Tropical Lung

Pulmonary Schistosomiasis

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Risk factors

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Chest radiography

difusse and nodular infiltrates

Symptoms

Pulmonary symptoms

Non productive cough, dyspnea, Chest pain

Systemic symptoms

Fever, chills, fatigue, headache, myalgia, abdominal pain

Pulmonary hypertension, Cor pulmonale

Schistosoma haematobium

Eggs escape vesical plexus and reach lungs directly

Schistisima mansoni and Schistosoma japonica

Eggs bypass the liver by portosistemic collateral vessels and reach lung

Being from a place where schistosoma is endemic, water exposure, partial
acquired immunity, age, and genetic susceptibility, Previous infection witch schistosomiasis, coinfection with hepatitis B or C, coinfection with HIV

Paragonimiasis

Paragonimus westermani

Risk Factors

Symptoms

Consumption of raw or undercook crayfish (crustaceans), Living near dreinage basin, Common pulmonary diseases

Initial symptoms

abdominal pain and diarrhea, followed by fever, chest pain, cough, urticaria, and eosinophilia

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Chest Radiography

Pleural effussion within 2-12 weeks

Chronic Symptoms

Productive cough of brownish sputum with intermittent
hemoptysis, chronic bronchitis or bronchiectasis with
profuse expectoration and pleuritic chest pain and dyspnea

Can be negative or show diffuse infiltration, cysts measuring about 4 cm in diameter, nodules, calcifications, pleural effusion, and pneumothorax.

CT

Nodules, internal mammary and cardiophrenic lymphoadenopathy, pericardial effusion, linear tracks between nodules and pleura

Other species

Paragonimus miyazaki, Paragonimus skrjabini and Paragonimus hueitungenis, Paragonimus heterotrema, Paragonimus uterobilateralis, Paragonimus africanus, Paragonimus mexicanus, Paragonimus kellicotti

Histoplasmosis

Symptoms

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Histoplasma capsulatum

Risk factors

Living near river valleys, template climates and humidity, Exposure to bird and bat feces, being near construction places, mines or disruption of soil. Immunocompromised and children younger than 2 years

mild influenza-like
illness

Fever that may reach 42° C, headache, nonproductive cough, chills, and chest pain, substernal discomfort Pleuritic chest pain, malaise, weakness

Clinical findings show crackles on auscultation and rarely hepatoesplenomegaly

Complications

Fibrosis and granuloma

postobstructive pneumonias, hypoxemia, and bronchiectasis

Chronic disease

Cavitary sindrome

low-grade fever, productive cough, dyspnea, and weight loss of insidious onset. Night sweats, chest pain, hemoptysis, and malaise are less common. Hemoptysis is rare

Non cavitary disease

cough, weight loss, and fever and chills.arthralgia, dyspnea, fatigue and chest pain

Radiography

nodules, infiltrates, and lymphadenopathy.
Less common are fibrosis, thickened pleura, and volume loss, cavitary lessions

Coccidioidomycosis

Paracoccidioidomycosis

Agents

Agents

Coccidioides immitis and Coccidioides posadasii

Risk Factors

Living in endemic areas, when there´s dry season followed by a rainy one.

Immunosupressed

Symptoms

Primary infection can be asymptomatic

chest pain, dyspnea, night sweating, cough, and fever, diffuse reticular pneumonia, fatigue

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Abnormal findings in radiography

unilateral infiltrates, hilar adenopathy, and pleural effusions

Nodules and cavities can be found in larger stages

Paracoccidioides brasiliensis and Paracoccidioides lutzii

Risk Factors

Symptoms

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minority of patients develop symptomatic infection

children, adolescents, and adults under 30 years of age, Living in areas of endemicity (tropical rainforest), agricultors, immunosupressed

Chronic disease: fever, asthenia, general malaise, weight
loss, cough, expectoration, hemoptysis. There´s lung involvement and frequent lesions in the mucosae,
skin, adrenal.

Radiography

interstitial infiltrates, mixed lesions such as nodular and alveolar infiltrates (frequently bilateral and symmetrical) located preferentially in the central and lower fields

CT

interlobular septal thickening, peribronchovascular interstitial thickening, centrilobular opacities, intralobular
lines, ground-glass opacities, cavities, and airspace consolidation