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Tropical Lungs, Bibliografía: Butrous, G. (2019). Schistosome infection…
Tropical Lungs
Paracoccidiomycoccis
Primary lung Infection
Cough (productive or nonproductive), dyspnea, malaise, fever, and weight loss are common symptoms
Patients with pulmonary fibrosis secondary to paracoccidioidomycosis may present with minimal to no respiratory symptoms.
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Paracoccidioides brasiliensis is the causative agent of paracoccidioidomycosis, a systemic mycosis endemic to Latin America.
Acute-Subacute
Fever and weight loss are seen. Superficial lympgh node involvement is most common in the cervical, axillary, and inguinal regions, and draining, fistulae may develop.
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Pulmonary Schistomiasis
The three main species infecting humans are Schistosoma haematobium, S. japonicum, and S. mansoni.
Risk factors
Hypertension
In one recent observation in patients with pulmonary hypertension due to schistosomiasis, dark pigments were frequently observed adjacent to pulmonary vascular lesions
Hepatic pathology
These pathological changes can be scattered in the liver parenchyma and in periportal spaces, resulting in periportal fibrosis, and the development of “Symmers pipe stem fibrosis”
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Clinical Manifestations
Abdominal pain, diarrhea, and blood in the stool
In advanced cases, hepatosplenomegaly is common and is repeatedly associated with ascites and other signs of portal hypertension.
Chest radiography (pa) showing multiple small pulmonary nodules scattered over both lungs without obvious predilection.
Paragonimiasis
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Clinical manifestation
Early manifestations
During the period of larval migration within the peritonel caviti, some patients experience: fever, malaise, diarrhea, or epigastric pain. Urticaria may also develop
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As migration progresses, symptoms may include:
-Chest pain, dyspnea, cough, and malaise.
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-Radiographic findings associated with pulmonary parenchymal migration consist of trasient, migratory pulmonary infiltrates.
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Late infection
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Malaise may be observed, althoughpatients may not feel or appear ill.
The expectorated material typically has a characteristic chocolate color; it is composed of blood, inflammatory cells, and eggs released when the capsules around mature flukes rupture into a bronchiole
Chest X ray findings
Ring shadow lesions, due to the relative lucency of cystic cavitaties
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Irregular linear streaks, often adjacent to the ring shadow; these represent burrowing tracts of the flukes
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Patchy pulmonary infiltrates nodules, and/or calcifications
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Coccidiomycosis
Valley fever, also called coccidioidomycosis, is an infection caused by the fungus Coccidioides. Coccidioides immitis and coccidioides posadasii.
Clinical Manifestarion
fever, cough, chest pain, chills, sputum production, sore throat, and hemoptysis.
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Histoplasmosis
Histoplasma capsulatum is the etiologic agent of histoplasmosis, a fungal disease that can affect both immunocompromised and immunocompetent individuals.
Clinical Manifestations
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Diseminated Disease
Fever, weight loss, hepatosplenomegaly, hematologic disturbances
Acute pulmonary histoplasmosis: Demonstrates an enlarged right hilar lymph node and right middle lobe infliltrate.
Chronic cavitary histoplasmosis deveplop: productive cough, dyspnea, chest pain, fever, fatigue, weight loss and sweats, fibrotic apical infliltrates with cavitation.
Bibliografía: Butrous, G. (2019). Schistosome infection and its effect on pulmonary circulation. DOI: 10.24542/gcsp.2019.5
