THORACIC Section 4: INFECTION - The immunocompromised Flashcards

1
Q

Post Bone Marrow Transplant (Pulmonary Findings)

Early Neutropenic (0-30 days)

A
  1. Pulmonary Edema, Hemorrhage, Drug Induced Lung Injury
  2. Fungal Pneumonia (invasive aspergillosis)
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2
Q

Post Bone Marrow Transplant (Pulmonary Findings)

Early (30-90 days)

A

CMV
PCP

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3
Q

Post Bone Marrow Transplant (Pulmonary Findings)

Late > 90 days

A
  1. Bronchiolitis Obliterans
  2. Cryptogenic Organizing Pneumonia
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4
Q

Pulmonary Graft vs Host Disease (GvHD) is characterized by?

A

Bronchitis Obliterans

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5
Q

Air trapping (Mosaic attenuation on expiratory imaging)

A

Bronchiolitis Obliterans

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6
Q

Pulmonary Graft vs Host

  1. Acute (20-100 Days) - ?
  2. Chronic (>100 Days) - ?
A
  1. Lung involvement is rare. Favors
    extrapulmonary systems
    (skin, liver, G1 tract)
  2. Lymphocytic Infiltration of the airways and bronchiolitis obliterans.
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7
Q

Most classic AIDS infection

A

Pneumocystis pneumonia (PCP)

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8
Q

Dominant finding of Pneumocystis pneumonia (PCP) in AIDS

A

GGO in the perihilar regions with sparing of the lung periphery.

Cysts, which are usually thin-walled, can occur in the ground glass opacities about 30% o f the time.

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9
Q

AIDS Related Infection

Most common airspace opacity

A

Strep Pneumonia

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10
Q

AIDS + Bilateral Ground Glass Opacities + Thin Walled Cysts + Pneumothorax = ?

A

Pneumocystis pneumonia (PCP)

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11
Q

AIDS related infection

“Flame-Shaped” Perihilar opacity

A

Kaposi Sarcoma

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12
Q

AIDS related infection

Persistent Opacities

A

Lymphoma

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13
Q

AIDS related infection

Hypervascular Lymph Nodes

A

Castleman or Kaposi

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14
Q

Infections in AIDS

CD4 >200

A

Bacterial Infections, TB

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15
Q

Infections in AIDS

CD4 < 200

A

PCP, Atypical Mycobacterial

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16
Q

Infections in AIDS

CD4 < 100

A

CMV
Disseminated Fungal
Mycobacterial

17
Q

Infections in AIDS

CD4 < 200

A

PCP
Atypical Mycobacterial

17
Q

Infections in AIDS

CD4 < 100

A

CMV
Disseminated Fungal
Mycobacterial

18
Q

CT Pattern - With AIDS

  1. Focal Airspace Opacity

Give DDx :
If with low CD4

If it’s a chrionic opacity

A
  1. Bacterial infection (Strep Pneumonia) is the most common
  2. DDx should include TB if low CD4.
  3. If it’s a chronic opacity think Lymphoma or Kaposi.
19
Q

CT Pattern - With AIDS

Multi-Focal Airspace Opacity

A

Bacterial, or fungal

20
Q

CT Pattern - With AIDS

  1. Ground Glass
  2. If CD4 is <100?
A
  1. Pneumocystis Pneumonia (PCP)
  2. CMV