Rev Pneumol Clin
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Paragonimiasis is a helminthic disease of carnivorous animals. Man is infected accidentally. It has a worldwide distribution but is mainly encountered in Southeast Asia, particularly in Korea. ⋯ Cerebral and lung involvement has recently been investigated by CT-scan and NMR. The diagnosis is based on the identification of parasite eggs in sputum or feces, and on ELISA serology. The treatment of choice is praziquantel.
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Patients with hematology disease in post-chemotherapy medullary aplasia are susceptible to life-threatening bronchopulmonary mycoses, especially aspergillosis. Other less common pulmonary mycoses are also observed. We report 4 cases due to Penicillium purpurogenum, Acromonium strictum and Scedosporium apiospermum (n = 2) infections. ⋯ They have common ubiquitous, opportunistic and low pathogenicity characteristics in immunocompetent subjects. The major risk factor is neutropenia. Isolating one of these fungi in an immunodepressed patient modifies management protocols since certain unusual fungi such as Scedosporium are resistant to amphotericin B.
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The presence of D-dimers in the serum reflects fibrin formation and lysis. If the serum D-dimer level is lower than a threshold level which depends on the assay technique (usually 500 micrograms/l), pulmonary embolism can be excluded with a predictive value of 95%. ⋯ For routine practice, only ELISA tests have been validated for this indication, the sensitivity of latex tests being too low. D-dimer assay would be of little benefit for patients hospitalized for more than 24 for reasons other than suspected pulmonary embolism as specificity is very low in this population.
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The different parameters used in cardiopneumologic exercise tests allow an assessment of exercise tolerance on the basis of the subject's ventilatory response, cardiac and metabolic adaptation and gas exchanges during exercise. VO2max and dyspnea are indicators of good or poor exercise tolerance. Normal values established for adults in three reference articles depend on age, body weight and height. ⋯ Measurement of the ventilatory threshold is less invasive, ventilatory outflow increasing with increasing lactate level as described by the Beaver or Wassermann model. These thresholds indicate the subject's aerobic capacity. The exercise test has diagnostic value but can also be useful for individual patient management, particularly cardiorespiratory rehabilitation.