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Flashcard 7682089159948

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Quelle est la nature du fluide pleural dans un pleurésie due à F.tularensis ? (bioch 2 + cyto 1)
Answer

  • Exsudatif
  • ADA augmentée
  • Lymphocytaire

"Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]" - UpToDate


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Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]. Pleural or lung biopsies can demonstrate granuloma formation and therefore be confused with pulmonary tuberculosis [1,23]. Empyema requiring decortication has been reported [8].

Original toplevel document

UpToDate
y nodules, pleural effusion, and mediastinal adenopathy have been described in a patient with typhoidal tularemia who had been treated with the anti-tumor necrosis factor agent infliximab [22]. <span>Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]. Pleural or lung biopsies can demonstrate granuloma formation and therefore be confused with pulmonary tuberculosis [1,23]. Empyema requiring decortication has been reported [8]. Respiratory failure requiring mechanical ventilation and the adult respiratory distress syndrome can result from either primary or secondary pneumonic tularemia. In one series of 128 pa






Flashcard 7682091519244

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Que peut-on observer sur une biopsie pleurale réalisée au cours d'une pleurésie due à F.tularensis ?
Answer

Granulome

"Pleural or lung biopsies can demonstrate granuloma formation and therefore be confused with pulmonary tuberculosis [1,23]." - UpToDate


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Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]. Pleural or lung biopsies can demonstrate granuloma formation and therefore be confused with pulmonary tuberculosis [1,23]. Empyema requiring decortication has been reported [8].

Original toplevel document

UpToDate
y nodules, pleural effusion, and mediastinal adenopathy have been described in a patient with typhoidal tularemia who had been treated with the anti-tumor necrosis factor agent infliximab [22]. <span>Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]. Pleural or lung biopsies can demonstrate granuloma formation and therefore be confused with pulmonary tuberculosis [1,23]. Empyema requiring decortication has been reported [8]. Respiratory failure requiring mechanical ventilation and the adult respiratory distress syndrome can result from either primary or secondary pneumonic tularemia. In one series of 128 pa






Flashcard 7682093878540

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
A quelles forme cliniques de la maladie s'associent généralement les pneumonies secondaires à F.tularensis ?
Answer

"Tyhpoidale" et ulcéro-glandulaire

"Secondary pneumonic disease can complicate any of the major forms of tularemia but is most common with the typhoidal and ulceroglandular forms [2,21]" - UpToDate


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Secondary pneumonic disease results from hematogenous spread to the lung. Secondary pneumonic disease can complicate any of the major forms of tularemia but is most common with the typhoidal and ulceroglandular forms [2,21]. The clinical presentation of secondary pneumonic tularemia is varied. Secondary pneumonia can present with bilateral disease, involvement of the lower lobes, and/or with miliary diseas

Original toplevel document

UpToDate
aise concern for tularemic pneumonia or pneumonic plague. (See "Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection)", section on 'Clinical manifestations'.) ●<span>Secondary pneumonic disease results from hematogenous spread to the lung. Secondary pneumonic disease can complicate any of the major forms of tularemia but is most common with the typhoidal and ulceroglandular forms [2,21]. The clinical presentation of secondary pneumonic tularemia is varied. Secondary pneumonia can present with bilateral disease, involvement of the lower lobes, and/or with miliary disease. There can be pulmonary infiltrates, pleural effusion, or both. In one series, some patients with secondary lung involvement had abnormal chest radiographs but no clinical evidence of pneumonia [2]. Pulmonary nodules, pleural effusion, and mediastinal adenopathy have been described in a patient with typhoidal tularemia who had been treated with the anti-tumor necrosis factor agent infliximab [22]. Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]. Pleural or lung biopsies can demonstrate






Flashcard 7682096237836

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Quelle est la répartition topographique et le pattern d'atteinte pulmonaire dans la forme secondaire de la pneumonie due à F.tualrensis ?
Answer

  • Atteinte bilatérale
  • Lobes inférieurs
  • Miliaire

"Secondary pneumonia can present with bilateral disease, involvement of the lower lobes, and/or with miliary disease." - UpToDate


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can complicate any of the major forms of tularemia but is most common with the typhoidal and ulceroglandular forms [2,21]. The clinical presentation of secondary pneumonic tularemia is varied. <span>Secondary pneumonia can present with bilateral disease, involvement of the lower lobes, and/or with miliary disease. There can be pulmonary infiltrates, pleural effusion, or both. In one series, some patients with secondary lung involvement had abnormal chest radiographs but no clinical evidence of pn

Original toplevel document

UpToDate
aise concern for tularemic pneumonia or pneumonic plague. (See "Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection)", section on 'Clinical manifestations'.) ●<span>Secondary pneumonic disease results from hematogenous spread to the lung. Secondary pneumonic disease can complicate any of the major forms of tularemia but is most common with the typhoidal and ulceroglandular forms [2,21]. The clinical presentation of secondary pneumonic tularemia is varied. Secondary pneumonia can present with bilateral disease, involvement of the lower lobes, and/or with miliary disease. There can be pulmonary infiltrates, pleural effusion, or both. In one series, some patients with secondary lung involvement had abnormal chest radiographs but no clinical evidence of pneumonia [2]. Pulmonary nodules, pleural effusion, and mediastinal adenopathy have been described in a patient with typhoidal tularemia who had been treated with the anti-tumor necrosis factor agent infliximab [22]. Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]. Pleural or lung biopsies can demonstrate






Flashcard 7682098597132

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
[VoF] - Il peut exister un franche dissociation radio-clinique au cours de la forme secondaire de pneumonie Tularémique
Answer

VRAI

Atteinte radiographique SANS signes cliniques

"In one series, some patients with secondary lung involvement had abnormal chest radiographs but no clinical evidence of pneumonia [2]." - UpToDate


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ia is varied. Secondary pneumonia can present with bilateral disease, involvement of the lower lobes, and/or with miliary disease. There can be pulmonary infiltrates, pleural effusion, or both. <span>In one series, some patients with secondary lung involvement had abnormal chest radiographs but no clinical evidence of pneumonia [2]. Pulmonary nodules, pleural effusion, and mediastinal adenopathy have been described in a patient with typhoidal tularemia who had been treated with the anti-tumor necrosis factor agent

Original toplevel document

UpToDate
aise concern for tularemic pneumonia or pneumonic plague. (See "Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection)", section on 'Clinical manifestations'.) ●<span>Secondary pneumonic disease results from hematogenous spread to the lung. Secondary pneumonic disease can complicate any of the major forms of tularemia but is most common with the typhoidal and ulceroglandular forms [2,21]. The clinical presentation of secondary pneumonic tularemia is varied. Secondary pneumonia can present with bilateral disease, involvement of the lower lobes, and/or with miliary disease. There can be pulmonary infiltrates, pleural effusion, or both. In one series, some patients with secondary lung involvement had abnormal chest radiographs but no clinical evidence of pneumonia [2]. Pulmonary nodules, pleural effusion, and mediastinal adenopathy have been described in a patient with typhoidal tularemia who had been treated with the anti-tumor necrosis factor agent infliximab [22]. Pleural effusions in pneumonic tularemia are exudative with a lymphocytic predominance and may have an elevated adenosine deaminase level [23]. Pleural or lung biopsies can demonstrate






Flashcard 7682101480716

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Quel pattern d'atteinte radiologique à la radiographie de thorax doit faire évoquer une Tularémie ?
Answer

Atteinte nodulaire associée à un épanchement pleural

"[...] although the presence of nodular infiltrates with a pleural effusion should raise concern for tularemic pneumonia or pneumonic plague" - UpToDate


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on radiographic changes include peribronchial infiltrates, lobar consolidation, pleural effusion, and hilar adenopathy. Rounded infiltrates and cavitation from pneumonic tularemia are uncommon, <span>although the presence of nodular infiltrates with a pleural effusion should raise concern for tularemic pneumonia or pneumonic plague. <span>

Original toplevel document

UpToDate
[19,20]. Patients sometimes complain of substernal or pleuritic chest pain. Findings on chest examination include rales, signs of consolidation, and a friction rub or evidence of pleural fluid. <span>Early after inhalational exposure, the chest radiograph may be normal, but abnormalities usually develop as respiratory findings become more prominent [19]. Common radiographic changes include peribronchial infiltrates, lobar consolidation, pleural effusion, and hilar adenopathy. Rounded infiltrates and cavitation from pneumonic tularemia are uncommon, although the presence of nodular infiltrates with a pleural effusion should raise concern for tularemic pneumonia or pneumonic plague. (See "Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection)", section on 'Clinical manifestations'.) ●Secondary pneumonic disease results from hematoge






Flashcard 7682104626444

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Dans un forme primaire de pneumonie tularémique, peut-on s'attendre à une radiographie de thorax normale alors que le patient a de francs symptômes et signes cliniques ?
Answer

Plutôt NON

"Early after inhalational exposure, the chest radiograph may be normal, but abnormalities usually develop as respiratory findings become more prominent [19]." - UpToDate


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Early after inhalational exposure, the chest radiograph may be normal, but abnormalities usually develop as respiratory findings become more prominent [19]. Common radiographic changes include peribronchial infiltrates, lobar consolidation, pleural effusion, and hilar adenopathy. Rounded infiltrates and cavitation from pneumonic tularemia a

Original toplevel document

UpToDate
[19,20]. Patients sometimes complain of substernal or pleuritic chest pain. Findings on chest examination include rales, signs of consolidation, and a friction rub or evidence of pleural fluid. <span>Early after inhalational exposure, the chest radiograph may be normal, but abnormalities usually develop as respiratory findings become more prominent [19]. Common radiographic changes include peribronchial infiltrates, lobar consolidation, pleural effusion, and hilar adenopathy. Rounded infiltrates and cavitation from pneumonic tularemia are uncommon, although the presence of nodular infiltrates with a pleural effusion should raise concern for tularemic pneumonia or pneumonic plague. (See "Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection)", section on 'Clinical manifestations'.) ●Secondary pneumonic disease results from hematoge






Flashcard 7682108820748

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Devant une pneumonie, la bradycardie relative orienterait-elle plus volontiers vers une Tularémie ou une Légionellose ?
Answer

Plutôt Légionellose

Cf : Thomas, L. D., & Schaffner, W. (2010). Tularemia pneumonia. Infectious Disease Clinics Of North America, 24(1), 43‑55. https://doi.org/10.1016/j.idc.2009.10.012

"Of note, the relative bradycardia that has been described with other atypical pneumonias, such as Legionella and psittacosis, is usually absent in pneumonic tularemia."


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Flashcard 7682110917900

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Au cours de l'atteinte pulmonaire de la Tularémie, quand débutent généralement les signes respiratoires par rapports aux premiers symptômes / signes ? (approximatif)
Answer

Plusieurs jours ou semaines après

Cf : Thomas, L. D., & Schaffner, W. (2010). Tularemia pneumonia. Infectious Disease Clinics Of North America, 24(1), 43‑55. https://doi.org/10.1016/j.idc.2009.10.012

"When a patient infected with F tularensis presents with pneumonia, it is likely that the respiratory symptoms began a few days and even weeks after initial symptoms occurred. High fevers (as high as 104°F) will occur abruptly, and headache is a prominent feature. Within time, a nonproductive cough with or without pleuritic chest pain (which occurs in about one third of cases) may occur."


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