scholarly journals The Findings of Pulmonary Nocardiosis on Chest High Resolution Computed Tomography

2021 ◽  
Author(s):  
Rashid S Al Umairi ◽  
Nenad Pandak ◽  
Mohammed Al Busaidi
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Organ Transplant ◽  
Solid Organ ◽  
Imaging Features ◽  
Immunocompromised Patients ◽  
High Resolution Computed Tomography ◽  
Pleural Thickening ◽  
Pulmonary Nocardiosis ◽  
Number Of Patients

Objectives: Pulmonary nocardiosis is a rare opportunistic infection that is often encountered in immunocompromised patients, in particular those with human immunodeficiency virus (HIV) infection and in solid organ transplant recipients. As the number of immunocompromised patients increase, it is expected that the number of patients with pulmonary nocardiosis will increase. The aim of this study is to review the chest HRCT findings of patients with confirmed pulmonary nocardiosis and to review the imaging features of pulmonary nocardiosis in the literature. Methods: We searched the electronic database of the Royal Hospital, Muscat, Oman for patients with a diagnosis of pulmonary nocardiosis between January 2006 and January 2019. Nine patients with pulmonary nocardiosis were identified, but three patients were excluded as no chest HRCT images were available. Patient clinical presentation was recorded and chest HRCT images were retrospectively reviewed. Results: The six patients enrolled in the study were male, aged between 29 and 49 years. Three patients were immunocompromised, two of whom had undergone a renal transplant. The main HRCT findings were cavitary nodules/masses, non-cavitary nodules/masses, septal thickening, centrilobular nodules, ground glass opacities, consolidation, pleural effusion, pleural thickening, enlarged lymph nodes and necrotic lymph nodes. Conclusion: Pulmonary nocardiosis has various findings on chest CT. Most common are pulmonary nodules and masses. Awareness of these findings can help radiologists to suggest the diagnosis in the appropriate clinical settings. Keywords: Nodules; Masses; Lung Infections; Opportunistic Pathogen; Pulmonary Nocardiosis; Computed Tomography.

scholarly journals High-Resolution Computed Tomography Based Comparative Analysis of Asbestosis vs. Fibrotic Hypersensitivity Pneumonitis

2021 ◽  
Author(s):  
Ruimin Ma ◽  
Shuang Li ◽  
Yuanying Wang ◽  
Shuqiao Yang ◽  
Na Bao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Hypersensitivity Pneumonitis ◽  
Interobserver Reliability ◽  
High Specificity ◽  
Imaging Features ◽  
Imaging Findings ◽  
High Resolution Computed Tomography ◽  
Disease Manifestation ◽  
Pleural Thickening

Abstract BackgroundAsbestosis and fibrotic hypersensitivity pneumonitis (FHP) are fibrotic interstitial lung diseases that develop secondary to inhalation exposure. The differential diagnosis is based on clinical evaluation of imaging findings, particularly in developing countries. We compared the imaging features between asbestosis and FHP to gain a better understanding of the differential diagnostic value of these conditions.MethodsThis comparative study included 204 patients with asbestosis and 74 patients with FHP. We compared patients’ clinical data and chest high-resolution computed tomography (HRCT) images obtained from a predesigned chart. The International Classification of HRCT for Occupational and Environmental Respiratory Diseases was used to categorize chest imaging findings in patients. Diagnostic tests were used to compare the imaging features of asbestosis and FHP.ResultsPatients with asbestosis were older and had a longer latent period until disease manifestation than those with FHP. Asbestosis was characterized by irregular and/or linear opacities, with lower lung preponderance, accompanied by ground-glass opacities and mosaic attenuation. Notably, 98.5% of patients with asbestosis showed benign pleural abnormalities, and >33% of these patients had diffuse pleural thickening with parenchymal bands and/or rounded atelectasis. Abnormalities of the mediastinal and diaphragmatic pleura were observed only in cases of asbestosis, and this finding showed high specificity for the diagnosis for asbestosis compared with that for FHP. Subpleural dots or diaphragmatic pleural abnormalities showed moderate sensitivity and high specificity for diagnosis of asbestosis compared with that for FHP. Interobserver reliability was good for evaluation of imaging findings including honeycombing, pleural calcification, lymphadenectasis, and lymph node calcification.ConclusionsHRCT-based imaging findings can distinguish between asbestosis and FHP to a certain extent, particularly with regard to subpleural dots and diaphragmatic pleural abnormalities that characterize the former.

scholarly journals Imaging diagnosis of classical and new pneumoconiosis: predominant reticular HRCT pattern

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Akira Masanori
Keyword(s):  
Computed Tomography ◽  
Interstitial Lung Disease ◽  
Imaging Features ◽  
Imaging Findings ◽  
Imaging Diagnosis ◽  
High Resolution Computed Tomography ◽  
Pleural Fibrosis ◽  
Pathologic Findings ◽  
Characteristic Imaging ◽  
The Individual

AbstractOur understanding of the manifestations of pneumoconioses is evolving in recent years. Associations between novel exposures and diffuse interstitial lung disease have been newly recognized. In advanced asbestosis, two types of fibrosis are seen, probably related to dose of exposure, existence of pleural fibrosis, and the host factor status of the individual. In pneumoconiosis of predominant reticular type, nodular opacities are often seen in the early phase. The nodular pattern is centrilobular, although some in metal lung show perilymphatic distribution, mimicking sarcoidosis. High-resolution computed tomography enables a more comprehensive correlation between the pathologic findings and clinically relevant imaging findings. The clinician must understand the spectrum of characteristic imaging features related to both known dust exposures and to historically recent new dust exposures.

scholarly journals The Role of Transthoracic Ultrasound in the Study of Interstitial Lung Diseases: High-Resolution Computed Tomography Versus Ultrasound Patterns: Our Preliminary Experience

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 439
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Angelamaria Giardinelli ◽  
Carla Maria Irene Quarato ◽  
Ennio Vincenzo Sassani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Pleural Line ◽  
Complementary Role ◽  
Number Of Patients ◽  
Significant Difference ◽  
Transthoracic Ultrasound

Transthoracic ultrasound (TUS) is a readily available imaging tool that can provide a quick real-time evaluation. The aim of this preliminary study was to establish a complementary role for this imaging method in the approach of interstitial lung diseases (ILDs). TUS examination was performed in 43 consecutive patients with pulmonary fibrosis and TUS findings were compared with the corresponding high-resolution computed tomography (HRCT) scans. All patients showed a thickened hyperechoic pleural line, despite no difference between dominant HRCT patterns (ground glass, honeycombing, mixed pattern) being recorded (p > 0.05). However, pleural lines’ thickening showed a significant difference between different HRCT degree of fibrosis (p < 0.001) and a negative correlation with functional parameters. The presence of >3 B-lines and subpleural nodules was also assessed in a large number of patients, although they did not demonstrate any particular association with a specific HRCT finding or fibrotic degree. Results allow us to suggest a complementary role for TUS in facilitating an early diagnosis of ILD or helping to detect a possible disease progression or eventual complications during routine clinical practice (with pleural line measurements and subpleural nodules), although HRCT remains the gold standard in the definition of ILD pattern, disease extent and follow-up.

scholarly journals Hepatitis E Virus Quasispecies and the Outcome of Acute Hepatitis E in Solid-Organ Transplant Patients

2012 ◽  
Vol 86 (18) ◽  
pp. 10006-10014 ◽  
Author(s):  
Sebastien Lhomme ◽  
Florence Abravanel ◽  
Martine Dubois ◽  
Karine Sandres-Saune ◽  
Lionel Rostaing ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Acute Hepatitis ◽  
Hepatitis E Virus ◽  
Organ Transplant ◽  
Hepatitis E ◽  
Solid Organ Transplant ◽  
First Year ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Serum Concentrations

Hepatitis E virus (HEV) infections are responsible for chronic hepatitis in immunocompromised patients, and this can evolve to cirrhosis. Like all RNA viruses, HEV exists as a mixture of heterogeneous viruses defining quasispecies. The relationship between the genetic heterogeneity described as a quasispecies, cytokine secretion, and the outcome of acute hepatitis in immunocompromised patients remains to be elucidated. We cloned and sequenced the region encoding the M and P capsid domains of HEV from eight solid-organ transplant (SOT) patients with acute HEV infection who subsequently cleared the virus and from eight SOT patients whose infection became chronic. We analyzed the cytokines and chemokines in the sera of these SOT patients by multianalyte profiling. The nucleotide sequence entropy and genetic distances were greater in patients whose infections became chronic. A lowerKa/Ksratio was associated with the persistence of HEV. The patients who developed chronic infection had lower serum concentrations of interleukin-1 (IL-1) receptor antagonist and soluble IL-2 receptor. Increased concentrations of the chemokines implicated in leukocyte recruitment to the liver were associated with persistent infection. Those patients with chronic HEV infection and progressing liver fibrosis had less quasispecies diversification during the first year than patients without liver fibrosis progression. Great quasispecies heterogeneity, a weak inflammatory response, and high serum concentrations of the chemokines involved in leukocyte recruitment to the liver in the acute phase were associated with persistent HEV infection. Slow quasispecies diversification during the first year was associated with rapidly developing liver fibrosis.

scholarly journals Inflammatory myofibroblastic tumor of the liver mimicking an infiltrative malignancy in computed tomography and magnetic resonance imaging with Gd-EOB

2014 ◽  
Vol 3 (7) ◽  
pp. 204798161454440 ◽  
Author(s):  
Tahir Durmus ◽  
Carsten Kamphues ◽  
Hendrik Blaeker ◽  
Christian Grieser ◽  
Timm Denecke
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Liver Tumors ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Diagnostic Challenge ◽  
Number Of Patients ◽  
Inflammatory Myofibroblastic Tumors ◽  
Malignant Liver

Inflammatory myofibroblastic tumors (IMT) are a benign tumor entity, which rarely develop in the liver. Surgery is the most common treatment for these lesions as it is difficult to distinguish them from malignant liver tumors and local recurrent growth may occur. IMT is a diagnostic challenge for imaging. Only a limited number of reports of single cases or small number of patients described the imaging features on computed tomography. Reports on IMT appearance on magnetic resonance imaging are scarce. We present a case of IMT of the liver with infiltration of the abdominal wall treated with surgery and describe the imaging features with the use of the hepatobiliary contrast agent, gadoxetic acid (Gd-EOB).

scholarly journals Hepatitis E Virus Immunopathogenesis

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1180
Author(s):  
Kush Kumar Yadav ◽  
Scott P. Kenney
Keyword(s):  
Hepatitis E Virus ◽  
Organ Transplant ◽  
Hepatitis E ◽  
Oral Route ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
In Vivo Models ◽  
Transplant Patients

Hepatitis E virus is an important emerging pathogen producing a lethal impact on the pregnant population and immunocompromised patients. Starting in 1983, it has been described as the cause for acute hepatitis transmitted via the fecal–oral route. However, zoonotic and blood transfusion transmission of HEV have been reported in the past few decades, leading to the detailed research of HEV pathogenesis. The reason behind HEV being highly virulent to the pregnant population particularly during the third trimester, leading to maternal and fetal death, remains unknown. Various host factors (immunological, nutritional, hormonal) and viral factors have been studied to define the key determinants assisting HEV to be virulent in pregnant and immunocompromised patients. Similarly, chronic hepatitis is seen particularly in solid organ transplant patients, resulting in fatal conditions. This review describes recent advances in the immunopathophysiology of HEV infections in general, pregnant, and immunocompromised populations, and further elucidates the in vitro and in vivo models utilized to understand HEV pathogenesis.

scholarly journals 865. Acanthamoeba Disease Associated With the Practice of Nasal Rinsing in Immunocompromised Patients

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S22-S22 ◽  
Author(s):  
Jennifer Cope ◽  
Shantanu Roy ◽  
Ibne Ali
Keyword(s):  
Tap Water ◽  
Organ Transplant ◽  
The United States ◽  
Case Report Form ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Free Living ◽  
Transplant Patients ◽  
Route Of Transmission ◽  
Free Living Ameba

Abstract Background The genus Acanthamoeba are free-living amebae found worldwide in water, including tap water, and soil that can cause rare but severe infections of the eye, skin, and central nervous system. Acanthamoeba spp. generally cause disease in immunocompromised persons, including those with HIV, hematologic malignancies, and solid organ transplants. The route of transmission and incubation period are not well known in humans, but animal studies have shown that disease can be produced via the intranasal, intrathecal, and intravenous routes. We describe 5 cases of Acanthamoeba disease among immunocompromised patients who practiced nasal rinsing prior to becoming ill. Methods The Centers for Disease Control and Prevention (CDC) offers a clinical consultation service for free-living ameba infections and maintains a Free-living Ameba laboratory with confirmatory diagnostic testing capabilities. When an Acanthamoeba case is confirmed in the United States, details about the case are collected on a standardized case report form which includes questions about the case–patient’s water and soil exposure prior to becoming ill. Questions about nasal rinsing were added to the form in 2011. Results Five Acanthamoeba case patients in CDC’s free-living ameba database were reported to have performed nasal rinsing prior to becoming ill. The median age was 60 years (range 36–73 years) and 3 of 5 patients were female. Two were solid-organ transplant patients (heart and kidney), 2 had chronic lymphocytic leukemia, and 1 had HIV. Three patients presented only with encephalitis and died. The 2-organ transplant patients had a combination of rhinosinusitis, osteomyelitis, and skin lesions. One survived and the other died, the cause of which was unrelated to Acanthamoeba. All reported using tap water to perform nasal rinsing, most for sinus congestion using a neti pot or similar device and one for religious purposes. Conclusion Acanthamoeba is an inhabitant of water, including treated tap water. Immunocompromised patients, like those presented here, might be at risk for infections caused by Acanthamoeba transmitted via tap water used for nasal rinsing. Clinicians caring for immunocompromised patients should advise their patients not to use tap water for nasal or sinus rinsing. Disclosures All authors: No reported disclosures.

Differential diagnosis of pulmonary infections in immunocompromised patients using high-resolution computed tomography

2019 ◽  
Vol 29 (11) ◽  
pp. 6089-6099 ◽  
Author(s):  
Yoshie Kunihiro ◽  
Nobuyuki Tanaka ◽  
Reo Kawano ◽  
Toshiaki Yujiri ◽  
Makoto Kubo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
High Resolution ◽  
Immunocompromised Patients ◽  
Pulmonary Infections ◽  
High Resolution Computed Tomography

scholarly journals Comparative Evaluation of QuantiFERON-TB Gold In-Tube and QuantiFERON-TB Gold Plus in Diagnosis of Latent Tuberculosis Infection in Immunocompromised Patients

2018 ◽  
Vol 56 (11) ◽  
Author(s):  
Mi Ra Ryu ◽  
Min-Seung Park ◽  
Eun Hye Cho ◽  
Chul Won Jung ◽  
Kihyun Kim ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Organ Transplant ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Clinical Approach ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Necrosis Factor Alpha ◽  
Hematopoietic Stem ◽  
The Difference

ABSTRACT QuantiFERON-TB Gold Plus (QFT-Plus) is a new-generation QuantiFERON-TB Gold In-Tube (QFT-GIT) assay which has two antigen-coated tubes called TB1, which contains long peptides derived from ESAT-6 and CFP-10, and TB2, which contains the same components as TB1 and additional short peptides which potentially stimulate CD8+ T cells through the presentation of major histocompatibility complex class I. This is the first study to compare QFT-Plus and QFT-GIT for use in the diagnosis of latent tuberculosis infection (LTBI) among immunocompromised patients in the Republic of Korea. Among 317 consecutive patients who underwent screening for LTBI before solid organ or hematopoietic stem cell transplantation and tumor necrosis factor alpha inhibitor treatment, LTBI was identified in 92 (29.0%) and 88 (27.8%) patients by QFT-GIT and QFT-Plus, respectively. The rate of concordance between QFT-GIT and QFT-Plus was 93.7% (κ value, 0.860), and the indeterminate rate (3.2%) was similar between QFT-GIT and QFT-Plus. Of 20 (6.3%) samples with discordant results, 11 (55.0%) and 7 (35.0%) were positive by QFT-GIT alone and QFT-Plus alone, respectively, and 2 (15.0%) were indeterminate by each assay. The interferon gamma level in samples with discordant results ranged from 0.39 to 1.10 IU/ml, except for one sample, in which the gamma interferon level was 2.97 IU/ml only in TB2. Conclusively, there was a high degree of agreement between the results of QFT-GIT and QFT-Plus for the screening of immunocompromised patients for LTBI. The reactivity in TB2 contributed substantially to the difference between QFT-GIT and QFT-Plus, particularly in solid organ transplant candidates. The significance of the discrete responses in TB1 and TB2 of QFT-Plus needs to be explored further by means of an immunological and clinical approach in different patient groups and clinical settings.

Sign in / Sign up

Export Citation Format

Share Document