Computed tomographic features of 23 sporadic cases with Legionella pneumophila pneumonia

Yu, Hui; Higa, Futoshi; Hibiya, Kenji; Furugen, Makoto; Shinzato, Takashi; Haranaga, Shusaku; Yara, Satomi; Tateyama, Masao; Fujita, Jiro; Li, Huiping

doi:10.1016/j.ejrad.2009.04.011

Cited by 23 publications

(14 citation statements)

References 25 publications

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“…Chest CT findings include ground-glass opacities and consolidation. Cavitation of consolidated lung is seen in about 10% of immunosuppressed patients [9]. [10].…”

Section: Legionella Speciesmentioning

confidence: 99%

Bacterial pneumonia in kidney transplant recipients

Wilmes

Coche

Rodríguez-Villalobos

et al. 2018

Respiratory Medicine

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Bacterial pathogens are the most frequent cause of pneumonia after transplantation. Early after transplantation, recipients are at higher risk for nosocomial infections. The most commonly encountered pathogens during this period are gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa …), but gram-positive coccus such as Staphylococcus aureus or Streptococcus pneumoniae and anaerobic bacteria can also be found. Empirical antibiotic therapy should be guided by previous colonisation of the recipient and bacterial resistance pattern in the hospital. Six months after transplantation, pneumonias are mostly due to community-acquired bacteria (S. pneumonia, H. influenza, Mycoplasma, Chlamydia and others). Opportunistic pathogens take advantage of the state of immunosuppression which is usually highest from one to six months after transplantation. During this period, but also occurring many years later in the setting of a chronically depressed immune system, bacterial pathogens with low intrinsic virulence can cause pneumonia. The diagnosis of pneumonia caused by opportunistic pathogens can be challenging. The delay in diagnosis preventing the early instauration of adequate treatment in kidney transplant recipients with a depressed immune system, frequently coupled with co-morbid conditions and a state of frailty, will affect prognosis and outcome, increasing morbidity and mortality. This review will focus on the most common opportunistic bacterial pathogens causing pneumonia in kidney transplant recipients: Legionella, Nocardia, Mycobacterium tuberculosis/nontuberculous, and Rhodococcus. Recognition of their specificities in the setting of immunosuppression will allow early diagnosis, crucial for initiation of effective therapy and successful outcome. Interactions with immunosuppressive therapy should be considered as well as reducing immunosuppression if necessary.

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“…Chest CT findings include ground-glass opacities and consolidation. Cavitation of consolidated lung is seen in about 10% of immunosuppressed patients [9]. [10].…”

Section: Legionella Speciesmentioning

confidence: 99%

Bacterial pneumonia in kidney transplant recipients

Wilmes

Coche

Rodríguez-Villalobos

et al. 2018

Respiratory Medicine

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“…CT scans display nonsegmental distribution as homogenous consolidation involving adjacent segments of a lobe. This consolidation usually begins in the periphery of the lung, and spreads along the pleura or the inter lobar fissure [10,11].…”

Section: Non-segmental Consolidation (Lobar Pneumonia)mentioning

confidence: 99%

Differential Diagnosis of Non-Segmental Consolidations

Haroon¹

2013

J Pulm Respir Med

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Consolidation and Ground-Glass Opacities (GGO) are common findings on chest Computed Tomographic (CT) scans. Consolidation and GGO can be divided into segmental, non-segmental and interstitial pneumonia types based upon distribution pattern. The aim of this review is to highlight the importance of the non-segmental distribution pattern, and to explain its relevancy in various conditions. Non-segmental distribution pattern presents as lobar pneumonia histologically, whereas segmental distribution appears as bronchopneumonia. The different diagnoses that can be derived from non-segmental distribution consist of infectious pneumonias caused by S. pneumoniae, K. pneumoniae and L. pneumophila, Chlamydophila psittaci, M. pneumoniae, measles, viral pneumonia and tuberculosis, as well as non-infectious inflammatory diseases including Cryptogenic Organizing Pneumonia (COP), Chronic Eosinophilic Pneumonia (CEP) and Pulmonary Alveolar Proteinosis (PAP), and other conditions including Anti-Neutrophil Cytoplasmic Antibody (ANCA) related pulmonary hemorrhage and Bronchoalveolar Carcinoma (BAC). A detailed analysis and correlation of non-segmental distribution with other CT findings (e.g., ground-glass opacity, interlobular septal thickening, fibrosis, pleural effusion, air trapping, nodular lesions, and air bronchiologram and air bronchogram) can facilitate the accurate diagnosis of these respiratory diseases. Specifically of interest is L. pneumophila infection, which first presents as bronchopneumonia but later converts into lobar pneumonia. The mechanism behind this conversion involves inflammatory exudates that can pass through Kohn's pores and Lambert's channel during L. pneumophila infection. Therefore, L. pneumophila pneumonia pattern first presents as segmental at the start of infection and after 2 weeks or more converts into non-segmental type. Overall, this review demonstrates that the nonsegmental distribution pattern can be very valuable in making respiratory disease diagnosis.

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“…CT findings of organizing pneumonia, according to previously reported data, are unilateral or bilateral, patchy ground-glass opacities or consolidation, nodules, fibrosis, interlobular septal thickening, and band-like opacities [5,6,[10][11][12][13][14][15]. Previously reported CT patterns of organizing pneumonia include subpleural [16,17], peribronchovascular [18] or perilobular [19] patterns.…”

Section: Introductionmentioning

confidence: 95%

“…Although the prognosis has improved greatly with the appropriate antibiotics, some patients who survive from acute pneumonia develop different pulmonary sequelae, which include pulmonary fibrosis and organizing pneumonia, with or without bronchiolitis obliterans [2][3][4][5][6][7]. Organizing pneumonia is defined as an inflammatory lung disease that corresponds to the presence of buds of granulation tissue in the lumen of distal airspaces.…”

Section: Introductionmentioning

confidence: 99%