Pleural involvement in cryptococcal infection

Pleural involvement of cryptococcal infection is uncommon and is more commonly observed in immunocompromised hosts than in immunocompetent ones.Pleural involvement in cryptococcal infections can manifest with or without pleural effusion.The presence of Cryptococcus spp.in the effusion or pleura is required for the diagnosis of cryptococcal pleural infection,which is commonly determined by pleural biopsy,fluid culture,and/or detection of cryptococcal antigen in the pleura or pleural fluid.

Analysis on the imaging features of AIDS with pulmonary fungal infection

Background Pulmonary fungal infection is one type of the common opportunistic infections in AIDS patients. The disease is hard to diagnose because of its complicated imaging features. The objective of this study was to investigate the imaging performance characteristics of pulmonary fungal infection in AIDS patients.Methods Fifty-one patients with AIDS complicated with pulmonary fungal infection and 56 patients of non-AIDS with pulmonary fungal infection were examined by CT scans and high-resolution CT scans. The contrast enhanced scans were performed in patients with the mass or suspected enlarged mediastinal lymph nodes. Results were compared between the two groups.Results The most common fungal infection in the two groups of patients was Candida albicans. The infection rates were 54.8% （28 cases） in the group （AIDS patients with pulmonary fungal infection） and 58.3% （32 cases） in another group （non-AIDS patients with pulmonary fungal infection）. In the two groups, the difference in diffuse distribution and the difference in incidence of affected upper and lower lobes in the bilateral lung fields were statistically significant. The differences in patchy or large consolidation shadow, cavitas, enlarged lymph nodes in mediastinum and pleural effusion were also significant when comparing the two groups.Conclusions The lesion in most of AIDS patients with pulmonary fungal infection tends to exhibit diffuse distribution,patchy or large consolidation shadow covering a more extensive region. The differences between AIDS with pulmonary fungal infection and non-AIDS with pulmonary fungal infection are statistically significant in lesion location and complicated imaging features. The most common fungal infection in AIDS patients is Candida albicans.

Initial computed tomography findings of invasive pulmonary aspergillosis in non-hematological patients

Background The computed tomography （CT） findings of invasive pulmonary aspergillosis （IPA） are unclear in non- hematological patients. The present study was a retrospective evaluation of CT images in non-hematological patients with IPA. Methods All adult patients who met the 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group （EORTC/MSG） criteria for proven or probable IPA were included during a 5-year study at our institutions. Initial CT findings in our cohort were retrospectively reviewed by two independent thoracic radiologists blinded to patient demographics and clinical outcomes. The presence, pattern, and distribution of abnormalities were recorded. Results Twenty-three non-hematological patients with pathologically confirmed IPA were included in our study. Areas of ground-glass opacities were present in 14 patients （61%）, which were bilateral in 10 patients and unilateral in four. This pattern mainly involved the middle and upper lung zones. Air-space consolidation was identified in 12 patients （52%）, and the areas were distributed along the bronchus or subpleura in most cases. Other findings, including five small nodules （22%）, three macronodules （13%）, and one halo sign （4%）, were less common. Conclusions CT findings of IPA in non-hematological patients frequently manifested as acute bronchopneumonia, and ground-glass opacities and air-space consolidations were the most common CT findings of IPA in these patients.

High risk factors for pulmonary fungous infection in intensive care units of neurosurgery

By analyzing the high risk factors for pulmonary fungous infection in intensive care units of neurosurgery,the strategy of early diagnosis and treatment was explored.According to the domestic diagnostic standard on pulmonary fungous infection,clinical data on 58 patients with the infection in our department were analyzed.One hundred and seventeen strains of fungi were separated from the 58 cases.Candidiasis was the most frequent type,accounting for 92.3%of the cases.Conditions such as the severity of primary diseases,long-time coma,long-term use of broad-spectrum antibiotic,abuse of glucocorticoid,the open airway,and some invasive intubations,may be regarded as high risk factors for pulmonary fungous infection.Fluconazole showed good clinical effects on the treatment of fungous infection.To eliminate these high risk factors,early diagnosis and the use of prophylactic antifungal agents can help reduce the incidence of pulmonary fungous infection.