Chronic Pulmonary Blastomycosis Mimicking Pulmonary Tuberculosis.
We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL). The patient was admitted to an outside hospital and he underwent bronchoscopy with transbronchial biopsies and bronchoalveolar lavage of the RUL. Histology and cultures were unremarkable however; Histoplasma serum antigen was positive. The patient was empirically treated for active pulmonary tuberculosis and soon discharged. He returned for medical evaluation 3 mo later with continued hemoptysis. Repeat bronchoscopy with transbronchial biopsies of the RUL cavity grew Blastomyces dermatitidis. The patient's symptoms resolved and chest imaging significantly improved with initiation of itraconazole. Discussion: Chronic pulmonary blastomycosis can present with a constellation of symptoms that may be indistinguishable from chronic pulmonary histoplasmosis, pulmonary tuberculosis, or lung cancer. Knowledge of endemic diseases and a thorough travel history should be an integral part of a military physician's infectious disease evaluation. PMID: 29547956 [PubMed - as supplied by publisher]
18F ‐FDG PET/CT has a higher sensitivity and diagnostic accuracy for malignant solitary pulmonary nodule. However, it has a high false positive rate and low specificity when diagnosing SPN in tuberculosis endemic areas. AbstractObjectiveTo determine the diagnostic efficacy of18F ‐FDG PET/CT in distinguishing between pulmonary tuberculosis (PTB) and lung cancer in solitary pulmonary nodule (SPN) in a country with a high prevalence of PTB.MethodsPatients with SPN who underwent18F ‐FDG PET/CT imaging were retrospectively included in the study. The final diagnosis was established by histopathology. A linear regression eq...
Conclusions: We report the largest retrospective nationwide cohort of patients hospitalized for CPA. In France, CPA is more commonly associated with COPD, emphysema, lung cancer or fibrosis than with TB. The alarming CPA morbidity and mortality rates observed should justify specific screening for CPA in some CPDs.
Abstract Paragonimiasis, or lung fluke disease, is a typical food-borne parasitic zoonosis caused by infection with trematodes belonging to the genus Paragonimus. More than 50 species of Paragonimus have been reported throughout the world, of which seven valid species infect humans, an estimated one million people annually worldwide. Among the seven species, P. westermani, P. heterotremus, and P. skrjabini/P. s. miyazakii, distributed in Asia, are the most important species as the cause of paragonimiasis. Humans acquire infection through the ingestion of raw, pickled or undercooked freshwater crustaceans, 2nd inte...
The present study aims to assess the performance of 18F-FDG PET-CT on mediastinal staging of non-small cell lung cancer (NSCLC) in a location with endemic granulomatous infectious disease.
Conclusion: From this first Indian series, it is clear that VATS lobectomy is feasible in both benign and malignant cases. It also shows that the fear of adhesions is unwarranted and properly selected benign cases can also undergo VATS lobectomy safely.
Conclusion: Even though the size of our study population was small, the positive rate of 7.4% was like or lower than those in other lung cancer screening studies. Early lung cancer was detected using LDCT screening in one participant. Lung-RADS may be applicable to participants in Korea, where pulmonary tuberculosis is endemic. PMID: 29962887 [PubMed - in process]
CONCLUSIONS: The addition of FDG PET/CT scanning to chest CT imaging provides better performance for predicting conversion to thoracotomy during VATS lobectomy in lung cancer patients. Therefore, in lung cancer patients undergoing surgical resection, FDG PET/CT can provide additional reliable information in selecting the appropriate surgical approach for a lobectomy. PMID: 28932548 [PubMed]
Conclusions Incidental detection of granulomatous inflammation in patients undergoing lung resection for cancer, even in a TB-endemic country, may not require any intervention. Such findings may be due to either mycobacterial infection in the past or ‘sarcoid reaction’ to cancer. Although all patients should have their resected specimen sent for acid-fast bacilli culture and followed up until the culture results are reported, the initiation of the management of such patients as per existing lung cancer management guidelines does not affect their outcome adversely.
Conclusion: In the management of lung cancer, we should consider the possibility of coexistence active pulmonary tuberculosis especially in endemic tuberculosis countries. This association should not make delays in the diagnosis and the treatment.
Authors: Mittal S, Khalid M, Sabir AB, Khalid S Abstract STUDY DESIGN: Retrospective study. PURPOSE: To note the magnetic resonance imaging (MRI) differences between pathologically proven cases of atypical spinal tuberculosis and spinal metastasis in 40 cases. OVERVIEW OF LITERATURE: Spinal tuberculosis, or Pott's spine, constitutes less than 1% of all cases of tuberculosis and can be associated with a neurologic deficit. Breast, prostate and lung cancer are responsible for more than 80% of metastatic bone disease cases, and spine is the most common site of bone metastasis. Thus, early diagnosis and prompt ...