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急性Q热肺炎:6例患者的高分辨率计算机断层扫描结果

Acute Q fever pneumonia: high-resolution computed tomographic findings in six patients.

作者信息

von Ranke Felipe Mussi, Clemente Pessoa Fernanda Miraldi, Afonso Felipe Batista, Gomes Josiani Bastos, Borghi Danielle Provençano, Alves de Melo Alessandro Severo, Marchiori Edson

机构信息

1 Department of Radiology, Fluminense Federal University , Rio de Janeiro , Brazil.

2 Department of Radiology, Federal University of Rio de Janeiro , Rio de Janeiro , Brazil.

出版信息

Br J Radiol. 2019 Mar;92(1095):20180292. doi: 10.1259/bjr.20180292. Epub 2019 Jan 4.

Abstract

METHODS

: We analyzed high-resolution CT (HRCT) findings from six male patients (mean age, 22.6 years) with confirmed diagnoses of acute Q fever. Two chest radiologists analyzed the images and reached decisions by consensus. All patients presented fever, myalgia, prostation, headache, and dry cough. They also had common epidemiologic factors (recent travel for military service, where they had contact with sheep and capybara). Diagnoses were confirmed by the detection of C. burnetii DNA in clinical samples by polymerase chain reaction.

RESULTS

: The predominant HRCT findings were areas of consolidation (100%) and nodules (66.6%) with halos of ground-glass opacity, predominantly with segmental and peripheral distributions. Lesions affected all lobes, and predominated in the left upper and lower lobes. Involvement of more than one lobe was observed in four patients. No pleural effusion or lymph node enlargement was found.

CONCLUSION

: The predominant HRCT findings in patients with acute Q fever pneumonia were bilateral, peripheral areas of consolidation and nodules with irregular contours and halos of ground-glass opacity.

ADVANCES IN KNOWLEDGE

: Acute Q fever should be included in the differential diagnosis of lesions with the halo sign on HRCT.

摘要

方法

我们分析了6例确诊为急性Q热的男性患者(平均年龄22.6岁)的高分辨率CT(HRCT)结果。两名胸部放射科医生分析图像并通过共识做出诊断。所有患者均出现发热、肌痛、乏力、头痛和干咳。他们还有共同的流行病学因素(近期因服兵役出行,在当地接触过绵羊和水豚)。通过聚合酶链反应检测临床样本中的伯氏考克斯体DNA确诊。

结果

HRCT的主要表现为实变区(100%)和结节(66.6%),伴有磨玻璃样密度影晕,主要呈节段性和外周分布。病变累及所有肺叶,以上叶和下叶为主。4例患者累及一个以上肺叶。未发现胸腔积液或淋巴结肿大。

结论

急性Q热肺炎患者HRCT的主要表现为双侧、外周实变区和轮廓不规则且伴有磨玻璃样密度影晕的结节。

知识进展

急性Q热应纳入HRCT上有晕征病变的鉴别诊断。

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