Presentation on theme: "Dante Luiz Escuissato. Infections are related to specific immunity defects. Phagocyte abnormalities and intravenous catheters: Aspergillus and Candida."— Presentation transcript:
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.
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
Halo sign: 33-60%, disappears after one week (~75%) Recommendation: CT scan performed not beyond 5 th day after symptoms onset.
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
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.
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).
Nodules >10mm and lesions with the halo sign associated to clinical context are enough to presume the diagnosis of pulmonary invasive fungal infection