Document Detail


Aspergillus infection of the respiratory tract after lung transplantation: chest radiographic and CT findings.
MedLine Citation:
PMID:  9477289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of our study was to assess radiographic and CT findings in lung transplant patients with evidence of Aspergillus colonization or infection of the airways and correlate the findings with clinical, laboratory, bronchoalveolar lavage, biopsy and autopsy findings. The records of 189 patients who had undergone lung transplantation were retrospectively reviewed for evidence of Aspergillus colonization or infection of the airways. Aspergillus was demonstrated by culture or microscopy of sputum or bronchoalveolar lavage fluid or histologically from lung biopsies or postmortem studies in 44 patients (23 %). Notes and radiographs were available for analysis in 30 patients. In 12 of the 30 patients (40 %) chest radiographs remained normal. In 11 of 18 patients with abnormal radiographs pulmonary abnormalities were attributed to invasive pulmonary aspergillosis (IPA) in the absence of other causes for pulmonary abnormalities (8 patients) or because of histological demonstration of IPA (3 patients). In these 11 patients initial radiographic abnormalities were focal areas of patchy consolidation (8 patients), ill-defined pulmonary nodules (2 patients) or a combination of both (1 patient). In some of the lesions cavitation was demonstrated subsequently. At CT a "halo" of decreased density was demonstrated in some of the nodules and lesion morphology and location were shown more precisely. Demonstration of Aspergillus from the respiratory tract after lung transplantation does not necessarily reflect IPA but may represent colonization of the airways or semi-invasive aspergillosis. The findings in patients with IPA did not differ from those described in the literature in other immunocompromised patients, suggesting that surgical disruption of lymphatic drainage and nervous supply or effects of preservation and transport of the transplant lung do not affect the radiographic appearances.
Authors:
S Diederich; M Scadeng; C Dennis; S Stewart; C D Flower
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European radiology     Volume:  8     ISSN:  0938-7994     ISO Abbreviation:  Eur Radiol     Publication Date:  1998  
Date Detail:
Created Date:  1998-04-09     Completed Date:  1998-04-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  306-12     Citation Subset:  IM    
Affiliation:
Department of Radiology, Papworth Hospital, Papworth Everard, Cambridge CB3 8RE, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aspergillosis / radiography*
Female
Humans
Immunocompromised Host
Lung Diseases, Fungal / radiography*
Lung Transplantation* / immunology
Male
Middle Aged
Opportunistic Infections / radiography
Radiography, Thoracic*
Retrospective Studies
Tomography, X-Ray Computed*

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