Pulmonary involvement in human visceral leishmaniasis: Clinical and tomographic evaluation

• Published in: PloS one Vol. 15; no. 1; p. e0228176
• Main Authors: Bispo, Ana Jovina Barreto, Almeida, Maria Luiza Dória, de Almeida, Roque Pacheco, Bispo Neto, José, de Oliveira Brito, Allan Valadão, França, Camila Mendonça
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 30-01-2020; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Biology and Life Sciences; Bone marrow; CAT scans; Chest; Chest x-rays; Child; Child, Preschool; Computed tomography; Cough; Cough - parasitology; Cross-Sectional Studies; Diabetes; Diagnosis; Diagnostic imaging; Diseases; Female; Health sciences; HIV; Hospitals; Human immunodeficiency virus; Humans; Hypertension; Hypothyroidism; Impairment; Infections; Laboratories; Leishmaniasis; Leishmaniasis, Visceral - complications; Leishmaniasis, Visceral - diagnostic imaging; Leishmaniasis, Visceral - physiopathology; Lung Diseases - diagnostic imaging; Lung Diseases - parasitology; Male; Medicine and Health Sciences; Middle Aged; Parasitic diseases; Patients; Physical Sciences; Pneumonia; Pneumonitis; Radiography; Research and Analysis Methods; Respiratory symptoms; Respiratory system; Signs and symptoms; Supervision; Tachypnea; Tomography; Tomography, X-Ray Computed; Tropical diseases; Variables; Vector-borne diseases; Visceral leishmaniasis; Young Adult; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0228176

Visceral leishmaniasis (VL) is a severe, systemic and potentially lethal parasitosis. The lung, like any other organ, can be affected in VL, and interstitial pneumonitis has been described in past decades. This research aimed to bring more recent knowledge about respiratory impairment in VL, characterizing pulmonary involvement through clinical, radiographic and tomographic evaluation. This is an observational, cross-sectional study that underwent clinical evaluation, radiography and high-resolution computed tomography of the chest in patients admitted with the diagnosis of VL in a university service in Northeast Brazil, from January 2015 to July 2018. The sample consisted of 42 patients. Computed tomography was considered abnormal in 59% of patients. Images compatible with pulmonary interstitial involvement were predominant (50%). The most observed respiratory symptom was cough (33.3%), followed by tachypnea (14.1%). Chest radiography was altered in only four patients. VL is a disease characterized by systemic involvement and broad spectrum of clinical manifestations. The respiratory symptoms and tomographic alterations found show that the involvement of respiratory system in VL deserves attention because it is more common than previously thought. Chest X-ray may not reveal this impairment.