Pulmonary disease - fungal pneumonia.pptx

ppt on fungal pneumonia

1. PULMONARY FUNGAL DISEASE

2. Pulmonary fungal disease  is caused by various organisms of varying virulence and varying sensitivity to antifungal drugs. Immunocompromise, particularly neutropaenia is a major risk factor for invasive and disseminated disease. Pathologic fungi include: Pulmonary aspergillosis : pulmonary aspergillus infection considered the most important in immunocompromised individuals  5 Aspergilloma  (saprophytic/non-invasive aspergillosis): the most common form seen radiographically Allergic bronchopulmonary aspergillosis (ABPA) Invasive aspergillosis Obstructive bronchopulmonary aspergillosis Pulmonary candidiasis Pulmonary histoplasmosis Pulmonary blastomycosis Pulmonary cryptococcosis Pulmonary mucormycosis

3. Pulmonary mucormycosis : Oppurtunistic pulmonary fungal infection Has to distinguished from invasive pulmonary aspergillosis Considered rare, but encountered in patients with prolonged neutropenia or h/o hematopoietic stem cell transplantation clinical features: Fever, nonproductive cough and progressive dyspnea symptoms refractory to broad spectrum Abx Invasiobn of major pulmonary vessels- Hemoptysis chest pain, pleural effusion are less likely

4. Diagnosis: Microbiological assessment usually make diagnosis Radiographic features: Can present as solitary nodule, lobular consolidation as in pneumonia, cavitatory lesion CT: On CT,  ground-glass opacities  may be encountered  3 . Recently the  reversed halo sign  or   bird's nest sign   has been demonstrated as a fairly specific sign capable of suggesting the diagnosis. In contrast to  cryptogenic organizing pneumonia  (COP), the peripheral capsule in the reversed halo sign tends to be thicker, which is highly suggestive of mucormycosis . The presence of more than ten lung nodules or a pleural effusion was found to discriminate mucormycosis from aspergillosis in a cancer patients

5. Reverse halo sign There is an ovoid lesion in the right lower lobe which demonstrates central ground-glass density surrounded by peripheral consolidation.

6. Bacterial pneumonia Fungal pneumonia consolidation Segmental/subsegmental consolidation without GGO or nodules Multifocal non segmental consolidation + GGO and nodules Halo sign uncommon common Reverse halo sign Very unlikely More specific cavitation can occur Cavitation with air cresent sign suggestive of ifd Pleural effusion More common Less common

7. Pulmonary aspergillosis: Multiple pulmonary round infiltrates with surrounding ground-glass opacity suggesting haemorrhage and raising the probability of this representing fungal infection. 

8. Chronic Necrotizing Aspergillosis

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