Learning objectives
To assess the HRCT findings in angioinvasive aspergillosis (AIA),
to characterize and to classify the type of infection,
according to the imaging findings as well as to compare all of the above in relation to age (children-adults)
Background
Aspergillusmay cause a broad spectrum of disease in the human host,
ranging from hypersensitivity reactions to direct angioinvasion.Aspergillusprimarily affects the lungs,
causing allergic bronchopulmonary aspergillosis (ABPA),
chronic necrotizingAspergillus pneumonia,
aspergilloma,
and invasive aspergillosis.
However,
in patients who are severely immunocompromised,Aspergillusmay hematogenously disseminate beyond the lung,
potentially causing endophthalmitis,
endocarditis,
and abscesses in the myocardium,
kidney,
liver,
spleen,
soft tissue,
and bone.
Aspergillosis is a common finding in immunocompromised patients,
potentially deadly and usually found in the invasive form.
Findings and procedure details
Patients and Methods: We retrospectively studied 29 cases of invasive aspergillosis (IA) diagnosed in our hospital’s pediatric and pathologic unit between 2005-2008.
The patients were6 children and23 adults and presented with clinical signs of lower respiratory tract infection.
They suffered from primary neoplasms,
vasculitis,
drug use and AIDS.
One of them was a transplant recipient.
They were hospitalized in standard rooms without any air filtration system.
The patients underwent thoracic X-ray and thoracic HRCT in every case.
The diagnosis was confirmed with broncho-alveolar lavage (BAL),...
Conclusion
- There is a tendency of nodules with necrosis appearing in adults(Fisher’s exact test p=0.056)
- The percentage of patients with 9 or more findings is statistically increased between adults(Fisher’s exact test p=0.046)
- There is no important statistical difference in the other findings between the two age groups.
Even if the imaging findings of pulmonary aspergillosis are not always specific,
affiliation with the findings in HRCT is of great importance in making the correct diagnosis in adults and children.
Despite the small number of...
References
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Klebsiella pneumoniae & Mycoplasma fermentans co-infection in a HIV infected...