Comparison of high-resolution computed tomography findings between Pseudomonas aeruginosa pneumonia and Cytomegalovirus pneumonia

Omeri, Ahmad Khalid; Okada, Fumito; Takata, Shoko; Ono, Asami; Nakayama, Tomoko; Ando, Yumiko; Sato, Haruka; Hiramatsu, Kazufumi; Mori, Hiromu

doi:10.1007/s00330-014-3326-3

Cited by 12 publications

(6 citation statements)

References 35 publications

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“… 5 Centrilobular nodules, a crazy-paving appearance and nodules are the most common manifestations of CMV infection. 6 Nodules distributed in multilobar segments are a typical image feature of varicella pneumonia. 4 PJ and CMV infections can show similarities in GGO, while CMV and VZV infections share similarities in centrilobular nodules.…”

Section: Discussionmentioning

confidence: 99%

Severe pulmonary co-infection with varicella-zoster virus, Pneumocystis jirovecii and Cytomegalovirus: a case report

Sun

et al. 2022

J Int Med Res

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Pneumocystis jirovecii, Cytomegalovirus and varicella-zoster virus are all opportunistically infective pathogens, but pulmonary co-infection with these pathogens is rare. Herein, this case report describes a patient with autoimmune haemolytic anaemia treated with methylprednisolone and cyclosporine that presented with rapidly progressive severe respiratory failure. Analysis of microbial nucleic acid sequences in both blood and sputum using next-generation sequencing revealed pulmonary co-infection with Pneumocystis jirovecii, varicella-zoster virus, and possibly Cytomegalovirus. After timely targeted and supportive treatments, the patient recovered. This case report highlights the imaging features of co-infection with these pathogens, the importance of next-generation sequencing for early diagnosis in immunosuppressed patients, and the effects of corticosteroid therapy.

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Section: Discussionmentioning

confidence: 99%

Severe pulmonary co-infection with varicella-zoster virus, Pneumocystis jirovecii and Cytomegalovirus: a case report

Sun

et al. 2022

J Int Med Res

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“…A "proven case" required histopathologic evidence (ie, viral inclusions and immunohistochemical staining) of CMV pneumonia in lung tissue. A "probable case" was defined as meeting all of the following criteria: (i) chest radiographic evidence consistent with CMV pneumonia, 14 (ii) CMV DNA detection in BALF, (iii) exclusion of alternative diagnoses that could account for signs and symptoms, and (iv) evidence of CMV infection elsewhere, such as in blood or another organ. A "possible case" required chest radiographic evidence of pneumonia and presence of CMV by shell vial or standard viral culture of BALF, but no lung biopsy, and no evidence of CMV in other organs.…”

Section: Study Population and Definitionsmentioning

confidence: 99%

Cytomegalovirus (CMV) DNA quantification in bronchoalveolar lavage fluid of immunocompromised patients with CMV pneumonia

Beam

Germer

Lahr

et al. 2017

Clinical Transplantation

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Cytomegalovirus (CMV) pneumonia causes major morbidity and mortality. Its diagnosis requires demonstration of viral cytopathic changes in tissue, entailing risks of lung biopsy. This study aimed to determine CMV viral load (VL) thresholds in bronchoalveolar lavage fluid (BALF) for diagnosis of CMV pneumonia in immunocompromised patients. CMV VL in BALF was studied in 17 patients (83% transplant recipients) and 21 control subjects with and without CMV pneumonia, respectively, using an FDA- 09/162). Receiver operating characteristic curve analysis produced a BALF CMV VL threshold of 34 800, IU/mL with 91.7% sensitivity and 100.0% specificity for diagnosis of possible, probable, and proven CMV pneumonia in transplant patients, while a threshold of 656 000 IU/mL yielded 100% sensitivity and specificity among biopsyproven cases. For all immunocompromised patients, a VL threshold of 274 IU/mL was selected. VL thresholds also were normalized to BALF cell count yielding a threshold of 0.32 IU/10 6 cells with 91.7% sensitivity and 90.5% specificity for possible, probable, and proven CMV pneumonia in transplant recipients. Monitoring CMV VL in BALF may be a less invasive method for diagnosing CMV pneumonia in immunocompromised patients. K E Y W O R D Sbronchoalveolar lavage, cytomegalovirus, nucleic acid test, viral load

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“…These differences in radiological presentations might result from intrinsic virulence factors and immune responses to these pathogens. Human cytomegalovirus belongs to the herpesvirus subfamily, with seroprevalence of 40-100% in the world's population [5,21]. Cytomegalovirus can establish life-long latent infection and reactivate during episodes of immunosuppression [22].…”

Section: Discussionmentioning

confidence: 99%

Differences and similarities of high-resolution computed tomography features between pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients

Liu

Chen

et al. 2020

Infect Dis Poverty

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Background Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the computerized tomography (CT) features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies. Methods A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 cytomegalovirus pneumonia) at Beijing Ditan Hospital from January 2017 to May 2019 were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Binary logistic regression analyses were conducted to identify the significant parameters that distinguished pneumocystis pneumonia from cytomegalovirus pneumonia. Correlations were analyzed by Pearson or Spearman correlation analyses. Result were considered significant if P < 0.05. Results The presence of consolidation, halo signs, and nodules (all P < 0.05) were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, P < 0.001) without perilymphatic distribution were particularly common in patients with cytomegalovirus pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity, reticulation, and bronchial wall thickening (all P > 0.05) were common in both groups. Conclusions Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients. CT features are potentially useful for the differential diagnosis of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients.

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Comparison of high-resolution computed tomography findings between Pseudomonas aeruginosa pneumonia and Cytomegalovirus pneumonia

Cited by 12 publications

References 35 publications

Severe pulmonary co-infection with varicella-zoster virus, Pneumocystis jirovecii and Cytomegalovirus: a case report

Severe pulmonary co-infection with varicella-zoster virus, Pneumocystis jirovecii and Cytomegalovirus: a case report

Cytomegalovirus (CMV) DNA quantification in bronchoalveolar lavage fluid of immunocompromised patients with CMV pneumonia

Differences and similarities of high-resolution computed tomography features between pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients

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