Excessive or thick pulmonary secretions are a common clinical challenge in the neonatal population. Mucus accumulation can cause many life-threatening complications, including plugging of the endotracheal tube and increasing the risk of pulmonary infections. We report 3 premature neonates who had critical pulmonary collapse secondary to mucous plugging. Different conventional ...

We describe a patient who developed pulmonary nocardiosis whilst taking long term oral steroids for asthma. Nocardiosis is more common than is generally appreciated by clinicians, is notoriously difficult to diagnose, and is associated with significant mortality. This patient developed progressive pneumonia despite antibiotic therapy, which is typical of pulmonary ...

The in vivo and ex vivo effects of macrophage colony-stimulating factor (M-CSF) were studied in a profoundly neutropenic rabbit model in order to determine its potential to augment pulmonary host defence against Aspergillus. M-CSF (100-600 microg/kg/d) was administered prophylactically to neutropenic rabbits with pulmonary aspergillosis starting three days pre-inoculation and ...

Of 156 cases of histoplasmosis observed in the State of Rio Grande do Sul (Brazil), during a 21-year period (1978-1999) 137 were included in this study. Sixty-seven per cent of the patients had hematogeneous disseminated histoplasmosis, 24% had a self-limited syndrome (acute pulmonary histoplasmosis, histoplasmoma or primary pulmonary lymph node ...

OBJECTIVE: To review the pharmacology, mycology, chemistry, pharmacokinetics, efficacy, safety, tolerability, dosage, administration, and economic issues of intravenous itraconazole. DATA SOURCES: A MEDLINE search from 1978 to June 2000 of the English-language literature and an extensive review of meeting abstracts was conducted. Due to the paucity of published information concerning ...

Most patients with pulmonary histoplasmosis experience a self-limited illness that rarely requires treatment. However, patients who inhale a large burden of organisms from the environment and those who are immunosuppressed may develop severe, life-threatening pneumonia. Chronic histoplasmosis occurs almost exclusively in patients with severe chronic obstructive pulmonary disease. Complications of ...

A case of opportunistic pulmonary infection in the form of fungal ball produced by the family of mucoraceae in the class of phycomycetes having nonseptate hyphae (cellophane tubules) with haphazard branching in a post-tubercular immunocompetent patient is described. Clinical course was chronic with right upper lobe cavity invaded by fungi ...

BACKGROUND: Invasive pulmonary aspergillosis is fulminant and often fatal in immunosuppressed patients. Percutaneous biopsy may select patients who could benefit from surgical resection. OBJECTIVE: We sought to determine the accuracy of percutaneous biopsy for pediatric invasive pulmonary aspergillosis. MATERIALS AND METHODS: We retrospectively reviewed 28 imaging-guided percutaneous biopsies of the ...

We report a female patient with left atrial wall invasion from pulmonary aspergillosis. She had been treated for diabetes mellitus. Pulmonary aspergillosis extended to the left atrial wall via the left pulmonary vein and formed a polypoid lesion in the left atrium. The polypoid lesion was composed of thrombus, and ...

The prevalence of pulmonary nocardiosis in a tuberculosis and chest diseases hospital in Amritsar is reported. Of 1510 sputum samples cultured from 1016 patients, 67 sputa originating from 16 patients were found to be positive for the Nocardia asteroides species complex. Based upon repeated isolation of N. asteroides from the ...

Invasive pulmonary aspergillosis (IPA) is usually a condition of the immunocompromised patients. The organism has a tendency to invade pulmonary blood vessels. Extension of a pulmonary parenchymal lesion to involve the mediastinal great vessels is very rare. This is the first case where the extension of IPA to the aortic ...

We compared the efficacies of amphotericin B and voriconazole against invasive pulmonary aspergillosis in a guinea-pig model. A susceptible isolate of Aspergillus fumigatus was used to produce the infection. Voriconazole-treated animals had significantly better survival and decreased fungal burden in the lungs as compared with controls. Although no statistical difference ...

Recent studies suggest that perioperative pulmonary aspiration is an infrequent event (approximately 1 : 2000-3000 general anesthetics), but its impact on individual patients can be devastating. Patients who appear to have the greatest risk of developing severe pulmonary morbidity or dying after aspiration are those who are sick (American Society ...

Histoplasma capsulatum is a dimorphic fungus endemic in the American continent but not in Europe, where cases are usually imported. Its favorite habitat is in warm humid soils. Guano from birds and bats enhance the sporulation of the mycelial phase.1 Man acquires H. capsulatum through inhalation of spores. Most people ...

We describe the chest CT and pathologic findings of semiinvasive pulmonary aspergillosis in six patients. Semiinvasive pulmonary aspergillosis should be considered in the mildly immunocompromised patient with CT findings that reveal persistent parenchymal abnormalities. Patterns include consolidation and mass.

A 52-year-old man developed achalasia and a lung abscess due to aspiration pneumonia. We conducted a right upper lobectomy by thoracotomy for the abscess and, 2 weeks later, video-assisted thoracoscopic myotomy and fundoplication (modified Belsey Mark IV procedure) though the left thorax for achalasia. Three months after surgery, the patient ...

A 14-year-old boy with X-linked chronic granulomatous disease developed severe invasive pulmonary aspergillosis. He was treated with itraconazole and amphotericin B. However, he deteriorated with progressive pulmonary lesions. Burkholderia cepacia was isolated from his bronchoalveolar lavage. Finally, he was given granulocyte transfusions. Following this procedure, his condition rapidly worsened leading ...

The sudden death of two horses was attributed to the rapid and acute development of pulmonary aspergillosis. One horse was making excellent postoperative progress after a jejunal resection and anastomosis for intestinal adhesions. The other horse was being treated routinely for equine protozoal myeloencephalitis (EPM). Signs of fever and an ...

We report the first case (to our knowledge) of vocal cord paralysis as a primary manifestation of invasive pulmonary aspergillosis, which occurred in a 69-year-old woman without immunodeficiency. Her chest radiograph showed left upper lobe infiltration with pleural thickening, and a computed tomogram of her chest showed a thick pleural ...

OBJECTIVES: This study was carried out to verify whether during neonatal stage gastroesophageal scintigraphy, may be useful not only to diagnose gastroesophageal reflux (GER), but also to detect pulmonary aspiration, at times responsible for respiratory symptoms frequently associated with GER. PATIENTS AND METHODS: Gastroesophageal scintigraphy was performed on 50 newborns ...

We evaluated the usefulness of PCR and antigen detection for the diagnosis of pulmonary aspergillosis. Forty-four serum samples from patients with pulmonary aspergillosis (33 with pulmonary aspergilloma, 4 with allergic bronchopulmonary aspergillosis, 4 with invasive pulmonary aspergillosis, and 3 with aspergillus pyothorax) were used in this study. PCR detection of ...

This study assessed the potential of lipopolysaccharide (LPS) purified from Pasteurella multocida to cause pulmonary pathology or exacerbate lesions produced by gamma-irradiated nonviable Aspergillus fumigatus conidia when administered via the intra-air sac route in turkeys. LPS provoked suppurative airsacculitis, pleuritis, and pneumonia. Nonviable conidia produced airsacculitis and transient pneumonitis but ...

Pulmonary lesions resulting from Aspergillus fumigatus inoculation were assessed in convalescent turkeys and compared with those in previously noninoculated (control) turkeys. In addition, lesions observed in small Beltsville white (SBW) turkeys were compared with those in broad-breasted white (BBW) turkeys challenged with the same inoculum. Turkeys were challenged by unilateral ...

PURPOSE: To evaluate prospectively the usefulness of thin-section computed tomography (CT) in the prediction of biopsy-proved invasive pulmonary aspergillosis in patients with neutropenia. MATERIALS AND METHODS: In 11 consecutively seen neutropenic patients, 12 open-lung biopsies were performed prospectively for suspected angioinvasive (n = 10) or airway-invasive (n = 2) pulmonary ...

The small number of patients suffering from pulmonary involvement with Sporothrix schenckii has prevented prospective controlled studies that could determine the optimal therapy for this chronic infection. The clinician's ability to determine the best medical treatment for chronic cavitary pulmonary sporotrichosis is also tempered by the limited use of newer ...

A rare case of pulmonary nocardiosis was presented in a nonimmunocompromised patient who had chronic airway obstruction and bronchiectasis without corticoid treatment. The microbial diagnosis was established after isolating Nocardia in bronchial aspirate and sputum samples. An in vitro study showed sensitivity only to imipenem, netilmicine, amikacin and ofloxacin. The ...

We report the identification of Blastomyces dermatitidis by microscopic examination of a direct faecal smear from a dog with pulmonary blastomycosis. A simultaneously obtained faecal culture grew Blastomyces dermatitidis. The fungus was also cultured from a transtracheal sample from this same dog. This report suggests that yeast-phase cells of B. ...

A 95 kg, 34-year-old woman undergoes a laparoscopic tubal ligation. Shortly after endotracheal extubation and during transport to the PACU, she attempts to cough, and gags and vomits. As she is wheeled into the PACU, she is coughing and cyanotic. The anesthesiologist quickly reanesthetizes and reintubates her. Concerned that she ...

Invasive pulmonary mycosis caused by Aspergillus niger and Rhizopus stolonifer is reported in a 2-year-old horse, one of three that died after being housed in a disused, uncleaned stable. Lesions were characterized by thrombosis of the blood vessels with haemorrhage and tissue necrosis. Fungal hyphae were observed both in thrombosed ...

OBJECTIVE: To characterize history, clinical signs, and pathologic findings in horses with histologically confirmed acute hemorrhagic pulmonary infarction and necrotizing pneumonia. DESIGN: Retrospective study. ANIMALS: 21 horses. RESULTS: 19 of the 21 horses were Thoroughbred racehorses in training. Eighteen horses had had strenuous exercise immediately prior to onset of illness. ...

Chronic necrotizing pulmonary aspergillosis (CNPA) is a rare locally destructive form of chronic aspergillosis that is recognized as a clinical syndrome, but has been poorly defined histologically. In this study, 10 cases of CNPA were evaluated from a morphological perspective. Three distinct forms of CNPA emerged. One form (n = ...

Five cats underwent lobectomy for the management of pneumonia. The mean presurgical duration of treatment was eight months. A potentially immunosuppressive disease process was present preoperatively in two of the five cats. Preoperatively, two of the cats had radiographically diffuse pneumonia, while three had focal pneumonia. A single pulmonary lobe ...

A case is presented of a 16-year-old girl with ectodermal dysplasia for whom dental surgery under general anaesthesia was planned. Following a priming dose of vecuronium, and immediately after injection of sodium thiopentone (5 mg.kg-1) pulmonary aspiration of gastric contents occurred. It is hypothesized that, because of the rapid speed ...

Although many species of the fungus Aspergillus have been identified, the most common human pathogen is A. fumigatus, which has a worldwide distribution. Although any organ may become infected, pulmonary aspergillosis is the most common manifestation. The spectrum of pulmonary aspergillosis includes saprophytic aspergillomas, allergic bronchopulmonary aspergillosis, chronic necrotizing aspergillosis, ...

Scarring alopecias are of diverse etiology and pathogenesis. They may be histologically classified as primary or secondary, depending on involvement of reticular dermis. The most important primary scarring alopecias include pseudopelade, lichen planopilaris, and diffuse scarring of the vertex in African-Americans. The most important secondary scarring alopecias include folliculitis decalvans ...

Aspiration pneumonitis describes the inflammatory reaction of the lung parenchyma following contamination by stomach contents. It is an uncommon but potentially lethal complication of general anaesthesia. Protection of the airway from contamination has long been one of the fundamentals of safe anaesthetic practice. Aspiration pneumonitis was first recorded by John ...

A 14-year-old boy with tuberculous pericarditis and tamponade is described. Confirmation was by culture of pericardial aspirate. Though he did not have a cough, acid-fast bacilli were detected following induced sputum. Chest X-ray did not show evidence of pulmonary tuberculosis, but enlarged mediastinal nodes were detected by computerized tomography. He ...

Atelectasis is one of the most commonly encountered abnormalities in chest radiology and remains a daily diagnostic challenge. At times atelectasis can be overlooked, particularly when pulmonary opacification is minimal or absent, and at other times it might be interpreted as being some other form of intrathoracic pathology, particularly pneumonia. ...

During anaesthesia the combination of breathing at low lung volume, the administration of nitrous oxide and high inspired oxygen concentrations produces conditions that favour absorption atelectasis. Measures such as adding nitrogen to the inspired mixture and avoiding high inspired oxygen concentrations would reduce the amount of perioperative atelectasis if gas ...

Patients with chemotherapy-induced granulocytopenia for neoplastic diseases and those receiving cyclosporin A plus corticosteroids for prevention and treatment of organ transplant rejection are two immunologically distinct patient populations with high risks for development of invasive pulmonary aspergillosis. In order to compare the pathogenesis of aspergillosis in these two high-risk populations ...

Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly occurring in immunocompromised patients. Beside cerebral involvement spinal cord lesions are extremely rare. To our knowledge, aspergillosis initially presenting with acute paraplegia due to mycotic thrombosis of the anterior spinal artery in a formerly healthy patient has, so ...

Although highly specific for Wegener's granulomatosis and other vasculitides, false-positive antineutrophil cytoplasmic antibody is occasionally encountered in other nonvasculitic conditions. We report a case of clinically suspected Wegener's granulomatosis with a large pulmonary cavity, renal failure, and positive cytoplasmic antineutrophil cytoplasmic antibody reaction. The patient died before initiation of immunosuppressive ...

A 61-year-old man with pulmonary aspergilloma received two antifungals intracavitarily. Although clinical, serological and roentgenographic improvement were observed with fluconazole therapy, bronchial secretions continuously yielded Aspergillus fumigatus. When fluconazole was switched to amphotericin B, the pathogen was eradicated immediately. The minimal inhibitory concentrations (MICs) of the isolate were 400 micrograms/ml ...

Invasive pulmonary aspergillosis is a frequent complication in immunocompromised patients. The role of the prolonged use of steroids in predisposing to invasive aspergillosis has been recognized, but exceptionally described in asthmatic patients. We report the case of a 59-year-old woman with bronchial asthma treated with steroid therapy for a long ...

We report on a female patient who received a polychemotherapy because of an extensive pemphigus vulgaris. Under this therapy, the general condition of the patient worsened. Noncharacteristic symptoms, such as dyspnoea and tachycardia occurred. In spite of comprehensive, also invasive diagnostics, pulmonary foci demonstrable by X-ray morphology and computer tomography ...

Pulmonary involvement with Aspergillus fumigatus is varied and largely dependent on the patient's underlying pulmonary and immune status. Hypersensitivity reactions from inhalation of spores can cause acute allergic alveolitis, and bronchial colonization can cause allergic bronchopulmonary aspergillosis (ABPA). The latter is found mainly in patients with asthma or cystic fibrosis. ...

Invasive pulmonary aspergillosis (IPA) has been recognized as an infectious complication in immunocompromised patients. We present a case of IPA, which occluded the descending aorta and left pulmonary artery and led to death after antileukemic chemotherapy. Contrast-enhanced CT demonstrated thrombi in the great vessels as low attenuation areas. These thrombi ...

The incidence of pulmonary atelectasis following head and neck surgery is not well reported. This study retrospectively evaluated the incidence of pulmonary atelectasis in 161 head and neck cancer patients, with 152 being evaluable. There were 90 patients evaluated following pectoralis musculocutaneous flap reconstruction with their effective flap size and ...

A man with allergic bronchopulmonary aspergillosis had pneumothorax and bronchopleural fistula while impacted mucus was being successfully dislodged from bronchiectatic airways. We believe this is the first report of pneumothorax with bronchopleural fistula in a patient with active ABPA, and we have proposed a mechanism to explain the development of ...

Intracardiac extension of pulmonary aspergillosis is uncommon. We report a case of a patient with chronic necrotizing pulmonary aspergillosis without clinical evidence of cardiac disease in whom transthoracic echocardiography revealed an intracardiac mass. A subsequent transesophageal examination clearly defined a large and complex mass in the left atrium and pulmonary ...