High-resolution computed tomographic findings of Aspergillus infection in lung transplant patients

Gazzoni, Fernando Ferreira; Hochhegger, Bruno; Severo, Luiz Carlos; Marchiori, Edson; Pasqualotto, Alessandro C.; Sartori, Ana Paula; Schio, Sadi Marcelo; Camargo, José de Jesus Peixoto

doi:10.1016/j.ejrad.2013.03.026

Cited by 26 publications

(11 citation statements)

References 27 publications

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“…147 In the latter case, the radiological aspects are then mostly area of consolidation or ground glass opacities. 144,154,155 Pleural effusion is frequently associated. Furthermore, coinfections by other fungi, bacteria, or viruses are frequent and they impact the radiological aspects.…”

Section: Chest Ct Scanmentioning

confidence: 99%

Invasive Pulmonary Aspergillosis

Ledoux

Guffroy

Nivoix

et al. 2020

Semin Respir Crit Care Med

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Invasive pulmonary aspergillosis (IPA) remains difficult to diagnose and to treat. Most common risk factors are prolonged neutropenia, hematopoietic stem cell or solid organ transplantation, inherited or acquired immunodeficiency, administration of steroids or other immunosuppressive agents including monoclonal antibodies and new small molecules used for cancer therapy. Critically ill patients are also at high risk of IPA. Clinical signs are unspecific. Early computed tomography (CT)-scan identifies the two main aspects, angioinvasive and airway invasive aspergillosis. Although CT-scan findings are not fully specific they usually allow early initiation of therapy before mycological confirmation of the diagnosis. Role of 18F-fludeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) is discussed. Confirmation is based on microscopy and culture of respiratory samples, histopathology in case of biopsy, and importantly by detection of Aspergillus galactomannan using an immunoassay in serum and bronchoalveolar lavage fluid. Deoxyribonucleic acid detection by polymerase chain reaction is now standardized and increases the diagnosis yield. Two point of care tests detecting an Aspergillus glycoprotein using a lateral flow assay are also available. Mycological results allow classification into proven (irrespective of underlying condition), probable or possible (for cancer and severely immunosuppressed patients) or putative (for critically ill patients) IPA. New antifungal agents have been developed over the last 2 decades: new azoles (voriconazole, posaconazole, isavuconazole), lipid formulations of amphotericin B (liposomal amphotericin B, amphotericin B lipid complex), echinocandins (caspofungin, micafungin, anidulafungin). Results of main trials assessing these agents in monotherapy or in combination are presented as well as the recommendations for their use according to international guidelines. New agents are under development.

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Section: Chest Ct Scanmentioning

confidence: 99%

Invasive Pulmonary Aspergillosis

Ledoux

Guffroy

Nivoix

et al. 2020

Semin Respir Crit Care Med

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“…Fungal infections can cause severe illnesses, especially when they enter the human internal system. For example, fungi such as Aspergillus can grow in the human lung and causes severe toxicity and allergy, while Cryptococcus can cause meningitis and brain damage in autoimmune patients [152,153]. …”

Section: Dep Applications In Biomedical Sciencesmentioning

confidence: 99%

Dielectrophoresis for Biomedical Sciences Applications: A Review

Rahman

Ibrahim

Yafouz

2017

Sensors

170

168

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Dielectrophoresis (DEP) is a label-free, accurate, fast, low-cost diagnostic technique that uses the principles of polarization and the motion of bioparticles in applied electric fields. This technique has been proven to be beneficial in various fields, including environmental research, polymer research, biosensors, microfluidics, medicine and diagnostics. Biomedical science research is one of the major research areas that could potentially benefit from DEP technology for diverse applications. Nevertheless, many medical science research investigations have yet to benefit from the possibilities offered by DEP. This paper critically reviews the fundamentals, recent progress, current challenges, future directions and potential applications of research investigations in the medical sciences utilizing DEP technique. This review will also act as a guide and reference for medical researchers and scientists to explore and utilize the DEP technique in their research fields.

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“…48,49 In SOT recipients, aspergillosis should be considered strongly when nodular opacities are seen, because it is the most common cause of nodular pneumonia. 38,50,51 The halo sign is much less sensitive for aspergillosis in SOT patients than for neutropenic patients with hematologic malignancy. 52 Specific risk factors that should increase suspicion for pulmonary aspergillosis include retransplantation, reoperation, renal failure, and transplantation for fulminant liver failure in liver recipients 53–57 ; single lung transplants, early airway ischemia, CMV infection, Aspergillus colonization, acquired hypogammaglobulinemia, and rejection in lung recipients 25–28,58–60 ; colonization of the respiratory tract with Aspergillus , reoperation, CMV disease, and posttransplant hemodialysis in heart recipients 32–34 ; and graft failure requiring hemodialysis, and prolonged duration of corticosteroid exposure in renal recipients.…”

Section: Recognition Of Invasive Fungal Infections By Clinical Syndromementioning

confidence: 99%