Learning objectives
The purpose of this paper is to review the imaging features of the main pathologies that affect the immuncompromised patient,
its complications and possible pitfalls on cross-sectional imaging.
Background
Nowadays,
the number of patients with some kind of immunosupression continues to increase,
much because of greater use of immunosupressors agents in many different contexts: in treatment of cancer,
connective tissue and other autoimmune disorders,
and in prevention of rejection in organ and stem cell transplant recipients.
Acquired immunodeficiency syndrome remains still a important burden,
like some congenital deficiencies.
The immunocomprosided population is at greater risk of developing infectious and non-infectious complications.
The lung is one of the main targets involved in these complications,
infections...
Findings and procedure details
Pulmonary Infections In Immunocompromised Patients
Bacterial Infections
Bacterial Pneumonias have a similar radiographic pattern in immunocompetent and imunnosupressed patients.
Findings are usually inespecific and include consolidation,
which may be focal (segmental ou lobar),
cavitation,
groud-glass opacities,
broncocentric nodules,
pleural effusion and lymphadenopathy ( Fig. 1 ).
Computed Tomography may demonstrate lesions earlier than chest radiographs,
when only ground-glass pattern might be seen.
Patiens in septicaemia may quickly progress to acute respiratory distress patterns.
Tuberculosis
Immunity integrity is the major predicting factor of the imaging pattern...
Conclusion
With an increasing immuncompromised population,
some uncommon diseases arise,
therefore the need for the radiologist to be aware of their main features and complications to an adequated treatment and better outcomes.
References
1 - Ahuja J,
Kanne JP.
Thoracic Infections in Immunocompromised Patients.
Radiol Clin North Am.
2014 Jan;52(1):121-36.
2 - Escuissato DL,
Warszawiak D.
Chest imaging in immunosuppressed patients.
Imaging 2014;23: 20120001.
3 - Allen CM,
AL-Jahdali HH,
Irion KL,
Al Ghanem S,
Gouda A,
Khan AN.
Imaging lung manifestations of HIV/AIDS.
Annals of Thoracic Medicine.
2010;5(4):201-216.
4 - Sharma S1Gupta P,
Gupta N,
Lal A,
Behera D,
Rajwanshi A.
Pulmonary infections in immunocompromised patients: the role of image-guided fine needle aspiration cytology.
Cytopathology.
2017 Feb;28(1):46-54....