Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0009
T. Ternes
Cardiac conduction devices (CCDs) include pacemakers and implantable cardioverter defibrillators (ICDs) and are used for permanent management of cardiac conduction abnormalities. Most CCDs consist of a generator which houses the battery and computer. They gather electronic information and send electric pulses through their attached leads. Typically, the leads are placed via transvenous approach into the right atrial appendage, right ventricle, or coronary sinus, depending on the purpose. A single chamber pacer may be utilized to manage SA nodal disease, with a lead in the right ventricle. Dual-chamber pacers are often used for AV nodal disease, and have leads in the right atrium and right ventricle. Biventricular pacing may be used to improve synchronized right and left ventricular function, with the additional lead positioned in the coronary sinus to stimulate the left ventricle. The presence of a thick “shock coil” confirms the defibrillator capability of the device (ICD). Radiographic evaluation following CCD placement should ensure proper lead placement, and exclude pneumothorax, hemothorax, and/or hemopericardium. Subsequent imaging should exclude Twiddler’s syndrome (change in generator position) and lead fracture. Temporary pacing devices may also be used in emergent and postoperative settings, and typically consist of epicardial leads that can be easily removed.
{"title":"Cardiac Conduction Devices","authors":"T. Ternes","doi":"10.1093/MED/9780199858064.003.0009","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0009","url":null,"abstract":"Cardiac conduction devices (CCDs) include pacemakers and implantable cardioverter defibrillators (ICDs) and are used for permanent management of cardiac conduction abnormalities. Most CCDs consist of a generator which houses the battery and computer. They gather electronic information and send electric pulses through their attached leads. Typically, the leads are placed via transvenous approach into the right atrial appendage, right ventricle, or coronary sinus, depending on the purpose. A single chamber pacer may be utilized to manage SA nodal disease, with a lead in the right ventricle. Dual-chamber pacers are often used for AV nodal disease, and have leads in the right atrium and right ventricle. Biventricular pacing may be used to improve synchronized right and left ventricular function, with the additional lead positioned in the coronary sinus to stimulate the left ventricle. The presence of a thick “shock coil” confirms the defibrillator capability of the device (ICD). Radiographic evaluation following CCD placement should ensure proper lead placement, and exclude pneumothorax, hemothorax, and/or hemopericardium. Subsequent imaging should exclude Twiddler’s syndrome (change in generator position) and lead fracture. Temporary pacing devices may also be used in emergent and postoperative settings, and typically consist of epicardial leads that can be easily removed.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129077265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0004
G. Abbott
The radiology report must communicate the results of imaging studies to the healthcare team in a clear, accurate, and timely manner - combining the radiologist’s medical knowledge, experience, and medical judgment to communicate their observations and form a summary impression of their findings. The key elements of a radiology report are 1) Administrative information, 2) Patient identification, 3) Clinical history and indications for the examination, 4) Imaging technique, 5) Comparison with prior studies, 6) Observations / Imaging findings, 7) Summary or Impression, and 8) Signature. These elements form the basis of “structured reporting”, a communication technique endorsed by the American College of Radiology (ACR).In structured reports of thoracic imaging studies, imaging findings are organized as separate paragraphs: 1) tubes and lines, 2) lungs and airways, 3) pleura, 4) heart and mediastinum, 5) bones, and 6) soft tissues. This format is preferred by clinicians, as information pertaining to specific organ systems can be retrieved and compared to previous reports more easily.
{"title":"The Radiology Report","authors":"G. Abbott","doi":"10.1093/MED/9780199858064.003.0004","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0004","url":null,"abstract":"The radiology report must communicate the results of imaging studies to the healthcare team in a clear, accurate, and timely manner - combining the radiologist’s medical knowledge, experience, and medical judgment to communicate their observations and form a summary impression of their findings. The key elements of a radiology report are 1) Administrative information, 2) Patient identification, 3) Clinical history and indications for the examination, 4) Imaging technique, 5) Comparison with prior studies, 6) Observations / Imaging findings, 7) Summary or Impression, and 8) Signature. These elements form the basis of “structured reporting”, a communication technique endorsed by the American College of Radiology (ACR).In structured reports of thoracic imaging studies, imaging findings are organized as separate paragraphs: 1) tubes and lines, 2) lungs and airways, 3) pleura, 4) heart and mediastinum, 5) bones, and 6) soft tissues. This format is preferred by clinicians, as information pertaining to specific organ systems can be retrieved and compared to previous reports more easily.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134387064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0055
Bethany Milliron, B. Little, T. Henry
Bronchiectasis represents irreversible bronchial dilatation. It can be focal or diffuse, and usually results from chronic infection, proximal airway obstruction, or a congenital bronchial abnormality. Traction bronchiectasis refers to irregular bronchial dilatation in the setting of surrounding pulmonary fibrosis. Patients with cystic fibrosis have a progressively worsening clinical course, with recurrent pneumonias and chronic airway colonization. Even with lung transplantation and modern antibiotic therapies, average life expectancy of cystic fibrosis patients remains limited to young adulthood. Non-cystic fibrosis related bronchiectasis can cause chronic cough and recurrent lung infection. Pulmonary function testing often reveals evidence of obstruction. Treatment of patients with mild to moderate bronchiectasis involves supportive care with bronchodilators, antibiotics, and other medical therapy. Surgical resection is uncommon, and usually reserved for cases of significant bronchiectasis limited to a single region of the lungs (such as a particular lobe or segment).
{"title":"Bronchiectasis","authors":"Bethany Milliron, B. Little, T. Henry","doi":"10.1093/med/9780199858064.003.0055","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0055","url":null,"abstract":"Bronchiectasis represents irreversible bronchial dilatation. It can be focal or diffuse, and usually results from chronic infection, proximal airway obstruction, or a congenital bronchial abnormality. Traction bronchiectasis refers to irregular bronchial dilatation in the setting of surrounding pulmonary fibrosis. Patients with cystic fibrosis have a progressively worsening clinical course, with recurrent pneumonias and chronic airway colonization. Even with lung transplantation and modern antibiotic therapies, average life expectancy of cystic fibrosis patients remains limited to young adulthood. Non-cystic fibrosis related bronchiectasis can cause chronic cough and recurrent lung infection. Pulmonary function testing often reveals evidence of obstruction. Treatment of patients with mild to moderate bronchiectasis involves supportive care with bronchodilators, antibiotics, and other medical therapy. Surgical resection is uncommon, and usually reserved for cases of significant bronchiectasis limited to a single region of the lungs (such as a particular lobe or segment).","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131604457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0049
R. Benson
Lung cancer staging is a process used to assess the extent of spread of lung cancer, determine the most appropriate treatment and predict the patient’s prognosis. Clinical staging is performed prior to surgical resection, while surgical-pathologic staging is based on histologic analysis of the resected tumor and lymph nodes. Restaging is performed following treatment. Staging is based on the TNM classification system. T refers to the primary tumor, N to thoracic lymph node involvement and M to metastatic disease. Recent changes to T and M descriptors were made to better reflect actual survival. For the majority of non-small cell lung cancers, the presence or absence of mediastinal lymph node spread is the most important outcome predictor. Although no changes were made to the N descriptor, the actual intrathoracic lymph node stations were recently clarified. Although the majority of small cell lung cancers are metastatic at the time of presentation, the presence of limited versus extensive spread of disease determines treatment options. However, the overall prognosis and survival for affected patients is poor. TNM staging is now recommended for carcinoid tumors as well as small cell lung cancer.
{"title":"Lung Cancer: Staging","authors":"R. Benson","doi":"10.1093/MED/9780199858064.003.0049","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0049","url":null,"abstract":"Lung cancer staging is a process used to assess the extent of spread of lung cancer, determine the most appropriate treatment and predict the patient’s prognosis. Clinical staging is performed prior to surgical resection, while surgical-pathologic staging is based on histologic analysis of the resected tumor and lymph nodes. Restaging is performed following treatment. Staging is based on the TNM classification system. T refers to the primary tumor, N to thoracic lymph node involvement and M to metastatic disease. Recent changes to T and M descriptors were made to better reflect actual survival. For the majority of non-small cell lung cancers, the presence or absence of mediastinal lymph node spread is the most important outcome predictor. Although no changes were made to the N descriptor, the actual intrathoracic lymph node stations were recently clarified. Although the majority of small cell lung cancers are metastatic at the time of presentation, the presence of limited versus extensive spread of disease determines treatment options. However, the overall prognosis and survival for affected patients is poor. TNM staging is now recommended for carcinoid tumors as well as small cell lung cancer.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"167 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132325941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0021
C. Raptis
Although rare, vascular injury represents one of the most feared complications of penetrating and blunt trauma. These life-threatening injuries can often be cured safely if detected early, especially in the era of vascular stenting. Original detection of aortic injury often relies on chest radiography and findings of mediastinal widening with displacement of structures away from the aortic isthmus. Great vessel injury may manifest with a mediastinal hematoma seen superiorly and on the right. Chest radiography is notoriously nonspecific as many causes of mediastinal widening may be encountered. Chest CT has become the standard for diagnosing thoracic vascular injury and relies on the identification of direct findings of vascular injury.
{"title":"Thoracic Vascular Injury","authors":"C. Raptis","doi":"10.1093/MED/9780199858064.003.0021","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0021","url":null,"abstract":"Although rare, vascular injury represents one of the most feared complications of penetrating and blunt trauma. These life-threatening injuries can often be cured safely if detected early, especially in the era of vascular stenting. Original detection of aortic injury often relies on chest radiography and findings of mediastinal widening with displacement of structures away from the aortic isthmus. Great vessel injury may manifest with a mediastinal hematoma seen superiorly and on the right. Chest radiography is notoriously nonspecific as many causes of mediastinal widening may be encountered. Chest CT has become the standard for diagnosing thoracic vascular injury and relies on the identification of direct findings of vascular injury.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122681216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0012
B. Little, T. Henry
Cardiogenic edema can be characterized in three phases: pulmonary venous hypertension, interstitial edema, and alveolar edema, each with different radiographic findings. Radiographic and clinical findings must be correlated to achieve an accurate diagnosis of pulmonary edema, as other causes of interstitial and airspace opacities can have overlapping appearances. Comparison with prior radiographs is extremely useful. Clinical information and the time course of findings should be considered to avoid misinterpretation. In the acute setting, pulmonary hemorrhage and diffuse pneumonia may manifest with bilateral perihilar consolidation and interstitial thickening. In the chronic setting, fibrosing interstitial lung disease may manifest with progressive basilar reticular opacities. Brain-type natriuretic peptide (BNP) is produced by cardiac myocytes. Serum levels are elevated in cardiogenic edema and can be used to support a suspected diagnosis of pulmonary edema at imaging. Although BNP can also be elevated in a variety of lung diseases, low BNP levels suggest a diagnosis other than cardiogenic pulmonary edema. Pulmonary edema is often diagnosed and monitored through noninvasive means, including BNP monitoring, clinical assessment, and imaging studies, rather than pulmonary artery catheterization. Treatment of cardiogenic edema usually involves medical therapy (inotropic agents and preload/afterload reduction) and ventilation support to improve oxygenation. Supportive devices such as intra-aortic balloon pumps can be used to stabilize patients with severe heart failure.
{"title":"Pulmonary Venous Hypertension and Edema","authors":"B. Little, T. Henry","doi":"10.1093/MED/9780199858064.003.0012","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0012","url":null,"abstract":"Cardiogenic edema can be characterized in three phases: pulmonary venous hypertension, interstitial edema, and alveolar edema, each with different radiographic findings. Radiographic and clinical findings must be correlated to achieve an accurate diagnosis of pulmonary edema, as other causes of interstitial and airspace opacities can have overlapping appearances. Comparison with prior radiographs is extremely useful. Clinical information and the time course of findings should be considered to avoid misinterpretation. In the acute setting, pulmonary hemorrhage and diffuse pneumonia may manifest with bilateral perihilar consolidation and interstitial thickening. In the chronic setting, fibrosing interstitial lung disease may manifest with progressive basilar reticular opacities. Brain-type natriuretic peptide (BNP) is produced by cardiac myocytes. Serum levels are elevated in cardiogenic edema and can be used to support a suspected diagnosis of pulmonary edema at imaging. Although BNP can also be elevated in a variety of lung diseases, low BNP levels suggest a diagnosis other than cardiogenic pulmonary edema. Pulmonary edema is often diagnosed and monitored through noninvasive means, including BNP monitoring, clinical assessment, and imaging studies, rather than pulmonary artery catheterization. Treatment of cardiogenic edema usually involves medical therapy (inotropic agents and preload/afterload reduction) and ventilation support to improve oxygenation. Supportive devices such as intra-aortic balloon pumps can be used to stabilize patients with severe heart failure.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116359078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0014
B. Little, T. Henry
Adult respiratory distress syndrome (ARDS) is a clinical diagnosis of diffuse lung injury leading to severe hypoxemia in spite of high inspired oxygen concentrations. Histologically, ARDS manifests as diffuse alveolar damage (DAD). Intrapulmonary causes of ARDS include pneumonia, inhalational injuries, aspiration, and chest trauma. Extrapulmonary or systemic causes include sepsis, multi-organ failure, transfusion reaction, pancreatitis, and drug toxicity. The early exudative phase occurs within 72 hours of the precipitating cause, and usually manifests with diffuse bilateral airspace opacities. The organizing phase occurs later, with a dependent gradient of consolidation worse in the posterior lower lungs; bronchial dilatation may develop rapidly. In survivors, the lung may return to a relatively normal state, or may develop fibrosis. Fibrosis is often more severe in the anterior portions of the lungs due to the protective effect of the typically posterior, dependent consolidation and atelectasis of ARDS. Imaging findings of ARDS may appear in patients with progressive dyspnea and tachypnea who require mechanical ventilation. Pneumothorax may occur in patients with ARDS due to barotrauma, with minimal loss of volume of the ipsilateral lung due to its increased density and decreased compliance
{"title":"Acute Respiratory Distress Syndrome","authors":"B. Little, T. Henry","doi":"10.1093/med/9780199858064.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0014","url":null,"abstract":"Adult respiratory distress syndrome (ARDS) is a clinical diagnosis of diffuse lung injury leading to severe hypoxemia in spite of high inspired oxygen concentrations. Histologically, ARDS manifests as diffuse alveolar damage (DAD). Intrapulmonary causes of ARDS include pneumonia, inhalational injuries, aspiration, and chest trauma. Extrapulmonary or systemic causes include sepsis, multi-organ failure, transfusion reaction, pancreatitis, and drug toxicity. The early exudative phase occurs within 72 hours of the precipitating cause, and usually manifests with diffuse bilateral airspace opacities. The organizing phase occurs later, with a dependent gradient of consolidation worse in the posterior lower lungs; bronchial dilatation may develop rapidly. In survivors, the lung may return to a relatively normal state, or may develop fibrosis. Fibrosis is often more severe in the anterior portions of the lungs due to the protective effect of the typically posterior, dependent consolidation and atelectasis of ARDS. Imaging findings of ARDS may appear in patients with progressive dyspnea and tachypnea who require mechanical ventilation. Pneumothorax may occur in patients with ARDS due to barotrauma, with minimal loss of volume of the ipsilateral lung due to its increased density and decreased compliance","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123576083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0033
S. Martinez-Jiménez
Pneumonia can be classified as: community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), healthcare-associated pneumonia (HCAP), and pneumonia in immunosuppressed patients. Although the above are similar pathologically, they are very different from a clinical perspective. Chest radiography is often performed to support the diagnosis and to determine the extent of involvement prior to the onset of therapy. Radiography should not be performed in the short term in patients who are improving clinically as it can lead to the misdiagnosis of treatment failure. Chest radiography in patients treated for pneumonia should only be obtained before 4-6 weeks after the onset of therapy if there is a failure of clinical response or if complications of pneumonia are clinically suspected. The majority of pneumonias will resolve after 6 weeks of appropriate antibiotic therapy.
{"title":"Pulmonary Infections","authors":"S. Martinez-Jiménez","doi":"10.1093/med/9780199858064.003.0033","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0033","url":null,"abstract":"Pneumonia can be classified as: community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), healthcare-associated pneumonia (HCAP), and pneumonia in immunosuppressed patients. Although the above are similar pathologically, they are very different from a clinical perspective. Chest radiography is often performed to support the diagnosis and to determine the extent of involvement prior to the onset of therapy. Radiography should not be performed in the short term in patients who are improving clinically as it can lead to the misdiagnosis of treatment failure. Chest radiography in patients treated for pneumonia should only be obtained before 4-6 weeks after the onset of therapy if there is a failure of clinical response or if complications of pneumonia are clinically suspected. The majority of pneumonias will resolve after 6 weeks of appropriate antibiotic therapy.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125267562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0020
S. Bhalla
Because of its low cost and relative ease of performance, the chest radiograph is often used as a first line of imaging in the Emergency Department. One must have a structured approach to this deceptively simple exam. The first step of imaging interpretation should be an understanding of the clinical context of the examination (chest pain, dyspnea, blunt or penetrating trauma, for example). The second step should be comparison with any prior imaging. The third step should involve a careful search for any abnormal lucency. The final step should be to focus on the integrity of 9 lines, stripes and interfaces of the mediastinum. Using these simple steps in the analysis of all chest radiographs will allow for the highest diagnostic yield.
{"title":"Introduction to Emergency Chest Radiology","authors":"S. Bhalla","doi":"10.1093/MED/9780199858064.003.0020","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0020","url":null,"abstract":"Because of its low cost and relative ease of performance, the chest radiograph is often used as a first line of imaging in the Emergency Department. One must have a structured approach to this deceptively simple exam. The first step of imaging interpretation should be an understanding of the clinical context of the examination (chest pain, dyspnea, blunt or penetrating trauma, for example). The second step should be comparison with any prior imaging. The third step should involve a careful search for any abnormal lucency. The final step should be to focus on the integrity of 9 lines, stripes and interfaces of the mediastinum. Using these simple steps in the analysis of all chest radiographs will allow for the highest diagnostic yield.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"16 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131851948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0036
S. Betancourt
Endemic fungi (EF) live in soil as saprophytes, infect humans when their spores are inhaled, and often affect healthy individuals that live in or have visited certain areas. EF infection should be suspected in patients from endemic areas who present with pulmonary opacities and/or cavitary disease on imaging. However, disseminated life-threatening disease may affect also immunocompromised patients (e.g. AIDS). Consider EF infection in patients with bronchopneumonia associated with lymphadenopathy that does not respond to antibiotics. Fungal infection may mimic tuberculosis, metastatic disease, lung cancer. Immunosupression is frequently associated with disseminated EF infection. Chronic mediastinal histoplasmosis is a common benign etiology of superior vena cava syndrome.
{"title":"Endemic Fungal Infection","authors":"S. Betancourt","doi":"10.1093/MED/9780199858064.003.0036","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0036","url":null,"abstract":"Endemic fungi (EF) live in soil as saprophytes, infect humans when their spores are inhaled, and often affect healthy individuals that live in or have visited certain areas. EF infection should be suspected in patients from endemic areas who present with pulmonary opacities and/or cavitary disease on imaging. However, disseminated life-threatening disease may affect also immunocompromised patients (e.g. AIDS). Consider EF infection in patients with bronchopneumonia associated with lymphadenopathy that does not respond to antibiotics. Fungal infection may mimic tuberculosis, metastatic disease, lung cancer. Immunosupression is frequently associated with disseminated EF infection. Chronic mediastinal histoplasmosis is a common benign etiology of superior vena cava syndrome.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"95 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130950307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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