as an essential supplement for nucleic acid examination.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
William Lim ◽  
Maham Suhail ◽  
Keith Diaz

The coronavirus disease 2019 (COVID-19) pandemic is wreaking havoc across the globe. This pandemic has given rise to a mindset where physicians tend to neglect other causes of pneumonia, especially if the patient presents with signs and symptoms commonly associated with COVID-19. Herein, we report a case of a young man presenting to the emergency department with common clinical, radiological, and laboratory features of COVID-19 pneumonia such as shortness of breath, hypoxia, pulmonary embolism, elevated D-dimer, and bilateral ground glass opacities on computed tomography of the chest but was later diagnosed with Pneumocystis pneumonia that was treated with appropriate antibiotics and corticosteroids. This case highlights the importance of performing a thorough clinical history and differentiating the clinical and radiological features of COVID-19 pneumonia from pneumonia of other etiologies.


2021 ◽  
Vol 2021 ◽  
pp. 1-7 ◽  
Author(s):  
Qian Wu ◽  
Lingshan Zhong ◽  
Hongwei Li ◽  
Jing Guo ◽  
Yajie Li ◽  
...  

We aimed to investigate changes in pulmonary function and computed tomography (CT) findings in patients with coronavirus disease 2019 (COVID-19) during the recovery period. COVID-19 patients underwent symptom assessment, pulmonary function tests, and high-resolution chest CT 6 months after discharge from the hospital. Of the 54 patients enrolled, 31 and 23 were in the moderate and severe group, respectively. The main symptoms 6 months after discharge were fatigue and exertional dyspnea, experienced by 24.1% and 18.5% of patients, respectively, followed by smell and taste dysfunction (9.3%) and cough (5.6%). One patient dropped out of the pulmonary function tests. Of the remaining 54 patients, 41.5% had pulmonary dysfunction. Specifically, 7.5% presented with restrictive ventilatory dysfunction (forced vital capacity <80% of the predicted value), 18.9% presented with small airway dysfunction, and 32.1% presented with pulmonary diffusion impairment (diffusing capacity for carbon monoxide <80% of the predicted value). Of the 54 patients enrolled, six patients dropped out of the chest CT tests. Eleven of the remaining 48 patients presented with abnormal lung CT findings 6 months after discharge. Patients with residual lung lesions were more common in the severe group (52.6%) than in the moderate group (3.4%); a higher proportion of patients had involvement of both lungs (42.1% vs. 3.4%) in the severe group. The residual lung lesions were mainly ground-glass opacities (20.8%) and linear opacities (14.6%). Semiquantitative visual scoring of the CT findings revealed significantly higher scores in the left, right, and both lungs in the severe group than in the moderate group. COVID-19 patients 6 months after discharge mostly presented with fatigue and exertional dyspnea, and their pulmonary dysfunction was mostly characterized by pulmonary diffusion impairment. As revealed by chest CT, the severe group had a higher prevalence of residual lesions than the moderate group, and the residual lesions mostly manifested as ground-glass opacities and linear opacities.


2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Mehdi Khazaei ◽  
Arash Mahdavi ◽  
Zahra Mahboubi-Fooladi ◽  
Yashar Moharamzad ◽  
Reyhaneh Asgari ◽  
...  

: Various manifestations may appear in chest computed tomography (CT) scan of patients with coronavirus disease 2019 (COVID-19). In this pictorial review, we present chest CT manifestations of 14 patients with laboratory-confirmed COVID-19 disease and various manifestations including ground-glass and consolidative opacities, reticular opacities, halo sign, and other findings.


e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Claudia R. E. Malaru ◽  
Alfa G. E. Y. Rondo ◽  
Christilia G. Wagiu

Abstract: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Indonesia reported its first case in March 2, 2020. Cases are increasing and spreading rapidly throughout Indonesia. One of the main imaging modalities for examination of COVID-19 is chest computed tomography scan (CT-scan) which plays an important role in detection, evaluation of severity, and follow-up of disease course. This study was aimed to obtain the description of CT scan results in patients with COVID-19. This was a literature review study using three databases, namely Pubmed, ClinicalKey, and ScienceDirect. The keywords used were COVID-19 AND Chest CT. Based on inclusion and exclusion criteria, there were 10 literatures selected. It was found that chest CT results could accurately evaluate the features and extent of lung lesions. The typical CT-scan results were ground-glass opacities (GGO), GGO with mixed consolidation, adjacent pleural thickening, interlobular septal thickening, and air bronchogram. Based on age, sex, and comorbidities, there was not any significant differences in chest CT findings. In conclusion, GGO, air bronchogram, and consolidation were found in chest CT-scan of COVID-19 patients. Meanwhile, based on age, sex, and comorbidities there were no significant differences in chest CT-scan.Keywords: COVID-19, chest CT-scan Abstrak: Coronavirus disease 2019 (COVID-19) merupakan suatu penyakit menular yang disebabkan oleh severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Indonesia melaporkan kasus pertama pada tanggal 2 Maret 2020. Kasus meningkat dan menyebar dengan cepat di seluruh wilayah Indonesia. Salah satu modalitas pencitraan utama yang menjadi pilihan untuk pemeriksaan COVID-19 ialah Computed Tomography Scan (CT-scan) toraks yang berperan penting dalam deteksi, evaluasi keparahan, dan tindak lanjut perjalanan penyakit. Penelitian ini bertujuan untuk mengetahui gambaran hasil CT-scan pada pasien COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu Pubmed, ClinicalKey, ScienceDirect. Kata kunci yang digunakan yaitu COVID-19 AND Chest CT. Hasil seleksi berdasarkan kriteria inklusi dan eksklusi mendapatkan 10 literatur. Didapatkan hasil CT-scan toraks dapat secara akurat mengevaluasi fitur dan luas lesi paru dan CT-scan yang khas ialah ground-glass opacities (GGO), GGO dengan konsolidasi campuran, penebalan pleura yang berdekatan, penebalan septum interlobular, dan bronkogram udara. Pada temuan CT-scan toraks berdasarkan usia, dan jenis kelamin tidak didapatkan perbedaan bermakna. Simpulan penelitian ini ialah terdapat GGO, air bronchogram, dan konsolidasi pada CT-scan toraks pasien COVID-19 sedangkan berdasarkan usia, jenis kelamin, dan komorbid tidak ditemukan perbedaan bermakna.Kata kunci: COVID-19, CT-scan toraks


Author(s):  
Min Cheol Chang ◽  
Jian Hur ◽  
Donghwi Park

Background: Little is known about the damage to the respiratory system in asymptomatic patients with coronavirus disease (COVID-19). Objective: Herein, we evaluated the findings of chest computed tomography (CT) and radiography in patients with COVID-19 who were asymptomatic. Methods: We retrospectively investigated patients with a confirmed diagnosis of COVID-19 but who did not show any symptoms. Among the 139 patients with COVID-19 who were hospitalized, 10 (7.2%) were asymptomatic. Their chest CT and radiographic findings were analyzed. Results: In the results, all patients (100%) had ground glass opacity (GGO) on chest CT. Further, the GGO lesions were predominantly distributed peripherally and posteriorly in all patients. In 9 (90%) patients, the GGO lesions were combined with reticular opacity. Air-bronchogram due to bronchiolectasis surrounded by GGO was observed in 8 patients (80%). Additionally, the lung lesions were dominant on the right side in all patients. Conclusions: In conclusion, considering our results that the lung is affected in asymptomatic patients, it will be necessary to extend the indications of COVID-19 testing for effective management of COVID-19 during the pandemic.


Author(s):  
Sergey Morozov ◽  
Anna Andreychenko ◽  
Nikolay Pavlov ◽  
Anton Vladzymyrskyy ◽  
Natalya Ledikhova ◽  
...  

This dataset contains anonymised human lung computed tomography (CT) scans with COVID-19 related findings, as well as without such findings. A small subset of studies has been annotated with binary pixel masks depicting regions of interests (ground-glass opacifications and consolidations). CT scans were obtained between 1st of March, 2020 and 25th of April, 2020, and provided by municipal hospitals in Moscow, Russia. Permanent link: https://mosmed.ai/datasets/covid19_1110. This dataset is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0) License.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kangjoon Kim ◽  
Seung Hyun Yong ◽  
Su Hwan Lee ◽  
Sang Hoon Lee ◽  
Ah Young Leem ◽  
...  

AbstractThere is no validated clinical biomarker for disease severity or treatment response for nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the correlation between elevated serum carbohydrate antigen (CA) 19-9 levels and NTM-PD disease activity, defined using an imaging severity score based on chest computed tomography (CT). We retrospectively examined 79 patients with NTM-PD who underwent serum CA19-9 level assessments and chest CT less than 1 month apart. NTM-PD severity was rated using a CT-based scoring system. The correlation between the CT score and serum CA19-9 levels was evaluated. Chest CT revealed nodular bronchiectasis without cavitation in most patients (78.5%). Serum CA19-9 levels were elevated in 19 (24%) patients. Serum CA19-9 levels were positively correlated with the total CT score and bronchiectasis, bronchiolitis, cavity, and consolidation subscores. Partial correlation analysis revealed a significant positive correlation between serum CA19-9 levels and CT scores for total score and bronchiectasis, bronchiolitis, cavitation, and consolidation subscores after controlling for age, sex, and BMI. Serum CA19-9 levels were positively correlated with the CT severity score for NTM-PD. Serum CA19-9 may be useful in evaluating disease activity or therapeutic response in patients with NTM-PD.


Sign in / Sign up

Export Citation Format

Share Document