Ball F
Abteilung für Pädiatrische Radiologie, Johann-Wolfgang-Goethe-Universität Frankfurt/Main.
Radiologe. 1990 Jul;30(7):303-9.
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.
在阐述了病理生理机制之后，将讨论支气管肺系统细菌感染和机会性感染在体液、细胞以及先天性和后天性联合免疫缺陷中出现时的放射学症状及鉴别诊断。讨论基于病例报告。体液免疫缺陷会导致支气管肺系统反复发生慢性细菌感染，常伴有支气管扩张。在细胞免疫和联合免疫缺陷的情况下，不仅会发生细菌感染，还会出现非常严重的机会性感染。肺部机会性感染主要由卡氏肺孢子虫、巨细胞病毒以及念珠菌、曲霉菌和毛霉菌等真菌引起。肺孢子虫也是艾滋病患儿肺部机会性感染最常见的病因。与成人情况不同，儿童在典型的机会性感染之前偶尔会出现相对轻度的淋巴细胞性间质性肺炎。由于其相对特征性的表现，儿童的淋巴细胞性间质性肺炎和肺孢子虫肺炎很容易相互区分。另一方面，真菌感染有时会带来严重的诊断问题。还将讨论自身免疫性疾病的胸部放射学表现。
