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      Imaging of Pulmonary Infections

      chapter-article
      Thoracic Imaging

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          Abstract

          Pulmonary infections have always been a cause of high morbidity and mortality, particularly in the pediatric and geriatric population and in immunocompromised hosts [1]. Pulmonary infections have various etiologies and have variegated patterns on radiographs and computed tomography (CT). Imaging plays an important role in the initial diagnosis and follow-up of various lung infections. Radiographs can be normal or non-specific during the initial evaluation, and CT findings may be more definitive. CT not only helps with the diagnosis but can also aid in management by guiding the diagnostic and therapeutic procedure. The pulmonary infections spread by direct or indirect contact with the infected host, droplet transmission, or an airborne spread. In rare cases, some infections can also be transmitted by vectors, namely, insect or animal hosts, and rarely by direct invasion from nearby infected organs. Pulmonary infections may have typical imaging patterns and distribution based on the mode of spread. There are a number of well-described imaging patterns of alveolar infections. The localization and morphological features on imaging may help in the diagnosis of infection and identification of mode of infection and, in certain cases, the microorganism responsible for the infection.

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          Most cited references37

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          Pulmonary tuberculosis: up-to-date imaging and management.

          S Lee, A Jeong (2008)
          Pulmonary tuberculosis (TB) is a common worldwide infection and a medical and social problem causing high mortality and morbidity, especially in developing countries. The traditional imaging concept of primary and reactivation TB has been recently challenged, and radiologic features depend on the level of host immunity rather than the elapsed time after the infection. We aimed to elaborate the new concept of the diagnosis and treatment of pulmonary TB, to review the characteristic imaging findings of various forms of pulmonary TB, and to assess the role of CT in the diagnosis and management of pulmonary TB. Fast and more accurate TB testing such as bacterial DNA fingerprinting and whole-blood interferon-gamma assay has been developed. Miliary or disseminated primary pattern or atypical manifestations of pulmonary TB are common in patients with impaired immunity. CT plays an important role in the detection of TB in patients in whom the chest radiograph is normal or inconclusive, in the determination of disease activity, in the detection of complication, and in the management of TB by providing a roadmap for surgical treatment planning. PET scans using 18F-FDG or 11C-choline can sometimes help differentiate tuberculous granuloma from lung malignancy.
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            Clinical characteristics of septic pulmonary embolism in adults: a systematic review.

            To describe the clinical characteristics of septic pulmonary embolism in adults in order to improve its diagnosis and treatment.
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              Radiological manifestations of pulmonary tuberculosis.

              Pulmonary tuberculosis (TB) is a common worldwide lung infection. The radiological features show considerable variation, but in most cases they are characteristic enough to suggest the diagnosis. Classically, tuberculosis is divided into primary, common in childhood, and postprimary, usually presenting in adults. The most characteristic radiological feature in primary tuberculosis is lymphadenopathy. On enhanced CT, hilar and mediastinal nodes with a central hypodense area suggest the diagnosis. Cavitation is the hallmark of postprimary tuberculosis and appears in around half of patients. Patchy, poorly defined consolidation in the apical and posterior segments of the upper lobes, and in the superior segment of the lower lobe is also commonly observed. Several complications are associated with tuberculous infection, such as hematogenous dissemination (miliary tuberculosis) or extension to the pleura, resulting in pleural effusion. Late complications of tuberculosis comprise a heterogeneous group of processes including tuberculoma, bronchial stenosis bronchiectasis, broncholithiasis, aspergilloma, bronchoesophageal fistula and fibrosing mediastinitis. Radiology provides essential information for the management and follow up of these patients and is extremely valuable for monitoring complications.

                Author and article information

                Contributors
                +656566022689 , ashchawla@gmail.com
                Journal
                978-981-13-2544-1
                10.1007/978-981-13-2544-1
                Thoracic Imaging
                Thoracic Imaging
                Basic to Advanced
                978-981-13-2543-4
                978-981-13-2544-1
                15 January 2019
                : 147-172
                Affiliations
                GRID grid.415203.1, ISNI 0000 0004 0451 6370, Department of Diagnostic Radiology, , Khoo Teck Puat Hospital, ; Singapore, Singapore
                GRID grid.415203.1, ISNI 0000 0004 0451 6370, Department of Diagnostic Radiology, , Khoo Teck Puat Hospital, ; Singapore, Singapore
                Article
                6
                10.1007/978-981-13-2544-1_6
                7120992
                f6f00cb8-dbab-4b10-87fb-4b29ee7dcbb3
                © Springer Nature Singapore Pte Ltd. 2019

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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                © Springer Nature Singapore Pte Ltd. 2019

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