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In patients with hyperinfection syndrome the massive migration of larvae through the lungs typically produces extensive pneumonia, pulmonary haemorrhage, and pleural effusion (Fig. 15a).
Post-mortem examination of mice IN-infected with C. gattii cells from leaf agar revealed extensive tissue damage in form of enlarged, mottled lung tissue consistent with extensive pneumonia, while lung and brains of mice infected with YPD grown C. gattii cells appeared less damaged (Fig. 7).
Clinically, necrotizing pneumonia is mainly characterized by a rapidly extensive pneumonia often associated with pleural effusion and progressing towards the acute respiratory distress syndrome.
Also, in the present study, one third of the calves, which showed extensive pneumonia at necropsy, has not been individually diagnosed previously.
Especially the initial symptoms of an infection with M. bovis, the dominant pathogen in the veal industry, are very subtle, even when extensive pneumonia is already present, and hard to evaluate in individual housing [ 38].
On histopathologic examination, the most striking lesions were found in the lung, with extensive pneumonia and severe pulmonary edema with hyaline material in the alveolar space and slight mononuclear infiltration in the area surrounding congested vessels.
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Histopathological examination of the lungs from mice immunized with BCG, ΔsecA2, or ΔsecA2ΔlysA showed relatively mild inflammation with less severe spreading lung lesions, less extensive granulomatous pneumonia, and reduced consolidation compared with naive mice (Figure 5B).
The CUP subgroup included those patients with any of these features at presentation: acute organ dysfunction, septic shock, hypotension, extensive infections (pneumonia, cellulitis >5 cm, typhlitis, meningitis and pyelonephritis) or any other acute comorbidity indicating hospital admission by itself.
Initial animal studies examined beagle dogs that inhaled BeO calcined at either 500 or 1000 degrees C. At similar lung burdens, the 500 degrees C BeO induced more severe and extensive granulomatous pneumonia, lymphocytic infiltration into the lung, and positive Be-specific lymphocyte proliferative responses in vitro than the 1000 degrees C BeO.
Focally extensive pyogranulomatous bronchointerstitial pneumonia with dilatation of airways by degenerate cells and debris was observed.
However, spinal surgery entails significant risks such as wound infections requiring a second surgery, extensive bleeding, postoperative pneumonia, and pulmonary embolism, which occur in more than 10% of the patients [ 1– 4].
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