摘要:

Tuberculosis is a disease that has plagued humankind for centuries. The “white plague” is not only treatable and curable but also preventable. Initially, tuberculosis fell in the province of the general physician. With the advent of technologic advances in thoracic surgery, surgical management of tuberculosis was brought to the forefront. Effective bactericidal drug therapy became available by 1954 after the development of streptomycin in 1945 and isoniazid in 1952. Additional effective antituberculous drugs have relegated surgical therapy for tuberculosis to a relatively minor role.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Classic tuberculosis is the result of infection with the human strain ofMycobacterium tuberculosis, and atypical tuberculosis is the result of infection with atypical mycobacteria. The pathology and course of the disease depend on the sensitivity of the host. Primary tuberculosis is the first infection in an unsensitized host, and secondary, postprimary, or chronic tuberculosis results from reactivation of previously acquired infection or, rarely, reinfection of a sensitized host. The pathology of infection withM avium-intracellularein patients with acquired immunodeficiency syndrome (AIDS) is different from that of tuberculosis; formation of noncaseating lesions and a marked macrophage response resemble changes seen in lepromatous leprosy. These infections in patients with AIDS are predominantly extrapulmonary.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

During the past several years, the previously steady decline in the annual incidence of tuberculosis has reversed. Primary tuberculosis, the most common form in children, presents with radiographic findings that are quite different from the characteristic changes of postprimary tuberculosis commonly seen in adults. This article presents the common manifestations of primary pulmonary tuberculosis, endobronchial tuberculosis, and hematogenous tuberculosis that are seen in infants and children. The less common findings of pleural tuberculosis, congenital tuberculosis, and tuberculosis of the spine are also addressed. Recognition of the characteristic changes of childhood tuberculosis on chest radiographs may lead to more prompt diagnosis and earlier therapy for children with this disease.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Adult pulmonary tuberculosis commonly presents with radiographic findings of upper lobe cavitary opacities, in which case the correct diagnosis is usually suspected. However, other radiographic presentations of this disease in the adult include intrathoracic adenopathy, pleural effusion, lower lobe consolidation, a miliary pattern, and a solitary nodule. In these latter cases, tuberculosis may not be considered in the differential diagnosis. This article discusses the protean manifestations of adult pulmonary tuberculosis.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

An association between tuberculosis and HIV infection is becoming increasingly evident. HIV seropositivity has been seen in nearly 30% of some populations with tuberculosis. In other populations nearly 25% of patients with AIDS had tuberculosis. Clinically these patients present with nonspecific findings including weight loss, night sweats, and fever. The symptoms are generally gradual in onset and last for several weeks. Early in the course of HIV infection a PPD skin test may be positive and the radiographic findings may be similar to those seen in individuals with normal immunity. Thus, upper lobe heterogeneous and cavitary opacities may be seen on the chest radiograph. In late HIV infection, however, the PPD skin test is generally negative and the radiograph demonstrates lymphadenopathy and diffuse heterogeneous parenchymal opacities. Tuberculosis should be suspected in HIV-infected patients when diffuse interstitial lung disease is demonstrated in conjunction with hilar or mediastinal lymph node enlargement. In contrast, lymphadenopathy is not expected in the most common opportunistic lung disease,Pneumocystis cariniipneumonia. Standard antituberculous drug therapy is extremely effective in treating tuberculosis in this setting.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Tuberculosis is a disease that has plagued humankind for centuries. In spite of excellent antituberculous chemotherapy, a number of important complications of tuberculosis are still commonly seen. Some of these are caused by the disease, and others are the sequelae of therapy. Thus some are seen immediately, and others occur months or even years after the onset of disease. These complications may involve the lungs, mediastinum, pleura, chest wall, or any combination of these structures. This article reviews the pathophysiology, diagnosis, and treatment of the many complications of thoracic tuberculosis.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Nontuberculous mycobacterial pulmonary infections have become more common in recent years. The diagnosis is often overlooked because the findings may be subtle or because the radiographic appearance may change slowly or not at all for long periods of time. As a rule, the radiographic findings of nontuberculous mycobacterial pulmonary infections are identical to those of tuberculosis in any given patient. Cavitary disease in nontuberculous mycobacterial infections is less common than in tuberculosis. The most common radiographic finding is one or more areas of clustered fibroproductive nodules that change slowly.Mycobacterium kansasiiinfection responds well to therapy, whereasM avium-intracellulareinfection is difficult to treat. Awareness of the radiographic appearance of the nontuberculous mycobacterial pulmonary infections will facilitate their diagnosis so that appropriate therapy may be initiated before the disease is far advanced.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

CT of the chest was performed in 25 patients with chest radiographs suspicious for hilar or mediastinal adenopathy, who subsequently proved to have sarcoidosis. In each case, CT detected more extensive adenopathy than suspected on chest radiographs. Adenopathy greater than 1.0 cm was present in the right paratracheal and pretracheal regions in all cases. Adenopathy was also frequently seen in the hilar (92%), anteroposterior window (88%), subcarinal (64%), anterior mediastinal (48%), and posterior mediastinal (16%) lymph node groups. The adenopathy occurred in multiple and varying combinations without a consistent identifiable pattern suggestive of sarcoidosis. It is concluded that while CT detects adenopathy more consistently, it does not offer a clear advantage over chest radiography in confirming a diagnosis of mediastinal and hilar involvement by sarcoidosis.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The authors present an interesting case of pulmonary embolus serendipitously diagnosed during an evaluation for a presumed metastatic pulmonary nodule.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Pleural infection byCryptococcus neoformansis uncommon and when present typically occurs in the immunocompromised host. We report two renal transplant patients who developed pleural cryptococcosis.

ISSN:0883-5993    

出版商:OVID    

年代:1990

数据来源: OVID