Posts Tagged ‘Lung

Typoxemia is a common occurrence in patients with asthma, a fact attributed to ventilation-perfusion (Va/Q) inequality secondary to uneven airway narrowing. Recent studies measuring continuous distributions of Va/Q ratios have detected considerable blood flow perfusing areas in the lung which have low Va/Q ratios. Uneven distribution of ventilation is undoubtedly a major factor causing Va/Q […]

BAL is a procedure considered to have a low incidence of complications and has not been associated with pneumothorax in patients with interstitial lung disease. The pathophysiology of BAL-induced pneumothorax is not clear, but presumably is related to the associated airway obstruction, with impaired pressure equilibration of entrapped intra-alveolar gases, interstitial dissection of air, and, […]

Fiberoptic bronchoscopy (FOB) is associated with various complications, including cough, bronchospasm, and hypoxia. Pneumothorax has been known to occur following FOB when transbronchial, brush, or endobronchial biopsies are performed. Complications associated with bronchoal-veolar lavage (BAL) include fever, pneumonitis, bleeding, stridor, and bronchospasm. Use of FOB with BAL alone has, to our knowledge, not been reported […]

Aspergillus spores are ubiquitous and are the most frequently found fungus in the environment. Increased concentrations of spores have been noted in winter months. Pathogenicity of the Aspergillus species has to do with properties of the spores; namely their light weight, thick walls and small size which allow for their growth in terminal bronchioles. Host […]

Invasive aspergillosis has become a significant cause of death in immunosuppressed patients. Patients with acute leukemia and lymphoma are particularly susceptible. Postulated risk factors include granulocytopenia, and treatment with corticosteroids, antibiotics and cytotoxic chemotherapy. Qualitative disorders of granulocyte function described in acute leukemia may also increase the risk of Aspergillus infection. Because Aspergillus species are […]

Prospective studies with stringent criteria for determination of diagnostic yield for any pulmonary procedure are difficult to design. These studies would clearly identify whether histology, autopsy, other cultures, or clinical outcome confirmed the pulmonary isolate. There are many situations for which the latter choice is appropriate, but these merit a separate category when diagnostic yield […]

As leukemia progresses and becomes refractory to treatment, the autopsy diagnosis is more often blood, edema, fibrosis, or the primary disease process rather than a specific infectious pathogen. Since OLB and autopsy do not provide a specific diagnosis in at least 20 percent of some subsets, including leukemia, we should not expect BAL and other […]