Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0078
Cylen Javidan-Nejad
Idiopathic pulmonary fibrosis (IPF) represents one of the most common chronic interstitial lung diseases. Usual interstitial pneumonia (UIP) is the pathologic diagnosis of IPF and can be diagnosed when honeycombing is present with a basilar and peripheral predominance and findings not typical of UIP are absent. In the current era, when a diagnosis of UIP is made with confidence on HRCT, biopsy can be avoided. Yet, one must be familiar with mimics of UIP/IPF (most notably pulmonary edema superimposed on emphysema) to avoid confusion misdiagnosis. Radiologists must also be familiar with potential complications of UIP including progression, infection, accelerated fibrosis (which can be lethal) and primary lung cancer (which has an increased incidence in UIP).
{"title":"Idiopathic Pulmonary Fibrosis","authors":"Cylen Javidan-Nejad","doi":"10.1093/MED/9780199858064.003.0078","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0078","url":null,"abstract":"Idiopathic pulmonary fibrosis (IPF) represents one of the most common chronic interstitial lung diseases. Usual interstitial pneumonia (UIP) is the pathologic diagnosis of IPF and can be diagnosed when honeycombing is present with a basilar and peripheral predominance and findings not typical of UIP are absent. In the current era, when a diagnosis of UIP is made with confidence on HRCT, biopsy can be avoided. Yet, one must be familiar with mimics of UIP/IPF (most notably pulmonary edema superimposed on emphysema) to avoid confusion misdiagnosis. Radiologists must also be familiar with potential complications of UIP including progression, infection, accelerated fibrosis (which can be lethal) and primary lung cancer (which has an increased incidence in UIP).","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"7 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":"114960943","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/9780199858064.003.0015
Christopher M Walker
Atelectasis is one of the most frequently encountered imaging abnormalities on chest radiography and CT, with different implications when detected in hospitalized patients as compared to those encountered in the outpatient setting. Bedridden and postoperative patients often have a dependent type of atelectasis, whereas lobar atelectasis detected in an outpatient is often a harbinger of underlying malignancy (e.g. lung cancer). Medical malpractice cases are sometimes based on the missed diagnosis of lung cancer manifesting as atelectasis and misinterpreted by a radiologist. It is imperative that radiologists be familiar with the direct and indirect imaging signs of atelectasis, as well as the classic patterns of lobar atelectasis. Specific signs of lobar atelectasis will be described including the S sign of Golden and the luftsichel sign. A confident knowledge of lung anatomy, particularly with regard to hilar anatomy and the normal appearance of mediastinal contours and the interlobar fissures, will enable the radiologist to confidently diagnose atelectasis and narrow the differential diagnostic considerations.
{"title":"Volume Loss","authors":"Christopher M Walker","doi":"10.1093/med/9780199858064.003.0015","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0015","url":null,"abstract":"\u0000 Atelectasis is one of the most frequently encountered imaging abnormalities on chest radiography and CT, with different implications when detected in hospitalized patients as compared to those encountered in the outpatient setting. Bedridden and postoperative patients often have a dependent type of atelectasis, whereas lobar atelectasis detected in an outpatient is often a harbinger of underlying malignancy (e.g. lung cancer). Medical malpractice cases are sometimes based on the missed diagnosis of lung cancer manifesting as atelectasis and misinterpreted by a radiologist. It is imperative that radiologists be familiar with the direct and indirect imaging signs of atelectasis, as well as the classic patterns of lobar atelectasis. Specific signs of lobar atelectasis will be described including the S sign of Golden and the luftsichel sign. A confident knowledge of lung anatomy, particularly with regard to hilar anatomy and the normal appearance of mediastinal contours and the interlobar fissures, will enable the radiologist to confidently diagnose atelectasis and narrow the differential diagnostic considerations.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"133 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":"116269202","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/9780199858064.003.0070
T. Henry, B. Little
Almost any medication may result in a reaction within the lungs. These reactions are often variable and include diffuse alveolar damage, organizing pneumonia, eosinophilic pneumonia, hypersensitivity reaction, interstitial pneumonitis/fibrosis, alveolar hemorrhage, pulmonary vasculitis/pulmonary hypertension, bronchiolitis obliterans, or a sarcoid-like reaction. Because these reactions may mimic their idiopathic counterparts, yet may respond to drug cessation or alternative therapies, suspicion must be high in patients with pulmonary findings who are on certain medications. This chapter will focus on the spectrum of drug reactions with the lungs. Amiodarone-related pulmonary abnormalities will also be discussed.
{"title":"Drug-Induced Lung Disease","authors":"T. Henry, B. Little","doi":"10.1093/med/9780199858064.003.0070","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0070","url":null,"abstract":"Almost any medication may result in a reaction within the lungs. These reactions are often variable and include diffuse alveolar damage, organizing pneumonia, eosinophilic pneumonia, hypersensitivity reaction, interstitial pneumonitis/fibrosis, alveolar hemorrhage, pulmonary vasculitis/pulmonary hypertension, bronchiolitis obliterans, or a sarcoid-like reaction. Because these reactions may mimic their idiopathic counterparts, yet may respond to drug cessation or alternative therapies, suspicion must be high in patients with pulmonary findings who are on certain medications. This chapter will focus on the spectrum of drug reactions with the lungs. Amiodarone-related pulmonary abnormalities will also be discussed.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"74 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":"123120983","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/9780199858064.003.0021
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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