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Dante Luiz Escuissato

Dante Luiz Escuissato. Infections are related to specific immunity defects. Phagocyte abnormalities and intravenous catheters: Aspergillus and Candida species.

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Dante Luiz Escuissato

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  1. Dante LuizEscuissato

  2. Infections are related to specific immunity defects. • Phagocyte abnormalities and intravenous catheters: Aspergillus and Candida species. • T cell abnormalities and corticosteroid therapy: Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, Pneumocystis jiroveci, andCandida species.

  3. Am J Roentgenol 2005;185:608-615

  4. Aspergillus sp Fusarium sp

  5. Pseudomonas sp.

  6. Infections • Fungal infections (invasive aspergillosis, candidiasis, zygomycosis, fusariosis) • Viral and bacterial infections • Neoplasia • Bronchoalveolar carcinoma • Kaposi sarcoma • Angiosarcoma metastasis • Vasculitis (Wegener granulomatosis) Br J Radiol 2005;78:862-865

  7. Invasive Pulmonary Aspergillosis • Chest X-ray: isolate or multiple nodular opacities, cavitate lesions, alveolar opacities. • CT: nodules and alveolar opacities, with or without the halo sign. Radiographics 2001;21:825-837 Braz J Infect Dis 2007;11:110-113

  8. Invasive Pulmonary Aspergillosis • Halo sign: 33-60%, disappears after one week (~75%) • Recommendation: CT scan performed not beyond 5th day after symptoms onset.

  9. Invasive Pulmonary Aspergillosis

  10. Invasive Pulmonary Aspergillosis

  11. Invasive Pulmonary Aspergillosis

  12. CT scan: nodules, consolidations, and ground-glass opacities. • Candidiais and IPA: similar CT findings in immunocompromised patients. • Halo sign and cavitation not helpful to differentiate fungal infections. Am J Roentgenol 2005;185:608-615 Radiology 2005;236:332-337

  13. Zygomycosis: imaging abnormalites are similar to IPA in immunocompromised patients. • Cryptococcosis:one or more nodules and masses (up 10cm in diameter), consolidations, and diffuse reticular a/o nodular opacities. Cavitations are seen in immunocompromised patients.

  14. Brodoefel et al.: • ~3 lesions (40 patients) • Lesions enlarges inicially (~ 9th day)  stabilization  regression (Am J Roentgenol 2006;187:404-413) • Cavitation: indicative of favorable evolution.

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  17. Chest X-ray: screening for lesions in patients with neutropenia and fever. • High-resolution CT scan shows abnormalities not seen in chest X-rays. • HRCT: differential diagnosis (infectious and not infectious lesions).

  18. Nodules >10mm and lesions with the halo sign associated to clinical context are enough to presume the diagnosis of pulmonary invasive fungal infection

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