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Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients

BACKGROUND: Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. MATERIAL/METHODS: CT image...

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Autores principales: Mehrian, Payam, Esfandiari, Ehsan, Karimi, Mohammad Ali, Memari, Behzad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288394/
https://www.ncbi.nlm.nih.gov/pubmed/25584096
http://dx.doi.org/10.12659/PJR.892042
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author Mehrian, Payam
Esfandiari, Ehsan
Karimi, Mohammad Ali
Memari, Behzad
author_facet Mehrian, Payam
Esfandiari, Ehsan
Karimi, Mohammad Ali
Memari, Behzad
author_sort Mehrian, Payam
collection PubMed
description BACKGROUND: Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. MATERIAL/METHODS: CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1). RESULTS: Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups. CONCLUSIONS: Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition.
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spelling pubmed-42883942015-01-12 Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients Mehrian, Payam Esfandiari, Ehsan Karimi, Mohammad Ali Memari, Behzad Pol J Radiol Original Article BACKGROUND: Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. MATERIAL/METHODS: CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1). RESULTS: Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups. CONCLUSIONS: Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition. International Scientific Literature, Inc. 2015-01-07 /pmc/articles/PMC4288394/ /pubmed/25584096 http://dx.doi.org/10.12659/PJR.892042 Text en © Pol J Radiol, 2015 This is an open access article. Unrestricted non-commercial use is permitted provided the original work is properly cited.
spellingShingle Original Article
Mehrian, Payam
Esfandiari, Ehsan
Karimi, Mohammad Ali
Memari, Behzad
Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients
title Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients
title_full Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients
title_fullStr Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients
title_full_unstemmed Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients
title_short Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients
title_sort computed tomography features of pulmonary nocardiosis in immunocompromised and immunocompetent patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288394/
https://www.ncbi.nlm.nih.gov/pubmed/25584096
http://dx.doi.org/10.12659/PJR.892042
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