1
|
Ong CC, Teo LL. Endemic Thoracic Infections in Southeast Asia. Radiol Clin North Am 2022; 60:445-459. [DOI: 10.1016/j.rcl.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
2
|
Rueckel J, Fink N, Kaestle S, Stüber T, Schwarze V, Gresser E, Hoppe BF, Rudolph J, Kunz WG, Ricke J, Sabel BO. COVID-19 Pandemic and Upcoming Influenza Season-Does an Expert's Computed Tomography Assessment Differentially Identify COVID-19, Influenza and Pneumonias of Other Origin? J Clin Med 2020; 10:E84. [PMID: 33379386 PMCID: PMC7795488 DOI: 10.3390/jcm10010084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/16/2020] [Accepted: 12/23/2020] [Indexed: 01/08/2023] Open
Abstract
(1) Background: Time-consuming SARS-CoV-2 RT-PCR suffers from limited sensitivity in early infection stages whereas fast available chest CT can already raise COVID-19 suspicion. Nevertheless, radiologists' performance to differentiate COVID-19, especially from influenza pneumonia, is not sufficiently characterized. (2) Methods: A total of 201 pneumonia CTs were identified and divided into subgroups based on RT-PCR: 78 COVID-19 CTs, 65 influenza CTs and 62 Non-COVID-19-Non-influenza (NCNI) CTs. Three radiology experts (blinded from RT-PCR results) raised pathogen-specific suspicion (separately for COVID-19, influenza, bacterial pneumonia and fungal pneumonia) according to the following reading scores: 0-not typical/1-possible/2-highly suspected. Diagnostic performances were calculated with RT-PCR as a reference standard. Dependencies of radiologists' pathogen suspicion scores were characterized by Pearson's Chi2 Test for Independence. (3) Results: Depending on whether the intermediate reading score 1 was considered as positive or negative, radiologists correctly classified 83-85% (vs. NCNI)/79-82% (vs. influenza) of COVID-19 cases (sensitivity up to 94%). Contrarily, radiologists correctly classified only 52-56% (vs. NCNI)/50-60% (vs. COVID-19) of influenza cases. The COVID-19 scoring was more specific than the influenza scoring compared with suspected bacterial or fungal infection. (4) Conclusions: High-accuracy COVID-19 detection by CT might expedite patient management even during the upcoming influenza season.
Collapse
Affiliation(s)
- Johannes Rueckel
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Nicola Fink
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
- Comprehensive Pneumology Center (CPC-M), German Center for Lung Research (DZL), 81377 Munich, Germany
| | - Sophia Kaestle
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Theresa Stüber
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
- Chair of Statistical Learning & Data Science, Department of Statistics, LMU Munich, 80539 Munich, Germany
| | - Vincent Schwarze
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Eva Gresser
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Boj F. Hoppe
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Jan Rudolph
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Wolfgang G. Kunz
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| | - Bastian O. Sabel
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (N.F.); (S.K.); (T.S.); (V.S.); (E.G.); (B.F.H.); (J.R.); (W.G.K.); (J.R.); (B.O.S.)
| |
Collapse
|
3
|
Carter BW, Muse VV, Mansouri M. Imaging of Nontraumatic Mediastinal and Pulmonary Processes. Emerg Radiol 2018. [DOI: 10.1007/978-3-319-65397-6_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
4
|
Poetter-Lang S, Herold CJ. [Community-acquired pneumonia]. Radiologe 2017; 57:6-12. [PMID: 28054135 DOI: 10.1007/s00117-016-0199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CLINICAL ISSUE The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. STANDARD RADIOLOGICAL METHODS For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. METHODICAL INNOVATIONS Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging. ACHIEVEMENTS/PRACTICAL RECOMMENDATIONS The radiological findings serve as proof or exclusion of pneumonia and can also be used to evaluate the extent of the disease (e.g. monolobular, multilobular, unilateral or bilateral). In cases of prolonged disease, suspicion of complications (e.g. pleural effusion or empyema, necrotizing pneumonia or abscess) or comorbid conditions (e.g. underlying pulmonary or mediastinal diseases) computed tomography is an important diagnostic tool in addition to chest radiography. Ultrasound is often used to diagnose pleural processes (e.g. parapneumonic effusion or pleural empyema).
Collapse
Affiliation(s)
- S Poetter-Lang
- Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Medizinische Universität Wien, Währinger Guertel 18-20, 1090, Wien, Österreich.
| | - C J Herold
- Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Medizinische Universität Wien, Währinger Guertel 18-20, 1090, Wien, Österreich
| |
Collapse
|
5
|
Cao B, Huang Y, She DY, Cheng QJ, Fan H, Tian XL, Xu JF, Zhang J, Chen Y, Shen N, Wang H, Jiang M, Zhang XY, Shi Y, He B, He LX, Liu YN, Qu JM. Diagnosis and treatment of community-acquired pneumonia in adults: 2016 clinical practice guidelines by the Chinese Thoracic Society, Chinese Medical Association. CLINICAL RESPIRATORY JOURNAL 2017; 12:1320-1360. [PMID: 28756639 PMCID: PMC7162259 DOI: 10.1111/crj.12674] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/25/2017] [Indexed: 02/05/2023]
Abstract
Community‐acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence. Corresponding recommendations are provided appropriately based on the level of evidence. This updated guideline covers comprehensive topics on CAP, including aetiology, antimicrobial resistance profile, diagnosis, empirical and targeted treatments, adjunctive and supportive therapies, as well as prophylaxis. The recommendations may help clinicians manage CAP patients more effectively and efficiently. CAP in pediatric patients and immunocompromised adults is beyond the scope of this guideline. This guideline is only applicable for the immunocompetent CAP patients aged 18 years and older. The recommendations on selection of antimicrobial agents and the dosing regimens are not mandatory. The clinicians are recommended to prescribe and adjust antimicrobial therapies primarily based on their local etiological profile and results of susceptibility testing, with reference to this guideline.
Collapse
Affiliation(s)
- Bin Cao
- National Clinical Research Center of Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Capital Medical University, Beijing 100029, China
| | - Yi Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China
| | - Dan-Yang She
- Department of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Qi-Jian Cheng
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
| | - Hong Fan
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan 610041, China
| | - Xin-Lun Tian
- Department of Pulmonary Medicine, Peking Union Medical College Hospital, Beijing 100730, China
| | - Jin-Fu Xu
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Jing Zhang
- Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yu Chen
- Department of Respiratory and Critical Care Medicine, Shengjing Hospital, China Medical University, Shenyang 110004, China
| | - Ning Shen
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Hui Wang
- Department of Laboratory Medicine, Peking University People's Hospital, Beijing 100044, China
| | - Mei Jiang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xiang-Yan Zhang
- Department of Respiratory and Critical Care Medicine, Guizhou Provincial People's Hospital, Guizhou 550002, China
| | - Yi Shi
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing 210002, China
| | - Bei He
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Li-Xian He
- Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - You-Ning Liu
- Department of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Jie-Ming Qu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
| |
Collapse
|
6
|
Garg M, Prabhakar N, Kiruthika P, Agarwal R, Aggarwal A, Gulati A, Khandelwal N. Imaging of Pneumonia: An Overview. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0209-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
7
|
Parsons CS, Helm EJ. Pneumonia and acute respiratory distress syndrome. IMAGING 2016. [DOI: 10.1183/2312508x.10003315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
8
|
Galván JM, Rajas O, Aspa J. Review of Non-Bacterial Infections in Respiratory Medicine: Viral Pneumonia. Arch Bronconeumol 2015; 51:590-7. [PMID: 25957460 PMCID: PMC7105177 DOI: 10.1016/j.arbres.2015.02.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 02/23/2015] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
Abstract
Although bacteria are the main pathogens involved in community-acquired pneumonia, a significant number of community-acquired pneumonia are caused by viruses, either directly or as part of a co-infection. The clinical picture of these different pneumonias can be very similar, but viral infection is more common in the pediatric and geriatric populations, leukocytes are not generally elevated, fever is variable, and upper respiratory tract symptoms often occur; procalcitonin levels are not generally affected. For years, the diagnosis of viral pneumonia was based on cell culture and antigen detection, but since the introduction of polymerase chain reaction techniques in the clinical setting, identification of these pathogens has increased and new microorganisms such as human bocavirus have been discovered. In general, influenza virus type A and syncytial respiratory virus are still the main pathogens involved in this entity. However, in recent years, outbreaks of deadly coronavirus and zoonotic influenza virus have demonstrated the need for constant alert in the face of new emerging pathogens. Neuraminidase inhibitors for viral pneumonia have been shown to reduce transmission in cases of exposure and to improve the clinical progress of patients in intensive care; their use in common infections is not recommended. Ribavirin has been used in children with syncytial respiratory virus, and in immunosuppressed subjects. Apart from these drugs, no antiviral has been shown to be effective. Prevention with anti-influenza virus vaccination and with monoclonal antibodies, in the case of syncytial respiratory virus, may reduce the incidence of pneumonia.
Collapse
Affiliation(s)
- José María Galván
- Servicio de Medicina Interna, Hospital Universitario de la Princesa, IIS-IP, Madrid, España
| | - Olga Rajas
- Servicio de Neumología, Hospital Universitario de la Princesa, IIS-IP, Madrid, España
| | - Javier Aspa
- Servicio de Neumología, Hospital Universitario de la Princesa, IIS-IP, Madrid, España.
| |
Collapse
|
9
|
Abstract
Although bacteria are the main pathogens involved in community-acquired pneumonia, a significant number of community-acquired pneumonia are caused by viruses, either directly or as part of a co-infection. The clinical picture of these different pneumonias can be very similar, but viral infection is more common in the pediatric and geriatric populations, leukocytes are not generally elevated, fever is variable, and upper respiratory tract symptoms often occur; procalcitonin levels are not generally affected. For years, the diagnosis of viral pneumonia was based on cell culture and antigen detection, but since the introduction of polymerase chain reaction techniques in the clinical setting, identification of these pathogens has increased and new microorganisms such as human bocavirus have been discovered. In general, influenza virus type A and syncytial respiratory virus are still the main pathogens involved in this entity. However, in recent years, outbreaks of deadly coronavirus and zoonotic influenza virus have demonstrated the need for constant alert in the face of new emerging pathogens. Neuraminidase inhibitors for viral pneumonia have been shown to reduce transmission in cases of exposure and to improve the clinical progress of patients in intensive care; their use in common infections is not recommended. Ribavirin has been used in children with syncytial respiratory virus, and in immunosuppressed subjects. Apart from these drugs, no antiviral has been shown to be effective. Prevention with anti-influenza virus vaccination and with monoclonal antibodies, in the case of syncytial respiratory virus, may reduce the incidence of pneumonia.
Collapse
Affiliation(s)
- José María Galván
- Servicio de Medicina Interna, Hospital Universitario de la Princesa, IIS-IP, Madrid, España
| | - Olga Rajas
- Servicio de Neumología, Hospital Universitario de la Princesa, IIS-IP, Madrid, España
| | - Javier Aspa
- Servicio de Neumología, Hospital Universitario de la Princesa, IIS-IP, Madrid, España.
| |
Collapse
|
10
|
Green DB, Raptis CA, Alvaro Huete Garin I, Bhalla S. Negative Computed Tomography for Acute Pulmonary Embolism: Important Differential Diagnosis Considerations for Acute Dyspnea. Radiol Clin North Am 2015; 53:789-99, ix. [PMID: 26046511 DOI: 10.1016/j.rcl.2015.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Computed tomography pulmonary angiography (CTPA) is the principal means of evaluating dyspnea in the emergency department. As its use has increased, the number of studies positive for pulmonary embolism (PE) has decreased to less than 20%. Many of the negative PE studies provide an alternative explanation for dyspnea, most commonly pneumonia, pulmonary edema, pleural effusion, or atelectasis. Nonthrombotic emboli may also be suggested. Airway and obstructive lung disease may be detected on CTPA. Pleural and pericardial disease may also explain the dyspnea, but more detailed evaluation of the serosal surfaces may be limited on the arterial phase of a CTPA.
Collapse
Affiliation(s)
- Daniel B Green
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway, St Louis, MO 63110, USA
| | - Constantine A Raptis
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway, St Louis, MO 63110, USA
| | | | - Sanjeev Bhalla
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway, St Louis, MO 63110, USA.
| |
Collapse
|
11
|
Geriatric chest imaging: when and how to image the elderly lung, age-related changes, and common pathologies. Radiol Res Pract 2013; 2013:584793. [PMID: 23936651 PMCID: PMC3713368 DOI: 10.1155/2013/584793] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 06/11/2013] [Indexed: 12/21/2022] Open
Abstract
Even in a global perspective, societies are getting older. We think that diagnostic lung imaging of older patients requires special knowledge. Imaging strategies have to be adjusted to the needs of frail patients, for example, immobility, impossibility for long breath holds, renal insufficiency, or poor peripheral venous access. Beside conventional radiography, modern multislice computed tomography is the method of choice in lung imaging. It is especially important to separate the process of ageing from the disease itself. Pathologies with a special relevance for the elderly patient are discussed in detail: pneumonia, aspiration pneumonia, congestive heart failure, chronic obstructive pulmonary disease, the problem of overlapping heart failure and chronic obstructive pulmonary disease, pulmonary drug toxicity, incidental pulmonary embolism pulmonary nodules, and thoracic trauma.
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW The article aims to indicate the current role of radiological imaging in immune competent and immunocompromised patients with pneumonia. The radiological findings in the most common conditions will be reviewed. RECENT FINDINGS Three basic patterns of radiographic abnormality are recognized: lobar (nonsegmental) pneumonia; bronchopneumonia (lobular pneumonia); and interstitial pneumonia. The chest radiograph remains the initial radiological investigation. Computed tomography (CT) is more sensitive than the chest radiograph. The appearances on CT with certain infections such as mycoplasma, invasive aspergillosis, and pneumocystis, in the appropriate clinical setting, may allow a treatment decision to be made when obtaining fluid or tissue for culture is problematical. MRI technology is advancing and this technique may provide an option for follow-up of chronic disease in younger patients in whom radiation exposure is a concern, but MRI does not yet match CT as a diagnostic test in this field. SUMMARY Radiology retains a key role in diagnosing pneumonia, excluding pneumonia, following up patients to check for resolution and to evaluate potential complications. The chest radiograph remains the initial examination. CT is more sensitive and with certain infections more specific. MRI provides an option for monitoring progress, although cannot yet match CT as an initial diagnostic test.
Collapse
|
13
|
Imaging of Nontraumatic Mediastinal and Pulmonary Processes. Emerg Radiol 2013. [DOI: 10.1007/978-1-4419-9592-6_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
14
|
Reynolds JH, McDonald G, Alton H, Gordon SB. Pneumonia in the immunocompetent patient. Br J Radiol 2011; 83:998-1009. [PMID: 21088086 DOI: 10.1259/bjr/31200593] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Pneumonia is an acute inflammation of the lower respiratory tract. Lower respiratory tract infection is a major cause of mortality worldwide. Pneumonia is most common at the extremes of life. Predisposing factors in children include an under-developed immune system together with other factors, such as malnutrition and over-crowding. In adults, tobacco smoking is the single most important preventable risk factor. The commonest infecting organisms in children are respiratory viruses and Streptoccocus pneumoniae. In adults, pneumonia can be broadly classified, on the basis of chest radiographic appearance, into lobar pneumonia, bronchopneumonia and pneumonia producing an interstitial pattern. Lobar pneumonia is most commonly associated with community acquired pneumonia, bronchopneumonia with hospital acquired infection and an interstitial pattern with the so called atypical pneumonias, which can be caused by viruses or organisms such as Mycoplasma pneumoniae. Most cases of pneumonia can be managed with chest radiographs as the only form of imaging, but CT can detect pneumonia not visible on the chest radiograph and may be of value, particularly in the hospital setting. Complications of pneumonia include pleural effusion, empyema and lung abscess. The chest radiograph may initially indicate an effusion but ultrasound is more sensitive, allows characterisation in some cases and can guide catheter placement for drainage. CT can also be used to characterise and estimate the extent of pleural disease. Most lung abscesses respond to medical therapy, with surgery and image guided catheter drainage serving as options for those cases who do not respond.
Collapse
Affiliation(s)
- J H Reynolds
- Department of Radiology, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, UK.
| | | | | | | |
Collapse
|
15
|
Corrêa RDA, Lundgren FLC, Pereira-Silva JL, Frare e Silva RL, Cardoso AP, Lemos ACM, Rossi F, Michel G, Ribeiro L, Cavalcanti MADN, de Figueiredo MRF, Holanda MA, Valery MIBDA, Aidê MA, Chatkin MN, Messeder O, Teixeira PJZ, Martins RLDM, da Rocha RT. Brazilian guidelines for community-acquired pneumonia in immunocompetent adults - 2009. J Bras Pneumol 2010; 35:574-601. [PMID: 19618038 DOI: 10.1590/s1806-37132009000600011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Accepted: 04/23/2009] [Indexed: 01/30/2023] Open
Abstract
Community-acquired pneumonia continues to be the acute infectious disease that has the greatest medical and social impact regarding morbidity and treatment costs. Children and the elderly are more susceptible to severe complications, thereby justifying the fact that the prevention measures adopted have focused on these age brackets. Despite the advances in the knowledge of etiology and physiopathology, as well as the improvement in preliminary clinical and therapeutic methods, various questions merit further investigation. This is due to the clinical, social, demographical and structural diversity, which cannot be fully predicted. Consequently, guidelines are published in order to compile the most recent knowledge in a systematic way and to promote the rational use of that knowledge in medical practice. Therefore, guidelines are not a rigid set of rules that must be followed, but first and foremost a tool to be used in a critical way, bearing in mind the variability of biological and human responses within their individual and social contexts. This document represents the conclusion of a detailed discussion among the members of the Scientific Board and Respiratory Infection Committee of the Brazilian Thoracic Association. The objective of the work group was to present relevant topics in order to update the previous guidelines. We attempted to avoid the repetition of consensual concepts. The principal objective of creating this document was to present a compilation of the recent advances published in the literature and, consequently, to contribute to improving the quality of the medical care provided to immunocompetent adult patients with community-acquired pneumonia.
Collapse
Affiliation(s)
- Ricardo de Amorim Corrêa
- Universidade Federal de Minas Gerais - UFMG, Federal University of Minas Gerais - School of Medicine, Belo Horizonte, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Sharma S. Computed tomography for the diagnosis of infectious diseases of the chest. ACTA ACUST UNITED AC 2008; 2:1247-62. [PMID: 23496684 DOI: 10.1517/17530059.2.11.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pulmonary infection is a common reason for imaging of the lung in immunocompetent and immunosuppressed patients. Findings on chest radiography are nonspecific and encompass poor sensitivity. The role of computed tomography (CT) has been evolving in the diagnosis of lung infections. OBJECTIVE This paper reviews recent developments in the efficacy and utility of CT in the diagnosis of suspected pulmonary infections in a variety of patient populations. METHODS Recent published literature was reviewed to prepare this treatise on the role of CT. CONCLUSION Knowledge and skills at pattern recognition are crucial for the CT interpretation in lung infections. Computed tomography scan is increasingly used to increase the sensitivity of the radiologic diagnosis of thoracic infections. The greatest value of CT is when the radiograph is normal, findings are equivocal, and to differentiate infection from non-infectious disorders.
Collapse
Affiliation(s)
- Sat Sharma
- Professor and Head University of Manitoba, St Boniface General Hospital, Section of Respirology, Department of Internal Medicine, BG034, 409 Tache Avenue, Winnipeg MB, R2H 2A6, Canada +204 237 2217 ; +204 231 1927 ;
| |
Collapse
|
17
|
Haque AK, Adegboyega PA. Pneumocystis jiroveci Pneumonia. DAIL AND HAMMAR’S PULMONARY PATHOLOGY 2008. [PMCID: PMC7121032 DOI: 10.1007/978-0-387-68792-6_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Pneumocystis pneumonia (PCP) is one of the most common pulmonary infections in persons with impaired cell-mediated immunity, and particularly those infected with human immunodeficiency virus (HIV).1–7 Pneumocystis was first described in the lungs of guinea pigs, during experiments on American trypanosomiasis by Carlos Chagas8 in 1909 and by Antonio Carinii9 in 1910. Both considered the cysts of Pneumocystis as part of the trypanosome’s life cycle. Shortly afterward the Delanoes10 found identical forms in the lungs of rats that had not been infected with trypanosomes and recognized the organism as a separate species. The name Pneumocystis carinii, was given to this organism as a generic name (Greek:pneumon, “lung”; kystis, “cyst”), honoring Carinii.11
Collapse
|
18
|
Washington L, Palacio D. Imaging of Bacterial Pulmonary Infection in the Immunocompetent Patient. Semin Roentgenol 2007; 42:122-45. [PMID: 17394925 DOI: 10.1053/j.ro.2006.08.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pulmonary infection is a common reason for imaging of the lung and a common incidental finding in immunocompetent patients. Findings on chest radiography are nonspecific in defining acute infection; however, the radiologist should be aware of classically described patterns of infection, including air space, bronchopneumonia, and interstitial patterns. The radiologist must also be aware of potential limitations of the sensitivity of chest radiography. Imaging findings at computed tomography in acute infection have been poorly studied but may be more specific. Aspiration and septic emboli are additional potential radiographic patterns of infection that may be very characteristic in appearance. In the setting of nonresolving pneumonia, the differential diagnosis includes noninfectious causes as well as a variety of atypical infectious agents, specifically, mycobacterial and fungal agents, which have overlapping but distinctive clinical and radiographic presentations.
Collapse
Affiliation(s)
- Lacey Washington
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | | |
Collapse
|