Infections -Immunocompromised Flashcards
pneumocystis jiroveci pneumonia
CD4 < 200, opportunistic fungal infection
PJP imaging findings
CXR: bilateral perihilar central airspace opacities
CT: perihilar GGO, crazy paving
can cause upper lobe pneumatoceles > pneumothoraxi/pneumomediastinum
cryptococcus neoformans
CD4 < 100
most common fungal infection in AIDS; can exist with meningitis
presents with GGO, consolidation, cavitating nodules, miliary disease
aspergillosus manifestations
immune response: asthma, ABPA
abnormal lungs/host: aspergilloma/mycetoma (sarcoid/TB), semi-invasive/chronic necrotizing (diabetic, alcoholic))
neutropenic/immunocompromised: angioinvasive, airway invasive
allergi bronchopulmonary aspergillosus
hypersensitivity reaction to aspergillus in pts with asthma
finger in glove: mucoid impaction of bronchiectasis, (also seen with segmental bronchial atresia and CF)
saprophytic aspergillosis/aspergilloma
conglomeration of fungal hyphae into fungus ball/mycetoma
mobile and will change position with imaging
may cause hemoptysis; forms in preexisting cavities from TB/sarcoid
Monod sign
crescent of air outline mycetoma against cavity
semi invasive/chronic necrotizing aspergillosus
segmental areas of consolidation with cavitation/pleural thickening which progresses over time
airway invasive aspergillosus
immunocompromised
bronchiolitis to bronchopneumonia; centrilobular and tree-in-bud nodules
may look like Staph aureus
angioinvasive aspergillosis
invasion into arterioles and smaller pulmonary arteries
CT halo sign
GG attenuation surrounding consolidation; hemorrhagic infarction of lung
air crescent sign
crescent of air from retraction of infarcted lung; good prognostic sign of recovery
angioinvasive aspergillosis
