Sinonasal computed tomography in pediatric cystic fibrosis: do we know the indications?
To investigated the correlation between sinonasal computed tomography (SNCT) findings and sinonasal symptoms, genotype, chronic colonization by Pseudomonas aeruginosa, forced expiratory volume in the first second (FEV1), body mass index (BMI), Shwachman-Kulczycki (SK) score, and Bhalla score in patients with cystic fibrosis.
This study examined early predictors of progressive structural lung abnormalities in children who completed the Australasian CF Bronchoalveolar Lavage (ACFBAL) clinical trial at age 5-years and participated in an observational follow-up study (CF-FAB). Eight Australian and New Zealand CF centres participated in CF-FAB and provided follow-up chest computed-tomography (CT) scans for children who had completed the ACFBAL study with baseline scans at age 5-years. CT scans were annotated using PRAGMA-CF scoring. Ordinal regression analysis and linear regression were used to investigate associations between PRAGMA-CF (Perth&ndas...
ConclusionsThe annual evolution of the Brody II HRCT scoring system demonstrated a predictive value and correlated with FEV1% decline, pulmonary exacerbations and oral antibiotic treatments.Key Points•HRCT evolution has prognostic value in cystic fibrosis.•Temporal evolution for the Brody II score is useful for clinical follow-up.•Brody II score changes correlate with FEV1% decline, pulmonary exacerbations and number of antibiotic treatments.
This article reviews the specific imaging features of CF using conventional imaging modalities (chest radiographs and high-resolution computed tomography [HRCT]) as well as emerging imaging technologies (digital chest tomosynthesis and MR imaging). In addition, the authors review the CF-specific HRCT imaging findings that are essential in the evaluation of these patients in the pre –lung transplant and post–lung transplant settings.
CONCLUSIONS: This is the first study to provide evidence of the implication of sex differences in HRCT findings in patients with CF. Women with CF present a more severe form of the disease that results in more frequent exacerbations, poorer functional and nutritional outcomes, deterioration of quality of life, and greater structural damage. PMID: 32107115 [PubMed - as supplied by publisher]
We describe a case of a staphylococcal lung abscess in a teenage girl with CF who presented with a two-week history of non-specific malaise followed by two days of left posterior chest pain and fever. A chest radiograph was consistent with a left sided pulmonary abscess, which was confirmed on a CT scan of the chest. The abscess was drained under ultrasound guidance and cultured methicillin-sensitive Staphylococcus aureus. The patient responded well to antibiotic treatment with the abscess cavity showing complete radiological resolution by six weeks post drainage.
Progressive lung disease characterized by airway obstruction, bacterial infection, and inflammation is the main cause of morbidity in cystic fibrosis (CF) patients. Structural lung anomalies are readily detected by chest computed tomography (CT) in CF infants within a few months of birth . Mucus obstruction and bacterial infections are not the sole causes of inflammation in early CF lung disease. Indeed, knockout of the CF transmembrane conductance regulator (CFTR) is sufficient to cause inflammatory lung disease in ferrets, even in the absence of bacterial infection .
Publication date: Available online 30 January 2020Source: Joint Bone SpineAuthor(s): Ana Catarina Duarte, Joanna Porter, Maria José LeandroABSTRACTBronchiectasis is defined as irreversibly damaged and dilated bronchi and is one of the most common pulmonary manifestations in patients with rheumatoid arthritis (RA).The model of RA-associated autoimmunity induced in some individuals by chronic bacterial infection in bronchiectasis is becoming increasingly acceptable, although a genetic predisposition to RA-associated bronchiectasis has also been demonstrated.Bronchiectasis should be suspected in RA patients with chroni...
We present a COPD case with an acute exacerbation due to Aspergillus fumigatus that lead to an aberrant clinical profile unresponsive to conventional treatment. Clinicians should consider Aspergillus fumigatus as an etiologic agent in an atypical and severe COPD exacerbation. PMID: 31986874 [PubMed - in process]
Congenital TEFs without esophageal atresia are rare but may occur more frequently than previously documented in literature. Careful history is required to suspect the diagnoses, as most patients will present with coughing associated with solid or liquids, recurrent unexplained pulmonary infections and complaints with eating. Some patients may show signs of chronic airway changes from recurrent aspiration pneumonia at the time of presentation. Diagnosis is challenging, with multiple imaging modalities including x ray, CT scan and esophogram able to identify a fistula.
Conclusion: Further studies are needed to characterize this group of patients in order to improve our clinical practice.