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Necrotizing Alveolitis
Alveolitis Necrotising

Presentation

[…] secondary to inhaled allergens Alternate/Historical Names Extrinsic allergic alveolitis (equvalent term) Many allergen specific names, a few of which are: Bird fancier's lung Farmer's lung Hot tub lung Humidifier lung Diagnostic Criteria Clinical May present [surgpathcriteria.stanford.edu]

Antigen present in blood vessel walls, syncytial cell (arrow). Scale bars = 50 µm. [figshare.com]

EST Thursday, Oct. 21 with the exception of research findings presented at IDSA press conferences. [idsa.confex.com]

[…] obliterans Infectious pneumonia – especially M. tuberculosis Usual interstitial pneumonia Desquamative interstitial pneumonia Nonspecific interstitial pneumonia Drug-induced pneumonitis Chronic presentation Nonspecific interstitial pneumonia Unusual [arupconsult.com]

The necrotic exudate that is present in the bronchi and to a lesser extent in the bronchioles is likely associated with coinfection with Mycoplasma bovis. [askjpc.org]

Entire Body System

  • Asymptomatic

    […] phagocytes Tuberculosis and Histoplasmosis Centroalveolar foamy eosinophilic exudate (does not invade lung tissue) Spherule containing yeast and granulomatous multinucleate giant cell response Broad-based budding, double contour walls Symptoms vary from asymptomatic [quizlet.com]

    Disease characteristics: This disease can be asymptomatic. Clinical signs can present as conjunctivitis, respiratory infections, and diarrhea. Pancreatitis has been noted in rhesus monkeys. Severe infections can develop in immunodeficient animals. [vetbook.org]

    Patients may have symptoms of dysphagia, throat pain or fullness, or exertional dyspnoea, but many are asymptomatic until significant obstruction occurs [ 60 ]. [err.ersjournals.com]

    It may be asymptomatic and be detected after CXR in patients with pre-existing cavitating lung disease. It may affect HIV-positive patients with a history of Pneumocystis jirovecii pneumonia. [patient.info]

    All smokers have various degrees of respiratory bronchiolitis, but it is usually asymptomatic. [radiologyassistant.nl]

  • Congestive Heart Failure

    Patients may have cardiac involvement most often in the form of rhythm disturbances. 2 More rarely, they may experience conduction abnormalities, pericarditis, myocarditis, cardiac arrest, and congestive heart failure. 2,3 All of the preceding are often [clinicaladvisor.com]

  • Metal Worker

    Coates EO, Watson JHL: Diffuse interstitial lung disease in tungsten carbide workers. Ann Intern Med 1971;75:709–716. Fischbein A, Luo J-CJ, Solomon SJ, Horowitz S, Hailoo W, Miller A: Clinical findings among hard metal workers. [karger.com]

Respiratoric

  • Sputum

    Diagnosis requires the demonstration of fungal hyphae in sputum/biopsy/BAL fluid. Management Early administration of voriconazole or itraconazole. [patient.info]

    Voriconazole or Posaconazole or Fluconazole In immunocompromized: Amphotericin B then Itraconazole Symptoms: asymptomatic respiratory illness, however up to 50% of patients will have cough, chest pain, sputum production, fever - CXR: can show lobar consolidation [quizlet.com]

    Search for Legionella and pneumococcal urinary antigen and sputum staining for Mycobacterium Tubercolosis were negative. A bronchoscopy revealed diffuse alveolar hemorrhage. [clinicalcasereports.jacobspublishers.com]

  • Rales

    Preliminary lung findings were inspiratory rales in both basal areas, decreased diffusion capacity and a radiological picture resembling sarcoidosis. A high-resolution computed tomography scan indicated patchy alveolitis as well. [karger.com]

    […] serum precipitin test, or BAL antibody X-ray or HRCT of chest showing changes consistent with HP BAL lymphocytosis (usually >40%) Histopathological changes on lung biopsy consistent with HP Positive inhalation provocation test Minor criteria Bibasilar rales [arupconsult.com]

  • Pulmonary Disorder

    Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, represents a group of pulmonary disorders mediated by an inflammatory reaction to inhalation of an allergen. [radiopaedia.org]

  • Sneezing

    […] of previously developing a dry socket with past extractions and inadequate oral hygiene. [3] [4] [8] Other factors in the postoperative period that may lead to loss of the blood clot include forceful spitting, sucking through a straw, and coughing or sneezing [en.wikipedia.org]

Musculoskeletal

  • Muscle Weakness

    The combined incidence of polymyositis and dermatomyositis is 4 to 10 cases per million population per year. 2 The idiopathic inflammatory myopathies share common features, including proximal muscle weakness, elevated muscle enzymes (creatinine phosphokinase [clinicaladvisor.com]

    This patient had a rash and muscle weakness. Scroll through the images. The predominant finding is ground glass opacity (GGO). [radiologyassistant.nl]

Workup

Microbiology

  • Staphylococcus Aureus

    Lobar pneumonia is classically due to Hemorrhagic, necrotizing, and abscessing Staphylococcus aureus pneumonia Hemorrhagic, necrotizing, and infarcting Pseudomonas aeruginosa pneumonia Acute non-necrotizing alveolitis and early infiltration by macrophages [quizlet.com]

    Pulmonary Alveolar Proteinosis Intra-alveolar lipoproteinaceous material Also defective macrophage function leading to superinfection, notably Nocardia, Staphylococcus aureus, Mycobacterium. Dx: BAL or lung biopsy. Rx: Whole lung lavage. [lumen.luc.edu]

  • Streptococcus Pneumoniae

    Streptococcus pneumoniae, Klebsiella, Haemophilus influenza Non-nectrotizing lymphocytic interstitial pneumonia; "ground glass" infiltrate on radiology Viral and mycoplasma pneumonia Septate hyphae with acute-angle branching Poorly staining on H&E, translucent [quizlet.com]

Treatment

Amphotericin may be used if initial treatment fails. [ 16 ] Echinocandin derivatives such as caspofungin, micafungin and anidulafungin are effective agents in the treatment of invasive pulmonary aspergillosis (IPA) refractory to standard treatment, or [patient.info]

[…] and immunoglobulin treatment (400 mg/Kg IV). [clinicalcasereports.jacobspublishers.com]

However, rheumatoid nodules have, at times, been noted to paradoxically enlarge with rheumatoid arthritis treatment, in particular, this has been observed with methotrexate treatment [ 76 ]. [err.ersjournals.com]

Along with a focus on the viruses themselves, it addresses the diseases they cause, current treatments and preventive measures. [books.google.com]

Prognosis

[…] azithromycin or levofloxacin What is the prognosis of mycoplasma? most recover with no sequelae [brainscape.com]

However, when smokers do develop hypersensitivity pneumonitis, it is more commonly fibrosing disease with a worse prognosis 10. [radiopaedia.org]

Prognosis CNPA has a significant mortality of up to 40%, even if promptly recognised and treated. It is easy to miss and, in such cases, carries a worse prognosis. [patient.info]

Centrilobular accentuation of peribronchiolar fibrosis is very suggestive of hypersensitivity pneumonitis Surrounds and may occlude bronchiole Fibrosis may bridge from centrilobular to peripheral zones Fibrosis is generally not reversible and imparts a poor prognosis [surgpathcriteria.stanford.edu]

[…] in response to inhalation of organic antigens • Higher prevalence in farmers, animal breeders, and agricultural industries • Mainly affect Adults (50 – 60 years) • 95% of HP cases occur in nonsmokers – Smoking is related to lower prevalence but worse prognosis [slideshare.net]

Etiology

Clues to these other etiologies are often apparent in the history. [clinicaladvisor.com]

Specific etiology Drug induced: nitrofurantoin Parasite: strongyloides, pulm. larva nigrans, tropical pulm. eosinophilia, histosomiases Fungus: hypersensitivity bronchopulm. aspergillosis, bronchocentric granulomatosis C. [enotes.tripod.com]

However, sarcoidosis does not have such well defined etiology as extrinsic allergic alveolitis. [journalpulmonology.org]

From these observations, it seems reasonable to consider that Wegeners granulomatosis begins as a progressive granulomatous inflammation of unknown etiology at one or more levels in the respiratory tract. [dokumen.tips]

Bronchiolitis obliterans of unknown etiology Bronchiolitis Obliterans and Organizing Pneumonia Also known as BOOP. Steroids effective. [lumen.luc.edu]

Epidemiology

It presents the latest concepts, methods and technologies in epidemiology, detection, investigation, modeling and intervention. [books.google.com]

Aspergilloma Epidemiology Aspergilloma has a variable prevalence depending on the amount of cavitating lung disease affecting a population. [patient.info]

Nature, Epidemiology, genetic diversity, and association of canine circovirus infection in dogs with respiratory disease | Scientific Reports [lalanguefrancaise.com]

Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]

Chronic presentation Nonspecific interstitial pneumonia Unusual interstitial pneumonia Bronchiolitis obliterans Chronic obstructive pulmonary disease (COPD) Idiopathic pulmonary fibrosis Sarcoidosis Asthma Silicosis Drug-induced pneumonitis Background Epidemiology [arupconsult.com]

Pathophysiology

[…] pneumothorax and passed away .Pneumothoracies occurred at a high frequency, were not readily explained by barotrauma, and were associated with adverse outcome Methods: This prompted us to perform limited cardiopulmonary autopsies to better understand the pathophysiological [idsa.confex.com]

[…] s lung, paprika slicer’s lung, wine maker’s lung, tobacco grower’s lung Animal proteins Pituitary snuff taker’s lung, pigeon breeder's lung, bird fancier’s disease, furrier’s lung, poultry worker's lung Chemicals Bathtub finisher's lung, Coptic lung Pathophysiology [arupconsult.com]

From a pathophysiological point of view HP with DAH is most likely due to immune complex mediated necrotizing alveolitis and bronchiolitis. [clinicalcasereports.jacobspublishers.com]

Pathophysiology In a healthy, immunocompetent individual, macrophages and neutrophils normally defend against the inhaled fungus. [patient.info]

Prevention

Along with a focus on the viruses themselves, it addresses the diseases they cause, current treatments and preventive measures. [books.google.com]

Therefore, cold fluids and foods are encouraged, which facilitate clot formation and prevent its disintegration. Avoiding smoking. [en.wikipedia.org]

Prevention: Quarantine new animals, minimize overcrowding, provide good sanitation. References ↑ Mansfield KG, King N. (1998) Viral Diseases In: Bennett B, Abee CR,Henrickson RV, eds. Nonhuman Primates in Biomedical Research: Diseases. [vetbook.org]

Management Due to its high morbidity and mortality, prevention in susceptible patients is always better (see below). [patient.info]

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