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

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.

Q Fever in Military Firefighters during Cadet Training in Brazil.

We report five cases of Q fever among cadets during a training program for Military Firefighters Academy in the state of Rio de Janeiro, Brazil. This cluster confirms the significance of Coxiella burnetii as an infectious agent in Brazil, where the occurrence of this zoonosis is poorly documented and highlights the potential risk for Q fever transmission in rural areas or farms with infected animals.

Lung in dengue: computed tomography findings.

BACKGROUND: Dengue is the most important mosquito-borne viral disease in the world. Dengue virus infection may be asymptomatic or lead to undifferentiated fever, dengue fever with or without warning signs, or severe dengue. Lower respiratory symptoms are unusual and lung-imaging data in patients with dengue are scarce. METHODOLOGY/PRINCIPAL FINDINGS: To evaluate lung changes associated with dengue infection, we retrospectively analyzed 2,020 confirmed cases of dengue. Twenty-nine of these patients (11 females and 18 males aged 16-90 years) underwent chest computed tomography (CT), which yielded abnormal findings in 17 patients: 16 patients had pleural effusion (the sole finding in six patients) and 11 patients had pulmonary abnormalities. Lung parenchyma involvement ranged from subtle to moderate unilateral and bilateral abnormalities. The most common finding was ground-glass opacity in eight patients, followed by consolidation in six patients. Less common findings were airspace nodules (two patients), interlobular septal thickening (two patients), and peribronchovascular interstitial thickening (one patient). Lung histopathological findings in four fatal cases showed thickening of the alveolar septa, hemorrhage, and interstitial edema. CONCLUSIONS/SIGNIFICANCE: In this largest series involving the use of chest CT to evaluate lung involvement in patients with dengue, CT findings of lower respiratory tract involvement were uncommon. When abnormalities were present, pleural effusion was the most frequent finding and lung involvement was often mild or moderate and bilateral. Extensive lung abnormalities are infrequent even in severe disease and when present should lead physicians to consider other diagnostic possibilities.

Manifestações clínicas na dengue: diagnóstico laboratorial / Clinical manifestations in dengue: laboratory diagnosis

A dengue é uma doença infecciosa de evolução aguda, transmitida por vírus (RNA vírus). Infecta o homem através da picada do inseto fêmea Aedes aegypti. Seus sinais e sintomas são variáveis, com formas oligossintomáticas, formas clássicas (febris) e formas graves hemorrágicas, podendo até apresentar síndrome cardiovascular hipovolêmica. O diagnóstico envolve critérios clínico-laboratoriais. O diagnóstico sorológico tem fundamental importância na classificação de infecção primária ou secundária, já que a dengue hemorrágica surge com maior frequência nas infecções secundárias. O isolamento do vírus é geralmente realizado para fins de pesquisa ou epidemiológicos. As epidemias ocorrem principalmente no verão, durante ou após períodos chuvosos.

The dengue is an infectious disease of acute evolution transmitted by virus (RNA virus), infecting humans through the bite of the Aedes aegypti female insect. Presenting signs and symptoms variables with oligosymptomatic forms, classical forms (fever) and severe hemorrhagic form (DHF), this can lead to cardiovascular hypovolemic syndrome. The diagnoses of dengue disease involves clinical and laboratory criteria. Serological diagnosis has fundamental importance in the classification of primary or secondary infection, since DHF appears most often in secondary infections.Virus isolation is usually carried out for research or epidemiological studies. Epidemics occur mainly in the summer, during or after rainy periods.