Penyerupa dan Penyerta Tuberkulosis Paru yang Terdiagnosis Berdasarkan Gambaran CT-scan Toraks Pada Rumah Sakit Rujukan Tersier

Nur Amelia Bachtiar; Sri Asriyani; Bachtiar Murtala; Nikmatia Latief; Irawaty Djaharuddin; Andi Alfian Zainuddin

doi:10.33476/mkp.v12i2.1747

Penyerupa dan Penyerta Tuberkulosis Paru yang Terdiagnosis Berdasarkan Gambaran CT-scan Toraks Pada Rumah Sakit Rujukan Tersier

Majalah Kesehatan Pharmamedika ◽

10.33476/mkp.v12i2.1747 ◽

2021 ◽

Vol 12 (2) ◽

Author(s):

Nur Amelia Bachtiar ◽

Sri Asriyani ◽

Bachtiar Murtala ◽

Nikmatia Latief ◽

Irawaty Djaharuddin ◽

...

Keyword(s):

Ct Scan ◽

Ground Glass Opacity ◽

Ground Glass ◽

Chi Square

Latar belakang: Sistem rujukan berjenjang dapat mempengaruhi karakteristik lesi pada CT-scan toraks pasien terduga tuberkulosis (TB) paru pada rumah sakit rujukan tersier. Hal ini dapat menyamarkan keberadaan penyerupa dan penyerta TB paru. Metode Penelitian: Sampel adalah pasien yang terdiagnosis TB paru oleh ahli radiologi pada periode Oktober 2018 hingga Juni 2019. Analisis Chi-square dilakukan untuk menguji kesesuain 12 karakteristik CT-scan toraks (Konsolidasi, kavitas, tree-in-bud, fibrokalsifikasi, air-bronchogram-sign, lesi noduler, efusi pleura, atelektasis, bercak infiltrat, lymphadenopathy, bronchiectasis, ground glass opacity) dengan diagnosis akhir klinisi. Pencatatan penyerupa dan penyerta TB dilakukan setelah diagnosis akhir ditegakkan. Hasil: Dari 137 sampel, hanya 61 (44.5%) pasien yang terdiagnosis sebagai TB paru aktif, 38 (27.7%) terdiagnosis sebagai bekas TB paru dan 38 (27.7%) lainnya terdiagnosis sebagai penyakit paru bukan tuberkulosis. Dari 12 variabel yang dievaluasi, karakteristik yang sesuai dengan diagnosis klinisi adalah tree-in-bud (p = 0.019) dan lymphadenopathy (p = 0.039). Penyakit penyerupa dan penyerta terbanyak adalah tumor paru dan infected bronchiectasis. Simpulan: Gambaran CT-scan pasien TB paru sangat beragam pada rumah sakit rujukan tersier. Diperlukan ketelitian ahli radiologi dan kerja sama yang baik dengan klinisi untuk mendeteksi berbagai kemungkinan diagnosis yang dapat menyerupai dan menyertai TB paru

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Gejala Klinis dan Pemeriksaan Penunjang pada Neonatus Terinfeksi COVID-19

e-CliniC ◽

10.35790/ecl.v9i1.32304 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Jason Rampengan ◽

Johnny Rompis ◽

Valentine Umboh

Keyword(s):

Cohort Study ◽

Case Report ◽

Literature Review ◽

Observational Study ◽

Ct Scan ◽

Clinical Symptoms ◽

Ground Glass Opacity ◽

Google Scholar ◽

Ground Glass ◽

Laboratory Examinations

Abstract: COVID-19 is spreading at an extremely rapid rate and can affect all age groups, albeit, information about clinical symptoms and laboratory examinations of COVID-19 I in neonates is still quite limited. This study was aimed to determine the clinical symptoms, radiographic examinations especially CT-scans, and laboratory tests that could appear in neonates suffering from COVID-19. This was a literature review study using three databases, namely Pubmed, Clinical Key, and Google Scholar. The keywords used were Covid-19 / SARS-CoV-2 AND Neonatus AND sign and symptoms AND laboratory. The selection based on inclusion and exclusion criteria, obtained 15 case report studies, three retrospective studies, one observational study, and one cohort study. The review revealed that the most frequent clinical features that appeared were fever (54.8%), dyspnoea (35.4%), and cough (29%). Meanwhile, for CT-Scan radiographs, there were 14 of 31 neonates (45.2%) did not show any abnormalities or normal. The most frequent abnormal image was ground glass opacity (GGO) (29%). Among laboratory examinations, lymphopenia was the most common abnormality (32.2%). Moreover, leukocytosis, leukopenia, thrombocytopenia, increased PCT, AST, etc. could also occur. Of all the reviewed literatures, there were no death cases of neonates died due to COVID-19. In conclusion, fever, dyspnea, cough, and lymphopenia are the most common findings as well as GGO in the CT-Scan radiograph.Keywords: COVID-19, neonates Abstrak: COVID-19 menyebar dengan sangat pesat dan dapat menjangkiti semua kelompok usia namun informasi mengenai gejala klinis dan pemeriksaan laboratorium terhadap kelompok neonatus masih terbatas. Penelitian ini bertujuan untuk mengetahui gambaran klinis, pemeriksaan radiografi khususnya CT-Scan, dan pemeriksaan laboratorium yang bisa muncul pada neonatus dengan COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu Pubmed, Clinical Key, dan Google Scholar. Kata kunci yang digunakan yaitu Covid-19/ SARS-CoV-2 AND Neonatus AND sign and symptom AND laboratory. Hasil seleksi berdasarkan kriteria inklusi dan ekslusi mendapatkan 15 penelitian case report, tiga retrospective study, satu observational study, dan satu cohort study. Hasil kajian menunjukkan bahwa gambaran klinis yang paling sering muncul ialah demam (54,8%), sesak (35,4%), dan batuk (29%). Pemeriksaan radiografi CT-Scan, neonatus yang tidak menunjukkan kelainan (normal) terdapat pada 14 dari 31 neonatus diamati (45,2%), sedangkan kelainan yang sering muncul ialah ground glass opacity/GGO (29%). Pada pemeriksaan laboratorium, limfopenia merupakan kelainan tersering (32,2%), sedangkan leukositosis, leukopenia, trombositopenia, peningkatan PCT, AST, dll juga bisa terjadi. Dari semua literatur yang dikaji, tidak ditemukan kasus kematian neonatus akibat COVID-19. Simpulan penelitian ini ialah gambaran klinis yang paling sering muncul pada neonatus ialah demam, sesak, dan batuk, limfopenia, dan GGO pada CT-Scan.Kata kunci: COVID-19, neonatus

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Predicting the 30-day Adverse Outcomes of Non-Critical New-Onset COVID-19 Patients in Emergency Departments based on their Lung CT Scan Findings; A Pilot Study for Derivation an Emergency Scoring Tool

Frontiers in Emergency Medicine ◽

10.18502/fem.v5i4.6691 ◽

2021 ◽

Author(s):

Alireza Jalali ◽

Ehsan Karimialavijeh ◽

Parto Babaniamansour ◽

Ehsan Aliniagerdroudbari ◽

Sepideh Babaniamansour

Keyword(s):

Ct Scan ◽

Prediction Models ◽

Ground Glass Opacity ◽

Adverse Outcomes ◽

Ground Glass ◽

Global Health Issue ◽

Discharged Patients ◽

History Of ◽

Scoring Tool ◽

New Onset

Introduction: Coronavirus Disease (COVID‐19) has become the most important global health issue, and chest computed tomography (CT) scan can help determine the severity of the infection. Objectives: This study aimed to provide an emergency scoring tool for predicting 30-day adverse outcomes in non-critical new-onset COVID-19 patients. Methods: This derivation study was conducted on new-onset COVID-19 patients presenting to the emergency department of an urban teaching hospital in Tehran, Iran, between 20 February and 20 March 2020. The total lobe severity score (TSS), age, history of comorbidities, and 30-day adverse outcomes (death, ICU admission or intubation) were taken into account to produce three prediction models. Results: Overall, 137 patients were included in the study. Their mean age was 59.9±16.8 years and 62% were male. The ground glass nodule, patch B/punctate ground-glass opacity, fibrous stripes, and air bronchogram sign with perihilar distribution, bilateral and ≥ 2 affected lobes were the most common findings. The mean TSS (model 1) was significantly higher in patients with an adverse outcome (9.4±3.2) compared to the discharged patients (7.2±3.3) (p<0.001, AUC: 0.703, sensitivity: 64.4% and specificity: 74.1%). The optimal cut-off point of model 2 (TSS and age) had the following parameters: AUC: 0.721, sensitivity: 71.2% and specificity: 67.2%. The optimal cut-off point of model 3 (TSS, age, comorbidities) had: AUC: 0.755, sensitivity: 79.7% and specificity: 65.5%. The discrimination achieved with model 3 based on Bonferroni’s test was significantly better than that achieved with TSS (p<0.001). Conclusion: TSS combined with age and history of at least one comorbidity had a better predictive value for adverse outcomes with a cut-off point above 8.

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Persistent Pure Ground-Glass Opacity Lung Nodules ≥ 10 mm in Diameter at CT Scan

CHEST Journal ◽

10.1378/chest.12-2987 ◽

2013 ◽

Vol 144 (4) ◽

pp. 1291-1299 ◽

Cited By ~ 121

Author(s):

Hyun-ju Lim ◽

Soomin Ahn ◽

Kyung Soo Lee ◽

Joungho Han ◽

Young Mog Shim ◽

...

Keyword(s):

Ct Scan ◽

Ground Glass Opacity ◽

Ground Glass ◽

Lung Nodules

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Prevalence of SARS-CoV-2 in Patients with Severe Pneumonia in Khuzestan Province, Iran

Iranian Journal of Allergy Asthma and Immunology ◽

10.18502/ijaai.v19i5.4462 ◽

2020 ◽

Author(s):

Farhad Abolnezhadian ◽

Manoochehr Makvandi ◽

Seyed Mohammad Alavi ◽

Azarakhsh Azaran ◽

Shahram Jalilian ◽

...

Keyword(s):

Ct Scan ◽

Real Time ◽

Real Time Pcr ◽

Severe Pneumonia ◽

Ground Glass Opacity ◽

Hospitalized Patients ◽

Ground Glass ◽

World Population ◽

Pcr Screening ◽

Khuzestan Province

The emergence of a highly pathogenic virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accounts for severe pneumonia throughout the world. More than 7 million world population have been infected with SARS-CoV-2, and the number of deaths is increasing every day. This study aimed to evaluate the frequency of SARS-CoV-2 in hospitalized patients with acute respiratory infection (ARI). During an outbreak of the SARS-CoV-2, the nasopharyngeal and oropharyngeal swabs were collected from 909 hospitalized patients with severe pneumonia, including 517 (56.9%) males and 392 (43.1%) females. All the collected samples were from different cities of Khuzestan province from 19 February to- 27 March 2020. The RNA was extracted from samples and subjected to real-time polymerase chain reaction (PCR) tests for the detection of the SARS-CoV-2. Simultaneously, the computerized tomography (CT) scan was tested for the presence of ground-glass opacity in the lung among the patients. Of the total number of 909 specimens, 328 (36.08%) cases, including 185 (20.35%) females and 143 (15.73%) males, were positive for the SARS-CoV-2 while, 581 (63.9%) cases, including 374 (41.14%) males and 207 (22.77%) were negative for the SARS-CoV-2 by real-time PCR (p=0.001).Four hundred sixteen (45.76%) cases were positive for ground-glass opacity in the lung by CT scan, while 328/909 (36.08%) trials proved positive for SARS-CoV-2 by the real-time PCR (p=0.003). In this study, 36.08% of patients were positive for SARS-CoV-2. Although the results of positive cases by CT scan showed higher than real-time PCR, screening the SARS-CoV-2 with a real-time PCR method is the first line of choice.

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COVID-19 and COVID-like Patients: A Brief Analysis and Findings of Two Deceased Cases

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5480 ◽

2020 ◽

Vol 8 (T1) ◽

pp. 490-495

Author(s):

Giosuè Mario Balzanelli ◽

Pietro Distratis ◽

Sergey K. Aityan ◽

Felice Amatulli ◽

Orazio Catucci ◽

...

Keyword(s):

Ct Scan ◽

Diffuse Alveolar Damage ◽

Clinical Signs ◽

Ground Glass Opacity ◽

Rapid Onset ◽

Ground Glass ◽

Rt Pcr ◽

Arterial Blood Gas ◽

Small Vessels ◽

Arterial Blood

BACKGROUND: The predominant pattern of lung lesions in patients affected by coronavirus disease (COVID-19) disease is diffuse alveolar damage with massive thromboembolism similar as described in patients infected with severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronaviruses. Hyaline membrane formation and pneumocyte atypical hyperplasia were frequent. Importantly, the formation of platelet–fibrin thrombi in small vessels was seen consistent with coagulopathy, which appeared to be a common feature in patients who died of COVID-19. However, many were the cases found with similar COVID-19 symptomatology though negative results from nasal-pharyngeal swab performed by reverse transcription-polymerase chain reaction (RT-PCR). This latter typology of patients, otherwise named COVID-like, showed analogous clinical signs with similar arterial blood gas, cell blood count and laboratory parameters, and same computed tomography (CT)-scan ground-glass opacities. Symptoms such as cough, fever, and difficulty breathing were highly similar as well. Both forms, COVID-19 and COVID-like, are primarily respiratory with multi-organ involvement and both revealed comparable incubation periods often with a rapid onset and unexpected decay. CASE REPORT: In this brief paper, we described two cases regarding two deceased males, one confirmed COVID-19 (RT-PCR but not CT scan) and the second a COVID-like (negative for RT-PCR but positive to CT scan with ground-glass opacity) whom condition, disease patterns, and analysis were highly similar. CONCLUSION: Improved investigation is mandatory, in which RT-PCR and CT scan procedures are completed by data from more detailed laboratory analysis, ABG analysis, BALF, and a deeper clinical assessment.

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Spectrum of Ground Glass Opacities in Chest CT of COVID-19 Patients in Karbala, Iraq

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v6i3.769 ◽

2020 ◽

Vol 6 (3) ◽

Author(s):

Dhia Mahdey Alghazali ◽

Maytham A Maamera ◽

Haider Fadel Alkazraji ◽

Ali A Abutiheen

Keyword(s):

Ct Scan ◽

Cross Sectional Study ◽

Chest Ct ◽

Ground Glass ◽

P Value ◽

Late Time ◽

Chi Square ◽

Cross Sectional ◽

Male Predominance ◽

Chest Ct Scan

Objective: To describe the ground-glass opacities (GGO) seen in chest CT scans of COVID-19 patients and to estimate the association between these opacities and the time of clinical presentation. Patients and methods: A cross-sectional study involving 81 COVID-19 confirmed patients in Imam Al-Hussein Medical city in Karbala-Iraq during the period from March 1st to April 20, 2020. Chest CT scan findings were evaluated by 2 radiologists and categorized accordingly. Chi-square test was used for statistical analysis and a P value of less than 0.05 was considered statistically significant. Results: The mean age ± standard deviation of patients was 53.5 ± 17.1 years, with male predominance as 63 (77.8%) of cases were males. Nearly half of the patients were presented within the second week of starting the sign and symptoms. GGO was present in 79 scans (97.5%), followed by consolidation opacity in 29 patients (35.8%). Four types of GGO were described. Bilateral multiple subpleural GGO was the most prevalent type. There was a significant association between late time of patient presentation and more extensive GGO type. Conclusion: Chest CT scan is valuable in the diagnosis and management of COVID-19 cases. The presence of GGO in CT scan of a patient that previously had no chest illness is highly suggestive of COVID-19 disease, different types of GGO were seen. Bilateral confluent type of GGO is associated with more serious and delayed status and warns the need for intensive care unit admission.

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Differences and similarities of high-resolution computed tomography features between Pneumocystis pneumonia and Cytomegalovirus pneumonia in AIDS patients

10.21203/rs.3.rs-34736/v2 ◽

2020 ◽

Author(s):

Chunjing Du ◽

Jingyuan Liu ◽

Hui Chen ◽

Shuo Yan ◽

Lin Pu ◽

...

Keyword(s):

Ground Glass Opacity ◽

Pneumocystis Pneumonia ◽

Ground Glass ◽

Wall Thickening ◽

High Resolution Computed Tomography ◽

Aids Patients ◽

Chi Square ◽

Similar Frequency ◽

Cytomegalovirus Pneumonia ◽

Ct Features

Abstract Background Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the CT features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies.Methods A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 were cytomegalovirus pneumonia) were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Significance was calculated by the chi-square (χ2) test.Results The presence of consolidation (61.77% in cytomegalovirus pneumonia, 35.9% in pneumocystis pneumonia, p=0.011), halo signs (32.35% in cytomegalovirus pneumonia, 11.54% in pneumocystis pneumonia, p＜0.001), and nodules (47.06% in cytomegalovirus pneumonia, 8.97% in pneumocystis pneumonia, p＜0.001), especially small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, p＜0.001) without perilymphatic distribution, were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity (100% in pneumocystis pneumonia and cytomegalovirus pneumonia), reticulation (57.69% in pneumocystis pneumonia, 52.94% in cytomegalovirus pneumonia, p=0.782) and bronchial wall thickening (34.62% in pneumocystis pneumonia, 47.06% in cytomegalovirus pneumonia, p=0.213) were common in both groups. Conclusions Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients.

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