X-ray diagnosis of immunologically induced lung diseases in children and adolescents

After coverage of pathophysiological mechanisms, radiological symptoms and differential diagnosis of bacterial and opportunistic infections of the bronchopulmonary system are discussed as they occur in humoral, cellular and combined congenital and acquired immune deficiencies. The discussion is based on case reports. Humoral deficiencies cause recurrent and chronic bacterial infections of the bronchopulmonary system, frequently with bronchiectasis. In the case of cellular and combined immune deficiencies, not only bacterial infections but also the very serious opportunistic infections occur. Opportunistic infections of the lung are predominantly caused by Pneumocystis carinii, by the cytomegaly virus, and by fungi such as Candida, Aspergillus and Mucor. Pneumocystis is also the most frequent cause of opportunistic infections of the lungs in children with AIDS. In contrast to the situation in adults, in children a relatively low-grade lymphocytic interstitial pneumonitis occasionally precedes the typical opportunistic infections. Lymphocytic interstitial pneumonitis and Pneumocystis pneumonia can be differentiated from each other easily in children because of their relatively characteristic appearances. Fungal infections, on the other hand, sometimes pose severe diagnostic problems. Radiological chest findings in autoimmune diseases are discussed.     

Military women's risk factors for and symptoms of genitourinary infections during deployment

Symptoms of vaginitis and urinary tract infections are miserable, distracting, and significantly affect women's quality of life. Among civilian women, these symptoms account for 10.5 million office visits per year. To examine the scope of the problem for military women during deployment situations, surveys were sent to randomly selected Army and Navy units. Of 841 women who completed the anonymous survey and had been deployed, vaginal infections were experienced by 30.1% and urinary tract infections by 18.4% of them during deployment. Vaginal symptoms were consistent with symptoms associated with the three most common vaginal infections (candida, bacterial, and trichomonas vaginitis). A variety of risk factors, both behavioral and situational, significantly differentiated women with and without infections. Urinary tract infections and vaginal infections are common during deployment situations where resources for self-care and appropriate primary health care for women are scarce or unavailable. One solution is a self-diagnosis and treatment kit for deployed military women.     

Bacterial dermatoses in sports

Bacterial skin dermatoses are common in athletes, and it is the role of team physicians to be able to recognize and treat such problems. Despite the skin's role as an efficient barrier, a moist environment coupled with frequent skin trauma and contact by athletes with equipment and other players predispose to acquiring infections. In the past 10 years, there has been a dramatic rise in methicillin-resistant Staphylococcus aureus (MRSA) infections. This article discusses community-acquired MRSA infections among athletes and focuses on the recognition of, management of, and return-to-play guidelines for common bacterial skin infections in athletes. Some of the more unusual bacterial infections that may present in this population are also reviewed.     

Susceptibility to infections in elite athletes: the S-curve

The susceptibility to upper respiratory tract infections (URTIs) after physical exercise has been described with a J-shaped curve, suggesting protection from infections with moderate exercise and increased risk for URTI's in elite athletes. Several factors such as time of inoculation, previous infections, pathogen exposure, other stressors than exercise etc. can influence infection outcome. Observed infections in athletes can, therefore, be either the result of increased susceptibility to a novel pathogen, or more severe symptoms of an already established infection. Moreover, the definitions of "strenuous" exercise and "elite" athletes are equivocal, making comparisons between studies difficult. Because absence of infections is inevitable to become and maintain status as an elite athlete, it is suggested that there is an S-shaped relationship between exercise load and risk of infections. To become an elite athlete one has to possess state-of-the-art physique, including an immune system able to withstand infections even during severe physiological and psychological stress.     

Borne identity: CT imaging of vascular infections

Vascular infections present in a multitude of ways with computed tomography (CT) aiding in the diagnosis of many of the uncommon vascular infections, which are equally dangerous and carry severe life-threatening consequences if untreated from a delay in diagnosis. This pictorial review aims to discuss and illustrate the CT findings of the following vascular infections including aortitis, mycotic aneurysms, infective endocarditis, septic thrombophlebitis in the chest and abdomen, and Kawasaki disease. Recognition and prompt diagnosis of these uncommon vascular infections are critical to the initiation of the appropriate management and therapy.     

Technetium-99m labelled fluconazole and antimicrobial peptides for imaging of Candida albicans and Aspergillus fumigatus infections

The aim of this study was to investigate whether technetium-99m labelled fluconazole can distinguish fungal from bacterial infections. Fluconazole was labelled with (99m)Tc and radiochemical analysis showed less than 5% impurities. The labelling solution was injected into animals with experimental infections. For comparison, we used two peptides for infection detection, i.e. UBI 29-41 and hLF 1-11, and human IgG, all labelled with (99m)Tc. Mice were infected with Candida albicans or injected with heat-killed C. albicans or lipopolysaccharides to induce sterile inflammation. Also, mice were infected with Staphylococcus aureus or Klebsiella pneumoniae. Next, accumulation of (99m)Tc-fluconazole and (99m)Tc-labelled peptides/IgG at affected sites was determined scintigraphically. (99m)Tc-fluconazole detected C. albicans infections (T/NT ratio=3.6+/-0.47) without visualising bacterial infections (T/NT ratio=1.3+/-0.04) or sterile inflammatory processes (heat-killed C. albicans: T/NT ratio=1.3+/-0.2; lipopolysaccharide: T/NT ratio=1.4+/-0.1). C. albicans infections were already seen within the first hour after injection of (99m)Tc-fluconazole (T/NT ratio=3.1+/-0.2). A good correlation (R(2)=0.864; P<0.05) between T/NT ratios for this tracer and the number of viable C. albicans was found. Although (99m)Tc-UBI 29-41 and (99m)Tc-hLF 1-11 were able to distinguish C. albicans infections from sterile inflammatory processes in mice, these (99m)Tc-labelled peptides did not distinguish these fungal infections from bacterial infections. It is concluded that (99m)Tc-fluconazole distinguishes infections with C. albicans from bacterial infections and sterile inflammations.     

Infection and the elite athlete: a review

Light to moderate exercise has been associated with an increase in immune function and reduced risk of infectious diseases. Conversely, heavy exercise has been implicated in suppression of many immune parameters and a concomitant increased risk of infectious diseases. Infections can result in lost training time and negatively affect the performance of the elite athlete. Exercising during an infection can also increase the risk of secondary complications, such as viral myocarditis and post-viral fatigue syndrome. In addition to immunosuppression, other factors responsible for increased infection rates among athletes are close bodily contact with other people during training and competition, and environmental factors during the pursuit of sporting activities that increase exposure to pathogens. Although there is a generally higher risk of infection among athletes compared to the general population, some sports are associated with a particularly high risk for certain infections. These are skin infections in rugby and wrestling, infections of the foot in long-distance runners, and ear infections in those involved in water sports. Upper respiratory tract infections are the most frequently reported disability among all athletes and are the cause of more lost training days than all other infections put together. Transmission of blood-borne pathogens, although very uncommon in the athletic setting, are the cause of the most serious infections an athlete may develop. When considering the negative impact of infections on performance, it seems prudent that athletes use interventions to decrease the immunosuppressive effects of heavy exercise, and to minimize exposure to pathogens as far as practically possible. Management of the infected athlete is especially important if there is to be a speedy return to full training, and if the incidence of a relapse or secondary complications are to be minimized.     

Immune Function in Adolescent Tennis Athletes and Controls

Light to moderate exercise has been associated with an increase in immune function and reduced risk of infectious diseases. Conversely, heavy exercise has been implicated in suppression of many immune parameters and a concomitant increased risk of infectious diseases. Infections can result in lost training time and negatively affect the performance of the elite athlete. Exercising during an infection can also increase the risk of secondary complications, such as viral myocarditis and post-viral fatigue syndrome. In addition to immunosuppression, other factors responsible for increased infection rates among athletes are close bodily contact with other people during training and competition, and environmental factors during the pursuit of sporting activities that increase exposure to pathogens. Although there is a generally higher risk of infection among athletes compared to the general population, some sports are associated with a particularly high risk for certain infections. These are skin infections in rugby and wrestling, infections of the foot in long-distance runners, and ear infections in those involved in water sports. Upper respiratory tract infections are the most frequently reported disability among all athletes and are the cause of more lost training days than all other infections put together. Transmission of blood-borne pathogens, although very uncommon in the athletic setting, are the cause of the most serious infections an athlete may develop. When considering the negative impact of infections on performance, it seems prudent that athletes use interventions to decrease the immunosuppressive effects of heavy exercise, and to minimize exposure to pathogens as far as practically possible. Management of the infected athlete is especially important if there is to be a speedy return to full training, and if the incidence of a relapse or secondary complications are to be minimized.     

Infection control in the department of nuclear medicine

Concern about the spread of infections in the hospital setting has prompted regulatory agencies to mandate infection control standards. Each hospital department is required to have written policies and procedures which describe measures to prevent and control the spread of nosocomial infections (hospital acquired infections), along with quality assurance programs to assure that procedures are followed. The Department of Nuclear Medicine, as other departments, should have procedures which address special precautions for the prevention of nosocomial infections. This article will focus on a new approach to prevent nosocomial infections, guidelines for handling patients and contaminated equipment, and the importance of quality assurance activities to monitor compliance to established standards. An opening discussion on the routes of transmission, and factors necessary for transmission of infection, will serve as a review to assist with understanding the concept for handling the hospitalized patient in a Nuclear Medicine setting.     

脂筏与病毒感染的相关性研究进展

脂筏（lipid raft）是细胞膜上的微结构域,参与细胞的多种生物学行为。脂筏在病毒感染中也具有重要作用,脂筏与病毒感染的相关性研究为阐明病毒与宿主细胞的相互作用机制和病毒感染的防治提供了新思路。本文综述了脂筏与病毒感染相关性研究的方法和进展。     

某部队医院2013-2018年真菌血流感染菌种分布和耐药性分析

 目的 调查医院真菌血流感染状况,为真菌血流感染的预防和治疗提供参考。方法 对某部队医院2013-2018年真菌血流感染的检测结果进行回顾性分析,对感染真菌种类、科室分布及耐药性状况进行分析。结果 共分离真菌血流感染菌株97株, 30.93%为白色念珠菌,但由2013年的41.67%,下降至2018年的27.78%,呈现下降趋势。真菌血流感染的主要科室为血液科(24.74%)和重症医学科(22.68%)。97株真菌对4种抗菌药物的敏感率:氟胞嘧啶97.80%、伏立康唑97.80%、氟康唑93.30%、伊曲康唑71.10%。结论 血流感染真菌以白色念珠菌为主,但非白色念珠菌感染有上升趋势;提高患者免疫力,减少有创性检查和治疗是减少真菌血流感染的重要环节;三唑类药是抗真菌药的主力军,在治疗过程中需要检测其耐药性的变化。     

Infections and infestations of the gastrointestinal tract. Part 2: parasitic and other infections

The purpose of this article is to provide a comprehensive review of the imaging findings of various parasitic infestations and other miscellaneous infections affecting the gastrointestinal tract. Barium examinations play an important role in the diagnostic workup of parasitic intestinal infections. Knowledge of differential diagnosis, sites of involvement, and imaging features of different infections and infestations can help in accurate diagnosis and guide treatment.     

Infectious disease and the extreme sport athlete

Extreme sport competition often takes place in locations that may harbor atypical diseases. This article discusses infections that may be more likely to occur in the extreme sport athlete, such as selected parasitic infections, marine infections, freshwater-borne diseases, tick-borne disease, and zoonoses. Epidemiology, presentation, treatment, complications, and return-to-sport issues are discussed for each of these diseases.     

Osteomyelitis: clinical update for practical guidelines

Bone infections represent a diagnostic or therapeutic challenge for the infectivologist, orthopaedic surgeon, radiologist and nuclear medicine physician. Staphylococcus aureus is the major bacterium responsible for bone infections although Mycobacterium tuberculosis is emerging as an infectious agent in Italy because of immigration from Africa and Asia. Osteomyelitis requires long and expensive antibiotic treatment, including rifampicin administered parenterally for several weeks and the use of antimicrobial-impregnated cement in prosthesis substitution. Sometimes it is necessary to carry out surgical debridement of a necrotic bone or the consolidation of compromised bones and joint prosthesis implants. Radiographs and bone cultures are mainstays for the diagnosis of bone infections but are often useless in the lengthy management of these patients. Diagnosis of skeletal infections still includes conventional radiography but magnetic resonance imaging is essential in haematogenous and spinal infections. Bone scans are still useful in acute osteomyelitis whereas scintigraphy using labelled white blood cells is preferred in infections of peripheral bone segments or joint prosthesis. In the axial skeleton a combination of an agent for detecting inflammation ((67)Ga citrate) and a metabolic agent ((99m)Tc-methylene diphosphonate) enables an infection and an area of increased metabolic activity to be distinguished. [(18)F]Fluorodeoxyglucose positron emission tomography, where available, has a significant impact in the study of infections using radionuclides: high-resolution tomographic images represent an effective alternative to gallium in the assessment of inflammation of spine lesions but a comparison with morphological examinations (computed tomography or magnetic resonance imaging) is essential.     

Infections and infestations of the gastrointestinal tract. Part 1: bacterial, viral and fungal infections

The purpose of this article is to review the imaging findings of various infections affecting the gastrointestinal tract. Barium examinations, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography all play an important role in the diagnostic workup of gastrointestinal tract infections. Knowledge of differential diagnosis, sites of involvement, and typical imaging features of different infections can help in accurate diagnosis and guide treatment.     

Cutaneous fungal and viral infections in athletes

Fungal and viral cutaneous infections are common among athletes and can develop quickly into widespread outbreaks. To prevent such outbreaks, the team physician must be familiar with common cutaneous infections including tinea corporis, tinea capitis, tinea pedis, herpes simplex, molluscum contagiosum, and human papillomaviruses. Appropriate treatment and management of these infections allows the athlete to safely return to play and safeguards teammates and opponents against the spread of these diseases.     

Computed tomography of cervical infections

Computed tomography of 31 patients with infections of the face and neck was reviewed and correlated with the clinical and surgical results. Computed tomography was found to be valuable for (a) distinguishing cellulitis from abscess, (b) defining the precise location and extent of complex infections, (c) demonstrating secondary complications, and (d) occasionally suggesting the etiology of infection. Based on this review, we concluded that CT provides important diagnostic information that aids clinical assessment and guides medical and surgical management of cervical infections. The anatomic relationships of selected cervical spaces are reviewed with respect to pathways of spread and potential complications of cervical infections.     

Training, injuries and infections among elite orienteers

Three years of registration of training, injuries, infections and stretching behaviour among national class orienteers is presented. Twenty-three runners were included for a 1- to 3-year period. Twenty-eight male-years and 27 female-years were analysed. A total of 219 injuries and infections were registered: 55 (25%) acute injuries, 71 (32%) overuse injuries and 93 (42%) infections. Overuse injuries were found to be the major problem, as these injuries affected training for an average of 35 days per runner per year, compared with 7 days caused by acute injuries and 10 days caused by infections. The acute injuries were mainly direct traumas and ankle distorsions. Overuse injuries affecting die knee region were the most numerous, but rear foot injuries affected training the most. An increase in training load was found in the last weeks before overuse injuries and infections. Stretching could not be found to prevent injuries.     

Nosocomial infections in the intensive care units

BACKGROUND/AIM: The risk for nosocomial infections (NIs) is 5-10 times higher in patients hospitalized in the Intensive Care Units (ICUs) than in patients staying in other wards. The higher incidence rates of NIs in the ICUs may be explained by the fact that the patients in the ICUs have more severe underlying disease, and are exposed to the invasive diagnostic and therapeutical procedures. The unreasonable use of antibiotics leads to the selection of multiresistant agents, which have been increasingly recorded as the NIs causative agents. The aim of this study was to investigate the characteristics of NIs in the ICUs in the period January-June 2005. METHODS: The study of incidence was performed in accordance with the methodology of the Centers for Diseases and Prevention. Any infections in the patients hospitalized in the ICUs in the period from January to June 2005 were registered. The results both from medical documentation and from the direct contacts with the medical personnel were analyzed. The samples were tested using standard methods in the microbiological laboratory. RESULTS: The incidence rates of NIs patients ranged from 1.5 to 40.8, and the incidence rates of infections were 1.5 to 65.6 per 1 000 patient's days. Out of the total number of NIs, urinary infections accounted for 44.6%, blood infections for 37.6%, and surgical site infections for 16.9%. CONCLUSION: The most frequent cause of nosocomial urinary infections was Klebsiella, of nosocomial sepsis--coagulase--negative staphylococci, and of surgical site infections--Staphylococcus aureus.