The development of pulmonary aspergillosis and its histologic, clinical, and radiologic manifestations

Davda, Sunit; Kowa, Xin-Ying; Aziz, Zelena A.; Ellis, Stephen; Cheasty, Emma; Cappocci, S.; Balan, Anu

doi:10.1016/j.crad.2018.06.017

Cited by 18 publications

(22 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hemoptysis, which is common in pulmonary aspergillosis and lung cancer, is rare in cryptococcosis. Nodules, especially small nodules adjacent to the pleura are common radiographic manifestation [23], while cavitary lesions are less frequent compared with that in pulmonary aspergillosis [24]. Serum CrAg is a useful predictor for cryptococcal infection [25] 38.2% of CM in lupus patients was misdiagnosed as non-fungal infection or active disease and the case-fatality rate was as high as 23.6% [7].…”

Section: Discussionmentioning

confidence: 99%

Infective patterns of cryptococcosis in patients with connective tissue disease: a retrospective study

et al. 2020

View full text Add to dashboard Cite

Background: Cryptococcal infection is a life-threatening complication in patients with connective tissue disease (CTD). This retrospective study was performed to explore the clinical features and associated factors of cryptococcosis in patients with CTD from southern China. Methods: Demographic and clinical data were collected between 2007 and 2018. Associated factors were analyzed by logistic regression analysis. Results: A total of 6809 inpatients with CTD were included. Cryptococcosis was diagnosed in 30 patients (prevalence, 0.4%). Cryptococcosis was predominant in patients with ANCAassociated vasculitis (AAV) (prevalence, 6/530, 1.1%). Lung was commonly involved (18/30, 60.0%), followed by meninges (6/30, 20.0%), blood stream (5/30, 16.7%) and disseminated cryptococcosis (1/30, 3.3%). Infiltrates (10/18, 55.6%) and small nodules (8/18, 44.4%) were the main radiographic manifestation of pulmonary cryptococcosis (PC). The positive rate of serum cryptococcal antigen (CrAg) in patients with PC was 88.2%. Cryptococcus spp. were found in 75% (3/4) patients who underwent lung biopsy. Most of the patients with cryptococcal meninges (CM) had elevated cerebrospinal fluid (CSF) opening pressure (6/7, 85.7%) and decreased CSF glucose level (5/7, 71.4%). Positive blood culture confirmed the diagnosis of cryptococcal sepsis (CS). Three patients died (10.0%), including one with CM and two with PC. Multivariate logistic regression analysis showed that accumulated dose of glucocorticoid (GC) odds ratio (OR) = 1.42, 95% confidence interval (CI) 1.08-1.87, P = 0.01 was associated with cryptococcosis in patients with CTD. Conclusions: Cryptococcosis developed in various organs. Typical radiological manifestation accompanied with positive serum CrAg were helpful clues for diagnosis. Lumbar puncture was a critical diagnostic method to distinguish CM. The accumulated dose of GC was associated with cryptococcosis in patients with CTD. Background Infection is one of the major threats to patients with connective tissue disease (CTD) because of the immune disturbance and immunosuppressive therapy [1 ,2 ]. As one of the opportunistic infections, invasive fungal disease (IFD) is a matter of concern in immunocompromised hosts. Our previous study found that approximately 1.1% of the lupus patients develops IFD [3]. Aspergillus spp., Candida spp. and Cryptococcus spp. are the common causative agents. However, due to the limitation of sample

show abstract

Section: Discussionmentioning

confidence: 99%

Infective patterns of cryptococcosis in patients with connective tissue disease: a retrospective study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Hemoptysis, which was common in pulmonary aspergillosis and lung cancer, was rare in cryptococcosis. Nodules, especially small nodules adjacent to the pleura were common radiographic manifestation [20], while cavitary lesions were less frequent compared to that in pulmonary aspergillosis [21]. Serum CrAg was a useful predictor for cryptococcal infection [22], and PAS-staining was a productive method to distinguish Cryptococcus spp.…”

Section: Discussionmentioning

confidence: 99%

Infective patterns of cryptococcosis in patients with connective tissue disease:a retrospective study

Lao

Gong

Shen

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Cryptococcal infection is a life-threatening complication in patients with connective tissue disease (CTD). This retrospective study was performed to explore the clinical features and associated factors of cryptococcosis in patients with CTD from southern China. Methods: Demographic and clinical data were collected between 2007 and 2018. Associated factors were analyzed by logistic regression analysis. Results: A total of 6809 inpatients with CTD were included. Cryptococcosis was diagnosed in 30 patients (prevalence, 0.4%). Cryptococcosis was predominant in patients with ANCA-associated vasculitis (AAV) (prevalence, 6/530, 1.1%). Lung was commonly involved (18/30, 60.0%), followed by meninges (6/30, 20.0%), blood stream (5/30, 16.7%) and disseminated cryptococcosis (1/30, 3.3%). Infiltrates (10/18, 55.6%) and small nodules (8/18, 44.4%) were the main radiographic manifestation of pulmonary cryptococcosis (PC). The positive rate of serum cryptococcal antigen (CrAg) in patients with PC was 88.2%. Cryptococcus spp. were found in 75% (3/4) patients who underwent lung biopsy. Most of the patients with cryptococcal meninges (CM) had elevated cerebrospinal fluid (CSF) opening pressure (6/7, 85.7%) and decreased CSF glucose level (5/7, 71.4%). Positive blood culture confirmed the diagnosis of cryptococcal sepsis (CS). Three patients died (10.0%), including one with CM and two with PC. Multivariate logistic regression analysis showed that accumulated dose of glucocorticoid (GC) [odds ratio (OR) = 1.42, 95% confidence interval (CI) 1.08-1.87, P = 0.01] was associated with cryptococcosis in patients with CTD. Conclusions: Cryptococcosis developed in various organs. Typical radiological manifestation accompanied with positive serum CrAg were helpful clues for diagnosis. Lumbar puncture was a critical diagnostic method to distinguish CM. The accumulated dose of GC was associated with cryptococcosis in patients with CTD.

show abstract

“…Radiological features for differential diagnosis: ground-glass opacities and crazy paving pattern are not typical and do not precede consolidations, which frequently present a surrounding ground-glass halo (halo sign) [ 29 ] (Fig. 2 f); in case of consolidations with no ground-glass halo and absence of other ground-glass opacities, COVID-19 pneumonia is unlikely; presence of air crescent sign [ 13 , 27 , 29 ] (Fig. 2 g); lymphadenomegalies and pleural effusions [ 29 ].…”

Section: Main Textmentioning

confidence: 99%

Differential diagnoses of COVID-19 pneumonia: the current challenge for the radiologist—a pictorial essay

et al. 2021

View full text Add to dashboard Cite

Background COVID-19 pneumonia represents the most severe pandemic of the twenty-first century and has crucial clinical, social and economical implications. The scientific community has focused attention and resources on clinical and radiological features of COVID-19 pneumonia. Few papers analysing the vast spectrum of differential diagnoses have been published. Main body Complexity of differential diagnosis lays in the evidence of similar radiological findings as ground-glass opacities, crazy paving pattern and consolidations in COVID-19 pneumonia and a multitude of other lung diseases. Differential diagnosis is and will be extremely important during and after the pandemic peak, when there are fewer COVID-19 pneumonia cases. The aim of our pictorial essay is to schematically present COVID-19 pneumonia most frequent differential diagnoses to help the radiologist face the current COVID-19 pneumonia challenge. Conclusions Clinical data, laboratory tests and imaging are pillars of a trident, which allows to reach a correct diagnosis in order to grant an excellent allocation of human and economical resources. The radiologist has a pivotal role in the early diagnosis of COVID-19 pneumonia because he may raise suspicion of the pathology and help to avoid COVID-19 virus spread.

show abstract

The development of pulmonary aspergillosis and its histologic, clinical, and radiologic manifestations

Cited by 18 publications

References 37 publications

Infective patterns of cryptococcosis in patients with connective tissue disease: a retrospective study

Infective patterns of cryptococcosis in patients with connective tissue disease: a retrospective study

Infective patterns of cryptococcosis in patients with connective tissue disease:a retrospective study

Differential diagnoses of COVID-19 pneumonia: the current challenge for the radiologist—a pictorial essay

Contact Info

Product

Resources

About