Disease manifestation depends on intensity of exposure, immune status, and underlying lung architecture
90% asymptomatic, and usually self-limited
Symptoms 1-4 weeks after exposure and consist of flu-like illness
Fever/chills
Headache
Malaise
Myalgias
Abdominal pain
Arthralgias
Dyspnea
Cough, hemoptysis
Hilar/mediastinal lymphadenopathy on CXR
Fever/chills
Headache
Malaise
Myalgias
Abdominal pain
Arthralgias
Dyspnea
Cough, hemoptysis
Mostly older patients or smokers with underlying structural lung disease
Symptoms:
Cough
Weight loss
Low-grade fever
Malaise
Night sweats
Sometimes hemoptysis, sputum production, dyspnea
CXR may show:
Upper lobe infiltrates
Fibrosis, scarring
Cavitations
Cough
Weight loss
Low-grade fever
Malaise
Night sweats
Sometimes hemoptysis, sputum production, dyspnea
Upper lobe infiltrates
Fibrosis, scarring
Cavitations
Seen in immunocompromised patients
SIRS
Acute form:
Diffuse interstitial or reticulonodular lung infiltrates
Respiratory failure
Coagulopathy
Multiorgan failure
Subacute form depends on focal organ system affected:
Fever
Weight loss
Hepatosplenomegaly
Meningitis, brain lesions
Mucosal or GI ulcerations
Adrenal insufficiency
Pericarditis
Chronic form: constitutional sx
Diffuse interstitial or reticulonodular lung infiltrates
Respiratory failure
Coagulopathy
Multiorgan failure
Fever
Weight loss
Hepatosplenomegaly
Meningitis, brain lesions
Mucosal or GI ulcerations
Adrenal insufficiency
Pericarditis
Enlarged lymph nodes that may undergo necrosis
This leads to granulomatous mediastinitis
Can lead to:
Superior vena cava syndrome
Obstruction of pulmonary vessels
Airway obstruction
Recurrent pneumonia
Hemoptysis
Respiratory failure
Superior vena cava syndrome
Obstruction of pulmonary vessels
Airway obstruction
Recurrent pneumonia
Hemoptysis
Respiratory failure
Histoplasmosis
Carcinoid Lung Tumors
Toxoplasmosis
Lung Cancer, Small Cell
Aspergillosis
Lymphoma, Mediastinal
Coccidioidomycosis
Mediastinal Cysts