Date: 26 November 2013
D Sinusitis radiology with fluid level
Copyright:
Fungal Infection Trust
Notes:
Bronchography (A & B)is an old technique for visualising the bronchial tree, by introducing radio-opaque dye into the airways and then taking a chest Xray. It was the first means used to diagnose bronchiectasis, seen in these examples below. An historical description of the technique from 1922 can be seen here
Nowadays CT scanning of the chest is used for this purpose with 3D reconstruction in some cases.
White cell scan (C) This pair of white cell scans from different people show almost no white cells in the lungs on the left, as in a healthy person (the spleen is the ‘hottest area). The scan on the right shows grossly increased update, especially in the left lung (seen on the right). This is the typical feature of severe bronchiectasis with large amounts of neutrophils and other phagocytes present.
Sinusitis Plain X-ray (D) of the face showing the maxillary sinuses. The right maxillary sinus is complete fluid filled and the left side (seen on the right) has a fluid level. These features may be seen with severe acute bacterial sinusitis, but also other causes of sinusitis, including allergic rhinosinusitis.
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Images and abstract taken from Mert D et.al., Hematol Rep. 2017 Jun 1;9(2):6997. doi: 10.4081/hr.2017.6997. Invasive Aspergillosis with Disseminated Skin Involvement in a Patient with Acute Myeloid Leukemia: A Rare Case.
Invasive pulmonary aspergillosis is most commonly seen in immunocompromised patients. Besides, skin lesions may also develop due to invasive aspergillosis in those patients. A 49-year-old male patient was diagnosed with acute myeloid leukemia.
The patient developed bullous and zosteriform lesions on the skin after the 21st day of hospitalization. The skin biopsy showed hyphae. Disseminated skin aspergillosis was diagnosed to the patient.
Voricanazole treatment was initiated. The patient was discharged once the lesions started to disappear.
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A pile of woodchip stored for use in a garden usually as a weed suppressing mulch. The heat building up in the pile is illustrated by the plumes of steam eminating from the top of the pile.
Aspergillus fumigatus is particularly well adapted to grow in the heat (up to 60C) found in such piles of rotting organic material and this characteristic, an adaption for its life in its natural environment also enables it to survive and grow in warm mammalian bodies at 37C. Most fungi cannot grow or survive at those temperatures
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MK is 59 years old and presented with right sided pleuritic chest pain and coughing over 1 week. A chest Xray and then CT scan revealed complete collapse of her right lower lobe and middle lobes. Mucous retention is seen just proximal to the abrupt cutoff. There was mild bronchiectasis.
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