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Vol. 14. Issue 6.
Pages 887-891 (November - December 2008)
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Vol. 14. Issue 6.
Pages 887-891 (November - December 2008)
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Leptospirosis of the lung presenting with crazy-paving pattern: Correlation between the high-resolution CT and pathological findings
Padrão de crazy-paving na leptospirose pulmonar: Correlação entre a tomografia computadorizada de alta resolução e os achados anatomopatológicos
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Edson Marchiori1,6,
Corresponding author
edmarchiori@gmail.com

Correspondence address/Correspondência: Edson Marchiori – Rua Thomaz Cameron, 438. Valparaiso. CEP 25685.120, Petrópolis, Rio de Janeiro, Brasil.
, Taisa Davaus Gasparetto2, Dante L. Escuissato3,5, Gláucia Zanetti4, Hilton Koch7
1 Professor Titular e Chefe do Departamento de Radiologia da Universidade Federal Fluminense (UFF). Coordenador Adjunto do Curso de Pós-Graduação em Radiologia da Universidade Federal do Rio de Janeiro (UFRJ) / Full Professor, Head, Department of Radiology of the University Fluminense (UFF). Associate Coordinator, Post-Graduate Course in Radiology, University of Rio de Janeiro (UFRJ)
2 Médica Pós-Graduanda do Departamento de Radiologia da UFF / Post-Graduate Doctor, Department of Radiology, UFF
3 Professor Adjunto de Radiologia da Universidade Federal do Paraná, Curitiba, Brasil / Associate Professor of Radiology, University of Paraná, Brazil
4 Doutoranda em Radiologia da UFRJ / PhD in Radiology, UFRJ
5 Departamento de Radiologia da Universidade Federal do Paraná, Curitiba, Brasil. Director: Prof. Dante L. Escuissato. Rua General Carneiro, 181. CEP 80.000-000. Curitiba, Paraná, Brasil
6 Departamento de Radiologia da Universidade Federal Fluminense (UFF) Director : Prof. Edson Marchiori Av. Marquês do Paraná, 330. Centro. Niterói – Rio de Janeiro – Brasil
7 Serviço de Radiodiagnóstico do Hospital Universitário Clementino Fraga Filho (HUCFF), da Universidade Federal do Rio de Janeiro (UFRJ). Av. Brigadeiro Trompowsky, s/n. Ilha do Fundão. Rio de Janeiro – Brasil
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Abstract

The authors present the high-resolution CT findings of a patient with diffuse pulmonary hemorrhage due to leptospirosis. The main finding consisted of extensive ground-glass opacities super imposed on mild interlobular septal thickening, resulting in the appearance termed “crazy- paving”. The patient died and the necropsy showed extensive haemorrhage filling the airspace and blood infiltrating the interlobular septa. The correlation between the high-resolution CT and pathological findings is emphasised.

Key-words:
Leptospirosis
pulmonary haemorrhage
crazy-paving pattern
high resolution CT
Resumo

Os autores apresentam os aspectos na tomografia computadorizada de alta resolução de um doente com hemorragia pulmonar difusa por leptospirose. O achado predominante consistiu de opacidades em vidro despolido difusas, com espessamento de septos interlobulares sobrepostos, resultando no padrão de crazy-paving. O doente morreu, e na necrópsia foi observada extensa hemorragia alveolar, com sangue infiltrando os septos interlobulares. É realçada a correlação entre os achados anatomopatológicos e na tomografia computadorizada de alta resolução.

Palavras-chave:
Leptospirose
hemorragia pulmonar
padrão de crazy-paving
tomografia computadorizada de alta resolução
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Bibliography
[1.]
A.M. Luks, S. Lakshminarayanan, J.V. Hirsch mann.
Leptospirosis presenting as diffuse alveolar hemorrhage: case report and literature review.
Chest, 123 (2003), pp. 639-643
[2.]
D. Arokianathan, K. Trower, S. Pooboni, A. Sosnowski, P. Moss, H. Thaker.
Leptospirosis: a case report of a patient with pulmonary haemorrhage successfully managed with extra corporeal membrane oxygenation.
J Infect, 50 (2005), pp. 158-162
[3.]
J.E. Carvalho, E.S. Marchiori, J.B. Guedes e Silva, B.A. Souza Netto, W. Tavares, A.V. Paula.
Pulmonary compromisse in leptospirosis.
Rev Soc Bras Med Trop, 25 (1992), pp. 21-30
[4.]
E. Marchiori, N.L. Muller.
Leptospirosis of the lung: high-resolution computed tomography findings in five patients.
J Thorac Imaging, 17 (2002), pp. 151-153
[5.]
J.G. Im, K.M. Yeon, M.C. Han, C.W. Kim, W.R. Webb, J.S. Lee, et al.
Leptospirosis of the lung: radiographic findings in 58 patients.
AJR, 152 (1989), pp. 955-959
[6.]
C.R. Murch, D.H. Carr.
Computed tomography appearances of pulmonary alveolar proteinosis.
Clin Radiol, 40 (1989), pp. 240-243
[7.]
T. Johkoh, H. Itoh, N.L. Müller, K. Ichikado, H. Nakamura, J. Ikezoe, et al.
Crazy paving appearance at thin-section CT: spectrum of disease and pathologic findings.
[8.]
S. Murayama, J. Murakami, H. Yabuuchi, H. Soeda, K. Masuda.
Crazy paving appearance on high resolution CT in various diseases.
J Comput Assist Tomogr, 23 (1999), pp. 749-752
[9.]
A.C. Nicodemo, M.I. Duarte, V. Alves, C.F.H. Takakura, R.T.M. Santos, E.L. Nicodemo.
Lung lesions in human leptospirosis: microscopic, immunohistochemical, and ultrastructural features related to thrombocytopenia.
Am J Trop Med Hyg, 56 (1997), pp. 181-187
[10.]
V.M. Arean.
The pathologic anatomy and pathogenesis of fatal human leptospirosis (Weil's disease).
Am J Pathol, 40 (1962), pp. 393-423
Copyright © 2008. Sociedade Portuguesa de Pneumologia
Pulmonology
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