1) Discuss spectrum of immunocompromised hosts and infections associated with specific immune deficits. 2) To review clinical presentation, and imaging findings of pulmonary infections with emphasis on immunocompromised hosts. 3) Review imaging signs in infections. 4) Review the role of percutaneous sampling especially in tissue invasive infections where bronchoscopy and bronchial lavage may have low yield. 5) Discuss revised EORTC/MSG criteria for diagnosis of invasive fungal infections. 6) Emphasize diagnostic conundrums such as presence of multiple infectious processes, mimics of infection and immune reconstitution inflammatory syndrome (IRIS). 7) Use case scenarios to illustrate formulation of differential diagnosis by combining clinical, serological data with imaging findings.
Infections are the most common pulmonary complications in immunocompromised patients and lung is the most frequently affected site of tissue invasive infection.
It is imperative to adopt an aggressive approach to getting specific microbiologic diagnosis. Early cross sectional imaging with CT allows narrowing of differential diagnosis using radiological features and gives clues about the mechanism of spread, possible organism, burden of disease and guides subsequent invasive procedures such as lung biopsy. Imaging signs must be applied with caution and it is important to consider non-infectious etiologies.
Pursuit of a unifying diagnosis is not always possible. Multiple infections may co-exist in a single organ.
The radiologist must take on the role of an image guided clinician and combine clinical, serological and microbiological data with imaging features in making a diagnosis.
Madan, R,
Imaging of Thoracic Infections: What's New?. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/14000740.html
