Coccidioidomycosis is a geographically limited infection with a wide spectrum of illness, ranging from mild, self-limited, and clinically unrecognized infection to widely disseminated and potentially life-threatening disease. Coccidioides immitis is a dimorphic fungus, found in the soil as an arthrospore and in human tissue as a round-walled spherule. It is found in semi-arid climates with [...]
A21-year-old black man, a nonsmoker previously in good health, presented to the Letterman Army Medical Center Pulmonary Service after six weeks of nonproductive cough, headaches, fevers, anorexia, and a 4.5 kg (ten pound) weight loss. He denied dyspnea, hemoptysis, chest pain, high risk behavior for human immunodeficiency virus (HIV) infection, or gastrointestinal symptoms. He lived [...]
A fall in FEV, and vital capacity (VC) led to transbronchial biopsy on 29 occasions for either infection or rejection. All the patients had symptoms at this time. On nine other occassions, the FEV, and VC were unchanged at a time of routine TBB and the histologic findings of the lung were normal. These patients [...]
A total of 38 transbronchial biopsies were carried out in the 15 HLT recipients during the period under review. Twenty (52.6 percent) of these showed acute lung rejection. Nine (23.7 percent) demonstrated evidence of infection, of which six were cytomegalovirus (CMV) pneumonia, two were bacterial bronchitis, and one was herpes simplex pneumonitis. The remaining nine [...]
The records of home spirometry and histologic findings of transbronchial biopsy specimens over the six-month period were reviewed. All the values of FEV, and FVC recorded every day by each patient were plotted against time and dates of TBB, both routine and on the occurrences of histologically diagnosed pulmonary rejection or infection, using a microcomputer [...]
Spirometer The pocket-sized spirometer (Micro-medical Ltd, Rochester, Kent, England) (Fig 1), the prototype of which has been fully described in a previous report, measures the FEV, and FVC by means of a turbine volume transducer. The turbine drives a low- inertia vane that, during forced expiration, reflects infrared light from an enclosed source onto a [...]
The benefits of lung transplantation are compromised by two common acute complications: acute lung rejection, and opportunistic infection. The lungs are a common site for these disorders. Chronic lung rejection appears to cause obliterative bronchiolitis, which has been reported to cause disability and death in up to 50 percent of long-term heart-lung transplant (HLT) recipients. [...]
