ABSTRACT
Chest high-resolution computed tomography (HRCT) is considered the "gold" standard radiological method in interstitial lung disease (ILD) patients. The objectives of our study were to evaluate the correlation between two transthoracic lung ultrasound (LUS) scores (total number of B-lines score = the total sum of B-lines in 10 predefined scanning sites and total number of positive chest areas score = intercostal spaces with ≥3 B-lines) and the features in HRCT simplified scores, in different interstitial disorders, between LUS scores and symptoms, as well as between LUS scores and pulmonary function impairment. We have evaluated 58 consecutive patients diagnosed with ILD. We demonstrated that there was a good correlation between the total number of B-lines score and the HRCT simplified score (r = 0.784, p < 0.001), and also a good correlation between the total number of positive chest areas score and the HRCT score (r = 0.805, p < 0.005). The results confirmed the value of using LUS as a diagnostic tool for the assessment of ILD compared to HRCT. The use of LUS in ILD patients can be a useful, cheap, accessible and radiation-free investigation and can play a complementary role in the diagnosis and monitoring of these patients.
ABSTRACT
AIM: To evaluate clinical manifestations of Aspergillus infections in our pulmonology practice. METHODS: Between 2002-2009, we assessed retrospectively and prospectively, Aspergillus related diseases in patients admitted in Clinical Hospital of Pneumology from Cluj-Napoca, Romania. Positive diagnosis was based on identification of Aspergillus speciae (A spp) on Sabouraud medium, pathological, or immunological proves. RESULTS: 83 patients were included. A spp was isolated in 73 patients from: sputum 46, bronchial lavages (BL) 17, both sputum and BL 4, sputum and nasal secretion 1, or from surgical samples 5 cases. In those 10 cases without A spp positive cultures, diagnosis was confirmed by pathologic examination on surgical or bronchoscopical samples in 6 and 2 cases respectively. 76 patients had previous chronic respiratory diseases and 7 had nonrespiratory chronic diseases. We identified the following clinical forms: chronic cavitary aspergillosis 46 cases, aspergillus tracheobronchitis 19 cases, allergic aspergillosis 15 cases, invasive aspergillosis 3 cases. We observed a poor definition on nosological forms, diagnosis like "pulmonary aspergillosis" or "aspergilloma" were the most common. In 12 cases no clinical significance was attributed for detection A spp in bronchial smears. 60 patients supported specific management: antifungal therapy in 38 cases, surgical procedures in 14 cases and both methods in 8 cases, with many differences in treatment and follow-up. CONCLUSIONS: Chronic cavitary aspergillosis was the most frequent clinical form observed in our pulmonology practice. Using the clinical guidelines for fungal respiratory infections we can avoid the wrong diagnosis and then include a correct antifungal treatment in the complex management of our chronic pulmonary patients.
