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

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Presentation on theme: "Dante Luiz Escuissato. Infections are related to specific immunity defects. Phagocyte abnormalities and intravenous catheters: Aspergillus and Candida."— Presentation transcript:

1 Dante Luiz Escuissato

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, and Candida species.

3 Am J Roentgenol 2005;185:

4 Fusarium sp Aspergillus sp

5 Pseudomonas sp.

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8 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:

9 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: Braz J Infect Dis 2007;11:

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

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14 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: Radiology 2005;236:

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16 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.

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

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20 18/0125/01

21 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).

22 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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