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 ...

The purpose of this study was to determine the influence of atelectasis on pulmonary function 6 days following coronary artery bypass grafting (CABG). After 6 days, 30 patients had normal chest radiographs, 38 had atelectasis, and 57 had pleural changes. In 11 patients, atelectasis only was observed in the radiograph, ...

The isolation of Aspergillus fumigatus from airway secretions from patients with cystic fibrosis (CF) is common and usually denotes asymptomatic colonization or allergic broncho-pulmonary aspergillosis (ABPA). A 12-year-old boy with CF acutely developed moderately severe symptoms of unremitting cough, fever, dyspnea, weight loss, and cyanosis. Chest radiographs demonstrated widespread unilateral ...

Intradermal end-point titres for commercial aqueous extracts of Micropolyspora faeni, Thermoactinomyces vulgaris and Aspergillus fumigatus were determined in control and chronic obstructive pulmonary disease (COPD) affected horses. The intradermal end-point titres of control and COPD-affected horses were not significantly different and values for individual horses for M. faeni, A. fumigatus ...

Eight control and 8 asymptomatic COPD-affected horses were given, on separate occasions, inhalation challenges with extracts of Micropolyspora faeni, Aspergillus fumigatus and Thermoactinomyces vulgaris. All horses were also given nebulised phosphate-buffered saline (PBS) challenges and 'natural challenges' (NCs), i.e. exposure to hay and straw, as control challenges. Responses were assessed ...

The authors report a case of pulmonary aspergilloma in which a fungus ball was visualized and a biopsy specimen was obtained at fiberoptic bronchoscopy. The fungus ball was successfully treated with bronchoscopic instillation of ketoconazole. It appears that this approach can be useful in the treatment of patients who are ...

A study was carried out to increase familiarity with the aetiology, pathogenesis, and radiographic features that characterise pulmonary gangrene. Four patients with one of the disorders vasoinvasive aspergillosis, infarcted tuberculous cavity, chronic necrotising aspergillosis, and gangrene due to Pseudomonas aeruginosa were selected because they showed the variations of the typical ...

Horses with asymptomatic or symptomatic chronic obstructive pulmonary disease (COPD) and control horses were challenged with oil seed rape either by exposure to a field of flowering Brassica campestris for six days, or by an inhalation challenge with freshly collected pollen from Brassica napus, or by inhalation challenge with a ...

The aspiration of gastric contents can occur in patients with a depressed level of consciousness. Pulmonary aspiration is a serious potential complication of pharmacosedation and general anesthesia. Sequelae associated with aspiration include pulmonary obstruction, chemical pneumonitis, secondary infection, and possibly death. Morbidity following aspiration is enhanced with an increased volume ...

Aspiration thrombectomy supported by an oscillating metal probe within the catheter allows continuous aspiration of large thrombi without catheter obstruction. Thrombus aspiration assisted by an ultrasound-driven probe (frequency 26 kHz) and by an electric motor-driven probe (frequency 40 Hz) was compared in two different in vitro models: aspiration of large ...

The objective of this study was to clarify conflicting reports of the sensitivity and specificity of bronchoalveolar lavage or bronchial washings for diagnosing invasive pulmonary aspergillosis. The study was a retrospective review of 300 consecutive patients in a tertiary referral centre subjected to 343 fiberoptic bronchoscopic procedures for the evaluation ...

Invasive pulmonary aspergillosis is a specific form of pulmonary Aspergillus infection that occurs almost exclusively in immunocompromised patients. It differs both histologically and in its clinical course from classic aspergillomas. During a 5-year period (1986-1990), 8 patients underwent resection for cavitating invasive pulmonary aspergillosis that developed as a consequence of ...

Opportunistic pulmonary infections are a leading cause of morbidity and mortality in patients with chemotherapeutically treated neoplasias. With increasingly aggressive cytotoxic regimens causing prolonged neutropenia, the risk of systemic mycoses and in particular of invasive pulmonary aspergillosis has increased. We review the case of a 10-year-old child suffering from relapsed ...

Complications of enteral nutrition may compromise respiratory function by direct mechanical injury by feeding tubes, aspiration of formula, or alterations in metabolism. Although much of the data reviewed in this paper were published more than 10 years ago, these studies still comprise most of the literature on pulmonary complications of ...

A previously healthy boy presented with cough and diffuse pulmonary interstitial infiltrates. Acute eosinophilic pneumonia was diagnosed by bronchoalveolar lavage in the absence of a demonstrable infectious etiologic agent. Corticosteroid therapy resulted in immediate improvement but was followed by respiratory distress and death from invasive aspergillosis and Pseudomonas cepacia sepsis.

Macrophages containing small ovoid intracytoplasmic yeast cells, surrounded by a slight "halo," were observed in Papanicolaou-stained smears of sputum submitted for cytologic examination from two patients with culture-confirmed pulmonary sporotrichosis. The cytologic findings are presented and discussed in relation to other pulmonary fungal infections and the appropriate stains to be ...

The most common cause of RUL atelectasis in adults is neoplasm obstructing the RUL bronchus. Scarring of the lobe following chronic infection comes next. Other causes of obstruction, whether central or peripheral, are less common. The only direct sign of atelectasis is approximation of the fissures. All other signs are ...

A 57-year-old man had subacute embolic ischemia of his right foot and subsequent acute embolic ischemia of his left foot after angiography. Thrombus removed at the time of the left femoral thromboembolectomy grew Histoplasma capsulatum confirming the diagnosis of disseminated histoplasmosis. Surgical revascularization of the right leg and parenteral amphotericin ...

A female patient with systemic lupus erythematosus (SLE) developed pulmonary aspergillosis with staphylococcal pneumonia and hepatic candidiasis. Aspergillus terreus, which is a rare causative organism of pulmonary aspergillosis, was identified from a pulmonary lesion by culture. The aleurioconidium production, a characteristic of the genus Aspergillus sect. terrei, was demonstrated on ...

Invasive pulmonary aspergillosis is an important cause of morbidity and mortality in granulocytopenic patients. The purpose of this article is to review the current understanding of the microbiology, hospital epidemiology, clinical manifestations, diagnosis, prevention, and treatment of invasive pulmonary aspergillosis. Aspergillus conidia (spores) are inhaled from environmental sources into the ...

We have described a patient with invasive pulmonary penicilliosis, documented by thoracotomy and cured with amphotericin B. Penicillium sp isolates in immunosuppressed patients should not be disregarded without a thorough investigation, especially if normally sterile sites are involved. Amphotericin B therapy may be successful, especially if accompanied by a reversal ...

The triazole Bay R 3783 was compared with fluconazole, itraconazole, ketoconazole, and amphotericin B in rodent models of superficial and systemic candidiasis, meningocerebral cryptococcosis, and pulmonary aspergillosis. Overall, Bay R 3783 was comparable or slightly superior to fluconazole and markedly superior to itraconazole and ketoconazole in both survival and short-term ...

Aspiration, or soiling of the tracheobronchial tree, can produce life-threatening pulmonary disease. Intermittent or persistent aspiration may cause symptoms including cough, intermittent fever, recurrent tracheobronchitis, atelectasis, pneumonia, and/or empyema. The pulmonary disease may be associated with weight loss, cachexia, and dehydration. In many cases the aspiration is caused by laryngeal ...

Pulmonary aspiration of gastric content remains the number one cause of anesthetic mortality. The combat casualty due to the nature of wounds inflicted is at risk for pulmonary aspiration on induction and emergence from anesthesia. The use of gastrointestinal pharmacology agents can reduce this risk significantly. Histamine-2 receptor blocking agents ...

Two immunocompromised patients with severe neutropenia developed acute airway obstruction due to Aspergillus mycetoma formation in the trachea and main bronchi. The mycetomas caused transmural necrosis of the airway. In one patient, the necrosis extended through the bronchus intermedius into the pulmonary artery, resulting in a fatal hemorrhage during bronchoscopy.

Pulmonary corpora amylacea (PCA) were found in 36 per cent of lambs with chronic non-progressive pneumonia. They were spheroidal or ovoid, concentrically lamellar, and commonly found in the alveoli. The components of PCA were complex and variable but staining reactions indicated that most of them contained deoxyribonucleoproteins, glycoproteins and ribonucleoproteins. ...

Aspiration can lead to serious pulmonary disease and occasionally death. Substances aspirated commonly include bacteria or gastric contents or both, but may be as unusual as diesel oil or a variety of foreign bodies. Pulmonary symptoms range from a subtle cough, wheezing, or hoarseness to severe dyspnea or asphyxiation. We ...

Nitrofurantoin is frequently used by the physiatrist for treatment of urinary tract infections or for urinary antimicrobial prophylaxis. There is a substantial risk of acute and chronic pulmonary side effects with this medication. The acute pulmonary toxicity presents with fever, leukocytosis, dyspnea, and nonproductive cough. Chronic nitrofurantoin use can lead ...

During 1988, pulmonary mycosis was diagnosed in four of 116 farmed deer examined on suspicion of tuberculosis. The histopathology showed allergic bronchopulmonary mycosis in a red deer (Cervus elaphus) and the agent was identified as a zygomycete, probably Absidia corymbifera, by immunofluorescence staining. Three fallow deer (Dama dama) had invasive ...

A case of spontaneous pulmonary abscess with cavitation caused by Neisseria mucosa in a chronically neutropenic child is reported. Neisseria mucosa was isolated as the sole pathogen from a percutaneous needle aspirate. It appears that the clinical course of the pulmonary lesion was indolent. Interestingly, a gallium scan was diagnostic ...

In this study, 152 Papanicolaou-stained pulmonary cytologic smears from 15 known cases of pulmonary fungal infection were randomly mixed with 194 control pulmonary smears. All slides were examined for fungi by three observers, first by light microscopy and then by fluorescent microscopy. The results of the light and fluorescent microscopy ...

Allergic bronchopulmonary aspergillosis is primarily an immunologic disorder manifested by episodic bronchial obstruction (asthma or chronic obstructive pulmonary disease). The host response to local Aspergillus antigens gradually results in irreversible pulmonary injury. A high index of suspicion is required to make the diagnosis. Early and aggressive treatment is important in ...

Chest radiographs of invasive pulmonary aspergillosis in immunocompromised patients typically show ill-defined pulmonary nodules. Direct tracheal involvement has not been previously documented radiologically. Radiographs and CT scans of a 16-year-old boy with aplastic anemia and invasive pulmonary aspergillosis showed increased paratracheal opacity, tracheal narrowing, and pneumomediastinum in combination with pulmonary ...

Transient fungemia has been thought to occur with acute pulmonary histoplasmosis in humans, but this has never been confirmed. We report two cases of acute pulmonary histoplasmosis in which transient fungemia was detected by the lysis-centrifugation blood-culturing technique. Both patients had self-limited acute pulmonary histoplasmosis, and neither was treated with ...

Antifungal therapy that included ketoconazole failed in a 44-year-old woman with pulmonary sporotrichosis progressing slowly over a seven-year period. On the basis of this case and the modest amount of experience reported in the literature, ketoconazole does not appear to be effective in the treatment of pulmonary sporotrichosis.

To determine the relationship between gastroesophageal (GE) reflux and pulmonary disease, we studied 21 asthmatics, 30 chronic bronchitics, 6 patients with GE reflux and no pulmonary symptoms, and 10 control subjects; GE reflux was diagnosed by pH monitoring and GE scintiscanning. Frequency of GE reflux in the asthmatics was 57%; ...

Recurrent attacks of pulmonary atelectasis were the leading sign of familial Mediterranean fever in a young man of Jewish-Georgian extraction. His mother suffered from the more common manifestations of the disease. Treatment with colchicine caused a complete disappearance of his attacks. However, when challenged by discontinuing colchicine therapy for eight ...

Sarcocystis falcatula is a protozoan parasite which obligatorily alternates its definitive host, the opossum (Didelphis virginiana), and a uniquely wide range of avian intermediate hosts. The disease produced by this coccidian parasite in intermediate hosts was studied in the budgerigar bird (Melopsittacus undulatus). The ultrastructure of pulmonary sporozoites, meronts and ...

A 62-year-old man, previously healthy but alcoholic, and who was clinically thought to have bacterial pneumonia, presented with a pulmonary infiltrate in the right apex, and suddenly died of exsanguinating hemoptysis. Sputum cultures yielded Aspergillus niger and Candida krusei while sputum cytology revealed numerous birefringent crystals in a background of ...

Pollen of Parietaria officinalis causes season-associated respiratory symptoms. In Southern Croatia (Yugoslavia) we found 65% patients with rhinitis and/or asthma to be allergic to this pollen. They showed positive cutaneous reactions and had specific IgE antibodies to the respective isolated allergen. The finding represents the first report on Parietaria officinalis-induced ...

The pathology of pulmonary aspergillosis in a piglet is described. The dominant feature is the pneumonic process which is acute, focal, disseminated and necrotising to purulent in character. Fungal hyphae typical of the aspergilli are present within the lesions. The comparative aspects of this case and the primary invasive form ...

Invasive pulmonary aspergillosis occurs predominantly in individuals who are neutropenic or who have severe defects in cell-mediated immunity. The isolation of Aspergillus from respiratory secretions of normal hosts usually signifies tracheobronchial colonization, not disease. Recent experience with three nonimmunocompromised patients who had invasive pulmonary aspergillosis, each of whom had Aspergillus ...

A four-year-old female developed pulmonary aspiration during nasal tracheal intubation after induction of general anesthesia. The earliest sign of aspiration was the hypoxemia that was recorded with a pulse oximeter. A discussion of treatment and criteria for discharge is presented.

Aspergillus terreus is an uncommon cause of human disease. A patient with acute myelomonocytic leukemia is described who developed an invasive pulmonary infection with A terreus characterized by an air-crescent sign on chest roentgenogram. Previous reports of A terreus infections and the pathogenesis and significance of an air-crescent sign in ...

One hundred specimens of purulent of mucopurulent sputum form patients clinically known to be suffering from a variety of broncho-pulmonary diseases including chronic bronchitis, bronchiectasis, lobar pneumonia, bronchopneumonia and pulmonary tuberculosis, were examined macroscopically, microscopically and by cultures to establish the aetiology of the infections. In the process, five cases ...

Monozygotic twins are reported; both had bronchial asthma with type I hypersensitivity to Aspergillus fumigatus but only one had type III hypersensitivity, together with pulmonary infiltrations compatible with the diagnosis of allergic bronchopulmonary aspergillosis. It is suggested that non-inherited factors other than the intensity of exposure to antigen may be ...

Pulmonary aspergillosis was discovered in apparently healthy young rabbits. Thirty-five rabbits of various ages raised in the same rabbitry were examined by histological, ultrastructural and microbiological methods. The pulmonary lesions were found only in rabbits younger than five weeks old. These lesions contained characteristically shaped hyphae surrounded by eosinophilic radiating ...

Pulmonary sporotrichosis in the absence of lymphocutaneous disease is unusual; however, its incidence may be greater than previously recognized. This report describes the AFIP experience in eight cases of primary pulmonary sporotrichosis and reviews an additional 23 cases. The disease is often a bilateral, apical, chronic and cavitary, progressive, destructive, ...

Invasive aspergillosis of the paranasal sinuses involving the orbit is termed sino-orbital aspergillosis. Prognosis of sino-orbital aspergillosis, complicated by impaired visual acuity and neurological signs, is disastrous and usually fatal. We herein report two patients with sino-orbital aspergillosis associated with total ophthalmoplegia. One patient was successfully treated with surgical eradication ...

Allergic bronchopulmonary aspergillosis (ABPA) occurs as a complication of asthma. It presents as an infiltrative pulmonary disorder with respiratory and systemic symptoms, eosinophilia, elevated total serum IgE, and skin sensitizing, as well as precipitating antibodies to Aspergillus fumigatus. Sputum cultures are not always positive for the organism. If unchecked, the ...