FEV1 spirometry

Date: 7 February 2014

  • spirometer 2

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Image B

Copyright:

Dr D Denning, Wythenshawe Hospital, Manchester.(© Fungal Infection Trust)

Notes:

Patient BC
A petite women in her 50’s with severe asthma and fungal sensitization (SAFS) had been unable to tolerate either itraconazole or voriconazole for any length of time, and was severely disabled with her symptoms. One treatment option which is occasionally helpful is to give nebulised amphotericin B (link to video of Helen). She was given 10mg of amphotericin B deoxycholate in water through a Pari LC nebulizer, supervised by a senior physiotherapist. Shortly after starting this, she felt much more breathless and the nebulizer was stopped. Salbutamol rescue was administered. After about 40 minutes she recovered.
 
The spirometer readings show a starting FEV1 of 2.35 L/sec. This fell to 1.05 L/sec, a dramatic fall with amphotericin B nebulisation. (Image A) She recovered with salbutamol to 2.25 L/sec. (Image B)

Images library

Showing 10 posts of 2574 posts found.

  • Title

    Legend

  • Bronchiectasis due to ABPA

    High resolution CT scan images with reconstruction of 1mm thick slices at approximately 10mm increments. The scan shows moderately severe multi-lobar cylindrical and varicose bronchiectasis predominantly centrally and in the upper lungs. There is no mucus plugging seen.

    The features are in keeping with allergic bronchopulmonary aspergillosis

    BMJune04344, BMscanjune04347, BMjune04348

  • Allergic aspergillosis

    Allergic aspergillosis

    mayer

  • pt.SB – 6/10/98 – bronchocentric granulomatosis. CT scan showing multiple small nodules of variable size in both lung fields, apparently close to the vascular bundles.

    pt.SB – 6/10/98 – bronchocentric granulomatosis. CT scan showing multiple small nodules of variable size in both lung fields, apparently close to the vascular bundles.

    dd2

  • dup

    abpab

  • dup

    abpae

  • Bronchial oedema.Remarkably oedematous bronchial mucosa, as seen in ABPA.

    Bronchial oedema.Remarkably oedematous bronchial mucosa, as seen in ABPA.

    abpa11

  • Longstanding allergic bronchopulmonary aspergillosis

    An example of longstanding allergic bronchopulmonary aspergillosis in a patient who has been steroid dependent for over 15 years showing remarkable kyphoscoliosis and honey combing and fibrosis of both lungs.

    ABPA pt HB

  • Normal bronchial anatomy.

    Normal bronchial anatomy.

    abpa10

  • Allergic aspergillosis

    Recurrent pulmonary shadows 1. 6 Jan 1988 – chest radiograph showing right hilar enlargement, consistent with ABPA.

    Recurrent pulmonary shadows 1. 3 Feb 1989 – chest radiograph showing right upper-lobe consolidation and contraction consistent with obstruction of RUL bronchus, in ABPA.

    Clearing of pulmonary shadows 3, pt BJ. 5 April 1989 – resolution of shadows seen in February, with a course of corticosteroids.

    Recurrence of pulmonary shadows 4, pt BJ. 2 September 1989 – recurrence of pulmonary shadows with an exacerbation of ABPA.

    Central bronchiectasis, pt BJ. CT scan of thorax October 1989 showing central bronchiectasis, characteristic of ABPA (and cystic fibrosis).

    Recurrent pulmonary shadows 1, pt BJ, Recurrent pulmonary shadows 2, pt BJ. , Clearing of pulmonary shadows 3, pt BJ., Recurrence of pulmonary shadows 4, pt BJ., Central bronchiectasis, pt BJ CT scan of thorax October 1989 showing central bronchiectasis, characteristic of ABPA (and cystic fibrosis).

  • Microscopy of sputum

    A typical example of a wet mount of a sputum sample from a patient with allergic bronchopulmonary aspergillosis.

    abpa1