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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.
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Restaging Pulmonary Schistosomiasis.

Federico Gobbi1, Dora Buonfrate1, Andrea Angheben1

  • 1Department of Infectious-Tropical Diseases and Microbiology, IRCCS-Sacro Cuore Don Calabria Hospital, Verona, Italy.

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Schistosomiasis lung involvement may include an early chronic phase, distinct from acute and late chronic stages. This phase involves female worms transiting the lungs, causing visible nodules that can resolve spontaneously.

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Area of Science:

  • Parasitology
  • Infectious Diseases
  • Radiology

Background:

  • Schistosomiasis is traditionally divided into acute and chronic phases, with lung involvement observed in both.
  • Pulmonary lesions in chronic schistosomiasis have been documented via CT scans, showing resolution post-treatment.
  • Spontaneous resolution of pulmonary nodules in schistosomiasis cases has also been reported.

Observation:

  • Seven cases of pulmonary lesions in African immigrants with chronic schistosomiasis showed complete resolution after praziquantel treatment.
  • One case demonstrated spontaneous disappearance of a pulmonary nodule before treatment.
  • Observed pulmonary nodules presented as well-defined or ground glass opacities, similar to those in the acute phase.

Findings:

  • A postulate for an 'early chronic phase' of schistosomiasis involving the lungs is proposed, exhibiting similarities to the acute phase.
  • Hypothesis: Female worms transit the lungs during the 'early chronic phase,' potentially laying eggs and causing transient, radiologically visible alterations.
  • The pathophysiology of late chronic schistosomiasis lung lesions likely differs, involving egg migration via portal-caval shunting.

Implications:

  • Pulmonary involvement may represent a distinct phase in the natural history of Schistosoma mansoni and Schistosoma haematobium infections.
  • Recognition of an 'early chronic phase' could refine understanding and diagnosis of schistosomiasis-related lung disease.
  • Further research is warranted to elucidate the distinct pathophysiological mechanisms of lung lesions across different schistosomiasis phases.