Tag Archives: pulmonary medicine

VA Resident Report: Where in the lungs are you most likely to find coccidioidomycosis?

The Bottom Line: About 5 percent of infected people have asymptomatic residua in their lungs, usually nodules or thin-walled cavities. In endemic areas, prior C. immitis infection is frequently diagnosed when a lung nodule is resected because of suspected carcinoma. … Continue reading

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VA Resident Report: Review of Allergic Bronchopulmonary Aspergillosis

In susceptible individuals, inhalation of Aspergillus spores can affect the respiratory tract  in many ways. These spores get trapped in the viscid sputumof asthmatic subjects which triggers a cascade of inflammatory reactions that can result in Aspergillus-induced asthma, allergic bronchopulmonary aspergillosis, … Continue reading

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EUHM Resident Report: What percentage of patients with no risk factors are diagnosed with tuberculosis?

For people with TB infection, no risk factors, and no treatment, the risk is about 5% in the first 2 years after infection and about 10% over a lifetime. Figure 2.5 Risk of Developing TB Disease Chapter 2. Page 32 … Continue reading

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VA Resident Report: What is the relationship between legionella and cavitary lung lesions?

Cavitary legionella pneumonia is an uncommon finding in immunocompetent patients, and has been commonly reported in immunosuppressed patients. In this study, this is almost identical to the authors’ finding of cavitary consolidation in 4 patients treated with high-dose steroid therapy. … Continue reading

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VA Resident Report: What is the etiology and therapy options for Postobstructive community-acquired pneumonia?

The Bottom Line: This study encourages more limited antibiotic use in patients with PO-CAP. Our experience has been that when patients fail to respond to a first course of antibiotics, physicians repeat sputum cultures, which now are contaminated with newly … Continue reading

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VA Resident Report: When to use antibiotices for post-obstructive pneumonia?

Post-obstructive pneumonia is usually the result of proximal airway obstruction with distal infection of the lung parenchyma. Since normal drainage mechanisms are impeded, the infection is usually slow to resolve. Poor drainage secondary to the obstruction, compounded by resistant bacteria … Continue reading

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EUH Resident Report: Gastric AFB

The Bottom Line: AFB smear of GA is a relatively insensitive but highly specific indicator of pulmonary tuberculosis warranting institution of antituberculosis treatment. Gastric AFB smear positivity appears to reflect a high bacillary burden within the respiratory tract. Reference: Bahammam … Continue reading

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