Please enable JavaScript.
Coggle requires JavaScript to display documents.
TROPICAL LUNG - Coggle Diagram
TROPICAL LUNG
PARAGONIMIASIS
Pathogenic agent
Paragonimus westermani
Main symptoms
Early infection
Fever, malaise, diarrhea, epigastric pain, urticaria, pleuritic chest pain
Progresses of the infecction
Chest pain, dyspnea, cough, and malaise
Late infection
Worms induce inflammation and fibrosis in the locations. Patients may not feel or appear ill
blood-tinged sputum or hemoptysis
Chocolate color and may have a foul odor
Risk factors for infection
Poverty, culture, raw and undercooked crabs
Chest imaging findings
Early infection
X-ray
Pneumothorax or pleural effusions (xudative and with eosinophils)
Late infection
X-ray
Ring shadow lesions, due to the relative lucency of cystic cavities
Patchy pulmonary infiltrates, nodules, and/or calcifications
Pleural effusion
Irregular linear streaks, often adjacent to the ring shadows; these represent burrowing tracts of the flukes
Parenchymal mass lesions
Pleural thickening
HISTOPLASMOSIS
Pathogenic agent
Histoplasma capsulatum
Risk factors for infection
Farmers, workers performing pest control, poultry keepers, construction workers, people who build or repair roofs, landscapers and gardeners, cave explorers (presence of bats)
Main symptoms
Acute infection (14 days after infection)
Fever (42°C)
headache
non-productive cough
Shaking chills
chest pain
Hepatosplenomegaly
Rales
Chronic
Low-grade fever, productive cough, dyspnea, and insidious-onset weight loss. Night sweats, chest pain, hemoptysis, and malaise are less common. Hemoptysis is rare.
Chest imaging findings
Acute infection
X-ray
pneumonitis with a patchy pattern, which eventually calcifies, and hilar lymphadenopathy
Chronic
X-ray
Scattered infiltrates and areas of dense consolidation develop and progress to cavitation.
Extensive fibrosis, shrinkage, and areas of compensatory emphysema develop over months or years unless effective treatment is given. The most common location is the upper lobes.
PARACOCCIDIODOMYCOSIS
Pathogenic agent
Paracoccidioides
P. brasiliensis, P. americana, P. restrepiensis, P. venezueliensis and P. lutzi
Risk factors for infection
Endemic area, male sex, patients with HIV, smoking and alcoholism
Main symptoms
3 categories
There are no clinical manifestations
Paracoccidioidomycosis infection
Asymptomatic for a month or years.
Evolves progressively and gives clinical manifestations
Paracoccidioidomycosis disease
Acute/subacute disease (moderate or severe)
Multiple organs affected
Lymph node, hepatic and splenic hypertrophy
Cutaneous manifestations, multiple
and are widely distributed throughout the body
Chronic progressive disease/adult form (mild, moderate or severe)
Significant lung involvement
Frequent lesions in the mucous membranes, skin, adrenal glands and others.
Severe
3 or more
1) weight loss greater than 10%
2) severe lung involvement
3) involvement of adrenal glands, central nervous system (CNS) and bones
4) presence of pseudotumoral lymph nodes (diameter >2 cm) in various lymph node chains, located superficially or deeply, with or without suppuration
5) high antibody titers
Residual form
Presence of sequelae originating in previously infected fibrous tissues (lung, adrenal glands and mucous membranes)
Chest imaging findings
Chest x-ray
Interstitial infiltrates
Mixed lesions consisting of nodular and alveolar infiltrates (bilateral, symmetrical and located in the central and lower fields)
High resolution computed tomography
Interlobular septal thickening (88%), peribronchovascular interstitial thickening (78%), intralobular opacities (63%), intralobular lines (59%), ground glass opacities (63%), cavities (17% ) and airspace consolidations (12%), with an “inverted halo sign” in 10% of cases
COCCIDIOIDOMYCOSIS
Pathogenic agent
Coccidioides spp. Especially C. immitis y C. posadasii
Risk factors for infection
Endemic areas, occupations or activities that expose dust, black or Filipino ethnic origin, HIV/AIDS, use of immunosuppressive drugs, receiving organ transplants, diabetes mellitus, pregnancy.
Main symptoms
Pulmonary (7 to 21 days after an exposure)
Similar to bacterial community-acquired pneumonia
Chest pain, cough, and fever
Extrapulmonary
Fever, drenching night sweats, extreme fatigue and weight loss.
Rheumatologic symptoms and cutaneous manifestations
Chest imaging findings
Chest x-ray
Dense and upper lobe parenchymal infiltrates and hilar or mediastinal adenopathy
BIBLIOGRAPHY
Bennett, J., Dolin, R., & Blaser, M. (2021). Enfermedades infecciosas. Principios y práctica (9th ed.). Elsevier .
https://www-clinicalkey-es.bibliotecavirtual.udla.edu.ec/#!/content/book/3-s2.0-B9788491134992003258
Blair, J. E., & Ampel, N. M. (2022). Coccidioidomycosis: Laboratory diagnosis and screening.
https://www-uptodate-com.bibliotecavirtual.udla.edu.ec/contents/coccidioidomycosis-laboratory-diagnosis-and-screening?search=Coccidioidomycosis:%20Laboratory%20diagnosis%20and%20screening&source=search_result&selectedTitle=1~145&usage_type=default&display_rank=1
Centers for Disease Control and Prevention. (2019, January 2). Información para profesionales de la salud sobre la fiebre del valle (coccidioidomicosis). Centers for Disease Control and Prevention.
https://www.cdc.gov/fungal/diseases/coccidioidomycosis/spanish/health-professionals.html#:~:text=Los%20factores%20de%20riesgo%20para,mellitus%2C14%20o%20estar%20embarazada
. Kauffman, C. (2022). Pathogenesis and clinical features of pulmonary histoplasmosis.
https://www-uptodate-com.bibliotecavirtual.udla.edu.ec/contents/pathogenesis-and-clinical-features-of-pulmonary-histoplasmosis?search=histoplasmosis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
Klion, A. (2022). Overview of pulmonary eosinophilia.
https://www-uptodate-com.bibliotecavirtual.udla.edu.ec/contents/overview-of-pulmonary-eosinophilia/print?search=lungIntestinalhelminths&source=…1/68OfficialreprintfromUpToDatewww.uptodate.com
Leder, K., & Weller, P. F. (2021). Paragonimiasis.
https://www-uptodate-com.bibliotecavirtual.udla.edu.ec/contents/paragonimiasis?search=Paragonimiasis&source=search_result&selectedTitle=1~24&usage_type=default&display_rank=1
Maguire, J. H. (2021). Trematodos (esquistosomas y otras especies hepáticas, intestinales y pulmonares).
https://www-clinicalkey-es.bibliotecavirtual.udla.edu.ec/#!/content/book/3-s2.0-B9788491134992002885
Mayo Clinic. (2022, March 24). Histoplasmosis. Mayo Clinic.
https://www.mayoclinic.org/es-es/diseases-conditions/histoplasmosis/symptoms-causes/syc-20373495
Uruburu, M., Granada, M., & Velásquez, L. E. (2008). Distribución parcial de Paragonimus (Digenea: Troglotrematidae) en Antioquia, por presencia de metacercarias en cangrejos dulciacuícolas. In Biomédica (Vol. 28).
http://www.scielo.org.co/pdf/bio/v28n4/v28n4a10.pdf
PULMONARY SCHISTOSOMIASIS
Pathogenic agent
Paragonimus
Risk factors for infection
Consumption of crabs raw and undercooked crabs
Tropical and subtropical countries in Asia, Africa and America
Poverty and cultural aspects
Main symptoms
2 and 15 days after ingestion of metacercariae
Abdominal pain and diarrhoea, followed by fever, chest pain, cough,
urticaria and eosinophilia
North American paragonimiasis
Pleural effusions within 2-12 weeks following ingestion of raw crayfish
Chronicle
Productive cough with brown sputum with intermittent hemoptysis, profuse expectoration, pleuritic pain, dyspnea, chronic cough, various types of chest pain, and hemoptysis
Chest imaging findings
X-rays
Negative or show diffuse infiltration, cysts of about 4 cm in diameter, nodules, calcifications, pleural effusion and pneumothorax
Computed tomography
Nodules, internal mammary and cardiophrenic nodes, pericardial thickening or effusion, linear connections between the nodules and the pleura, and inflammation of the greater omentum
