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Pulmonary Tuberculosis I01:29

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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
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Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
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Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
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Pulmonary Tuberculosis IV01:26

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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Pulmonary Tuberculosis V01:28

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Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
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Pulmonary Tuberculosis III01:31

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Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
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Pulmonary Cryptococcosis in the Immunocompetent Patient-Many Questions, Some Answers.

John F Fisher1, Paula A Valencia-Rey1, William B Davis1

  • 1Medical College of Georgia, Augusta University.

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|October 6, 2016
PubMed
Summary

Pulmonary cryptococcosis in immunocompetent individuals often resolves spontaneously. Negative fungal cultures may not preclude response to treatment, and antigen titers can remain elevated despite disease resolution.

Keywords:
Cryptococcus neoformanscryptococcosispulmonary cryptococcosispulmonary fungal infections

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Area of Science:

  • Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Pulmonary cryptococcosis management in immunocompetent patients lacks prospective data.
  • Current guidelines recommend fluconazole for mild/moderate and amphotericin B plus flucytosine for severe disease.
  • The significance of negative cultures in patients with histological evidence of Cryptococcus neoformans is unclear.

Purpose of the Study:

  • To evaluate the management and outcomes of pulmonary cryptococcosis in immunocompetent patients.
  • To address questions regarding negative cultures, antifungal choices, therapy duration, and disease resolution.
  • To review existing literature on immunocompetent patients with pulmonary cryptococcosis.

Main Methods:

  • Case report and retrospective review of case reports and series over 55 years.
  • Defined "Definite" pulmonary cryptococcosis as clinical/radiographic findings with positive C. neoformans culture.
  • Defined "Probable" pulmonary cryptococcosis as clinical/radiographic findings with histopathologic evidence and negative cultures (with or without positive antigen).

Main Results:

  • Most immunocompetent patients experience resolution of pulmonary cryptococcosis, with or without antifungal therapy.
  • Clinical, radiographic, and serologic resolution is a slow process, potentially taking years.
  • Persistently positive antigen titers are common in untreated patients and may persist despite partial or complete disease resolution.
  • Respiratory fungal cultures are frequently negative, possibly indicating nonviable organisms.

Conclusions:

  • Pulmonary cryptococcosis in immunocompetent hosts often has a benign course.
  • Negative fungal cultures do not necessarily indicate a lack of response to antifungal treatment.
  • Antigen persistence should not be the sole indicator of treatment failure or active infection.