El documento resume las principales patologías infecciosas del tórax, incluyendo neumonías bacterianas, virales y micóticas. Describe los patrones radiográficos y de tomografía computarizada de infecciones como neumonía neumocócica, estafilocócica, micoplasma, histoplasmosis, aspergilosis y coccidiodomicosis, entre otras. También aborda abscesos pulmonares, empiema y neumatoceles, proporcionando detalles sobre sus características radiológicas.
47. Influenza A H1N1 TC Tórax: Patrón en vidrio despulido, distribuido de manera bilateral, asociado a áreas basales de consolidación. La cabeza de flecha indica la pesencia de un pequeño pneumotórax. Las flechas muestran el signo del “anillo alrededor de la arteria”, producido por la presencia de aire alrededor de la arteria lobar en el lóbulo medio, en relación a enfisema intersticial. RadioGraphics 2010; 30:327–333
CXR of patient with pneumocystis jiroveci pneumonia , showing reticular interstitial markings in all lung fields. CLINICAS DE NA
Right upper lobe pneumonia caused by S pneumoniae. Posteroanterior (PA) chest (A) and CT scan (B) soft windows demonstrating air bronchogram.
Transverse thin-section CT scan demonstrates C pneumoniae bronchopneumonia with airway dilatation in 66-year-old man. Centrilobular nodules (arrows) and lobular areas of consolidation with bilateral airway dilatation (arrowheads) are seen. Note the associated areas of linear opacity. Bronconeumonía leve: Engrosamiento peribronquial y opacidades mal definidas B. severa: Áreas mal definidas de consolidación que afectan varios lóbulos.
Neumonía Intersticial por CMV: Px con VIH, patrón intersticial micronodular
Chest x-ray of a 65 year old woman, immunocompromised as a result of Crohn disease , demonstrates a large left sided pulmonary cavity with a small dependent air-fluid level. The wall is relatively thin. CT confirms the abnormality as well as demonstrates extensive adjacent and separate areas of consolidation. Small pleural effusions are also present. Findings are in keeping with a large pulmonary abscess .
Chest x-ray of a 65 year old woman, immunocompromised as a result of Crohn disease , demonstrates a large left sided pulmonary cavity with a small dependent air-fluid level. The wall is relatively thin. CT confirms the abnormality as well as demonstrates extensive adjacent and separate areas of consolidation. Small pleural effusions are also present. Findings are in keeping with a large pulmonary abscess .
Lung abscess . A single, contrast-enhanced axial CT scan image of the chest shows a large cavitary lesion in the left lower lobe with a relatively thick wall(black arrows). The cavity has a smooth inner margin and an air-fluid level (white arrow). There is inflammatory reaction in the surroundig lung (yellow arrow). Notice the acute angle the abscess makes with the posterior chest wall.
DD de Absceso Pulmonar Hernia Hiatal (Sp para absceso pulmonar retrocardiaco) Granulomatosis de Wegener Empiema CA Broncogénico cavitado
CT of the chest demonstrates a very large right sided pleural collection with thickened surrounding pleura (the so called split pleura sign ) and multiple gas bubbles. The adjacent lung is compressed an collapsed. Split pleura sign (recuadro)
Radiographs and CT scans. —A pneumatocele appears as an approximately round, thin-walled airspace in the lung.
Lobar pneumonia. Posteroanterior chest radiograph show diffuse right upper lobe consolidation. The patient was a 79-year-old man with lobar pneumonia due to S. pneumoniae. Lobar pneumonia. Lateral view demonstrates that the consolidation involves the anterior and posterior segments of the right upper lobe. Because the consolidation crosses the boundaries between two adjacent segments it is known as nonsegmental or lobar consolidation. The patient was a 43-year-old woman with lobar pneumonia due to S. pneumoniae.
Round pneumonia caused by S pneumoniae. (A) PA chest. (B) CT scan.
White arrows outline the area of consolidation. Round pneumonia - “Round pneumonia in a 9 month old. Treated with antibiotics and resolved Round pneumonia - “A round pneumonia refers to a rounded region of consolidative parenchymal pulmonary infection. AUSENCIA DE LAS VIAS DE COMUNICACION INTERALVEOLAR
Septic pulmonary emboli in a 30-year-old man with AIDS who had an indwelling central venous catheter. (a) Frontal chest radiograph shows multiple nodular opacities (arrows) and right pleural effusion. (b) Transverse CT scan through the carina obtained 2 days later demonstrates bilateral peripheral nodules and cavities. Note the feeding vessels (arrows) leading to cavitary nodules. Blood and sputum cultures revealed Staphylococcus aureus .
a) Initial posteroanterior (left) and lateral (right) chest radiographs depict a minimally widened mediastinum with right paratracheal fullness (arrow), bilateral hilar enlargement (arrowheads), small bilateral pleural effusions, and subtle left lower lobe air-space disease b) Initial transverse CT images. (a) Widespread hyperattenuating adenopathy. The largest lymph node (arrow) is in the subcarinal region
Large pneumonia consolidation in the right lower lobe
Bacterial pneumonia in a 37-year-old man with common variable immunodeficiency. Frontal chest radiograph shows consolidation and volume loss (arrows) in the lower lobe of the left lung. Sputum cultures were positive for H influenzae
Nosocomial pneumonia in a 15-year-old boy with Wiskott-Aldrich syndrome who required mechanical ventilation. Frontal chest radiograph shows patchy consolidation (arrow) in the right lower lobe and atelectasis (∗) in the left lower lobe behind the heart. Bronchoscopy recovered P aeruginosa
Invasión de la pared torácica izquierda
Transverse thin-section CT scan demonstrates C pneumoniae pneumonia with consolidation predominance in 79-year-old man. Segmental consolidation with partially intermingled areas of GGO in right middle lobe and patchy areas of GGO in both lower lobes (∗) are seen. Associated linear opacities (arrows) and scattered dotlike areas of low attenuation (arrowheads), which are indicative of centrilobular emphysema, are also noted.
Mycobacterium avium-intracellulare complex organisms. Chest radiograph coned to left upper lung shows well-circumscribed cavitary left upper lobe mass
a) Axial CT image (5-mm section, lung window setting) obtained at more caudal level shows right lower lobe tree-in-bud opacities ( white arrows ) consistent with endobronchial spread of infection. Note left lower lobe cavity ( asterisk ) and bronchiectasis ( black arrow ). c) Axial high-resolution CT image of chest shows diffusely distributed ground-glass nodules. Clinical, imaging, and histopathologic features are consistent with "hot tub lung."
a. Chest radiograph coned to left upper lung shows well-circumscribed cavitary left upper lobe mass. b. Axial CT images (5-mm section, lung window setting) confirm left upper lobe cavity and show adjacent cluster of small nodules ( arrows, C )
CT scan of viral pneumonia before (A) and after (B) antiviral treatment.
Influenza pneumonia. View of the right lung at the level of the right upper lobe bronchus shows slightly more extensive abnormalities. The patient was a 33-year-old man who developed influenza pneumonia after hematopoietic stem cell transplant
Nódulos alveolares múltiples mal definidos
Severe acute respiratory syndrome (SARS). Chest radiograph shows patchy bilateral areas of consolidation. The patient was a 44-year-old woman with SARS Severe acute respiratory syndrome (SARS). High-resolution CT image shows patchy bilateral ground-glass opacities in the lower lobes. The patient was a 48-year-old woman with SARS
Cytomegalovirus pneumonia in a 45-year-old woman with rapidly progressive glomerulonephritis. Thin-section CT of the right lung base demonstrates multiple tiny nodules (arrows) with the CT halo sign in the right lower lobe.
High-resolution CT shows areas of consolidation in the lower lobes, bilateral ground-glass opacities, and small nodules. The patient was a 60-year-old man with acute histoplasmosis.
The nodule is larger and satellite nodules have improved.
Chronic histoplasmosis. A 55 year old man undergoing routine pre-employment physical examination. A PA chest radiograph demonstrates several well defined uniform-sized calcified nodules in both lungs with bilateral hilar and mediastinal lymph node calcification
High-resolution CT shows a lobular consolidation and a few, small, centrilobular, nodular opacities in the right middle lobe in a 38-year-old man with acute coccidioidomycosis. High-resolution CT shows a cavitating nodule in the right upper lobe.
Coccidioidomycosis. Asymptomatic 64 year-old male from Arizona had a nodule detected on a routine chest radiograph. A chest radiograph (not shown) one year before was negative. Chest CT image demonstrates a 13mm nodule surrounded by tiny satellite nodules in the right middle lobe. Surgical resection revealed caseating granulomas and coccidioidomycosis
CT scan of blastomycosis appearing mass-like
Microscopic features of A fumigatus
CT scan of an aspergilloma or fungus ball
1. The air crescent has developed. 2. Angioinvasive aspergillosis in a 42-year-old man with acute myelogenous leukemia. Chest CT scan (lung window) reveals a 2-cm nodular lesion with a wide halo of ground-glass attenuation representing adjacent hemorrhage.
Allergic bronchopulmonary aspergillosis in a 43-year-old asthmatic man. (a, b) Thin-section CT scans ( b obtained at a lower level than a ) show multiple tubular areas of increased attenuation in the left upper lobe.
Necrotizing bronchial aspergillosis in a 54-year-old man. (a) Chest CT scan (mediastinal window) obtained at the level of the carina shows a thickened, narrowed right main bronchus with associated right upper lobe collapse.
Portable chest radiograph in a patient with pneumocystis carinii pneumonia (PCP) shows multifocal patchy opacities with diffuse reticular markings. These findings are nonspecific, but in the setting of a CD4 count less than 200 /mm3, should raise suspicion for PCP.
Opacidades en vidrio despulido
CT scan of pneumatoceles caused by P carinii pneumonia infection. PCP pneumnia - Utility of Minimum intensity Projections 24 year old male presented with fever and breathlessness. HRCT thorax revealed pneumatocoeles in left upper lobe.
Right-sided amebic pleural empyema and pneumonia in a 43-year-old man with an abscess of the right hepatic lobe. Chest CT scan helps confirm pleural involvement and right-sided basal alveolar infiltrates.
Diagram illustrates the life cycle of Echinococcus species Pulmonary hydatid disease from E granulosus in a 43-year-old man. Chest radiograph shows a large cyst in the right lower lung. Pulmonary hydatid disease from E granulosus in a 32-year-old woman. CT scan of the lung shows a hypoattenuating crescent sign (meniscus sign) (arrows).
Pulmonary paragonimiasis in a 35-year-old man. (a) Chest radiograph shows alveolar areas of increased opacity, predominantly in the left lung. (b) CT scan demonstrates bilateral ill-defined areas of consolidation and areas of ground-glass attenuation associated with left pneumothorax.
Diagram illustrates the life cycle of Schistosoma species Early pulmonary schistosomiasis in a 28-year-old man who had traveled to Mali Chest CT scan shows multiple nodular lesions with ill-defined borders in the lower lobes La neumonia eosinofílica se produce porque la larva al pasar por los capilares pulmonares produce una rpta alérgica , que se traduce como opacidades transitorias de la vía aérea. Luego la larva pasa a la circulación sistémica . Se produce la arteriolitis obliterativa por una inflamación granulomatosa producida por la persona, debido a q el parasito implanta sus huevos dentro y alrededor de las arteriolas pulmonares.