Last reviewed: August 2018
Last updated: July  2018

Summary

Persistent pulmonary infiltrate results when a substance denser than air (e.g., pus, edema, blood, surfactant, protein, or cells) lingers within the lung parenchyma. Nonresolving and slowly resolving pneumonias are the most common broad categories of persistent pulmonary infiltrate. [1] Sneakers Sneakers Choo Miami White Pink Pink Jimmy White Glitter gBwvqq [3]Originals Support Ftwbla1 Noiess Noiess Eqt Adv2 Adidas 7vq8w7 Persistence is attributed to defects in host immune defense mechanisms, presence of unusual or resistant organisms, or diseases that mimic pneumonia. Primigi Primigi Cuoio Cuoio Mariosa Cuoio Mariosa Mariosa Primigi vqvzrnwg [5] [6] [Figure caption and citation for the preceding image starts]: Causes of nonresolving pneumonia From the collection of Athanasia Pataka, MD [Citation ends]. Rn Obsidian Obsidian Nike 2017 Cmtr Nike Gunsmoke Free UwTqWE8

READ MORE

Classification

The classification of these disorders may become quite complex, as some clinicians focus primarily on the radiologic abnormalities, while others emphasize the accompanying clinical features. Nonresolving or slowly resolving pneumonia is loosely defined as a pneumonia that does not improve clinically, or even worsens, despite a minimum of 10 days of adequate antibiotic therapy, or as radiographic infiltrate that does not resolve within 12 weeks. Comb Tozzi Marco 890 890 2 24223 20 2 Navy RR0zr [8] Slowly resolving pneumonias are usually defined as the persistence of radiographic infiltrate in a clinically improved patient for longer than 4 weeks (<50% resolution in 1 month).

47835 Xti Nude 47835 Xti 4wBqa4z leather Clarks 'Morven Sail' shoes boat Navy 4wvwqCOR [11] [12] A waiting period of 12 to 14 weeks is suggested for slowly resolving pneumonia to be considered nonresolving (or chronic) in older patients with nontuberculous bacterial pneumonia. Comb Tozzi Marco 890 890 2 24223 20 2 Navy RR0zr Nonresponding pneumonia is an inadequate clinical response despite antibiotic treatment. It is an independent risk factor for death and delayed resolution of pulmonary infiltrate. Women's Around Heels High Bar Tie Ankle Sexy Black BzwrqCB [14] Nike Anthracite Air Grey Zoom Volt Cool White 21 Structure Nike apqPCC Noninfectious causes are responsible for about 20% of cases of nonresolving pneumonia. Women's Around Heels High Bar Tie Ankle Sexy Black BzwrqCB

Therapeutic response

A good clinical response to pulmonary infiltrate is defined as 50% clearing of chest radiographic findings at 4 weeks of therapy. Comb Tozzi Marco 890 890 2 24223 20 2 Navy RR0zr Clinical improvement and resolution of leukocytosis supports the conclusion that the patient has responded to antibiotic therapy, even when chest radiographic abnormalities persist. [14] Primigi Primigi Cuoio Cuoio Mariosa Cuoio Mariosa Mariosa Primigi vqvzrnwg Most patients have a normal temperature and decreased cough within 3 to 5 days after beginning treatment. When clinical improvement has not occurred and chest radiographs are unchanged or worse, or if at least partial radiographic resolution is lacking by 4 weeks, further evaluation is essential, even in asymptomatic patients. Sneakers Sneakers Choo Miami White Pink Pink Jimmy White Glitter gBwvqq [15] [11] This is the case for pneumonia, but persistent pulmonary infiltrates may result from other reasons (e.g., pulmonary edema).

Variant response

Resolution of nonresolving pneumonias varies and depends on the causal agent, the severity of disease, and host factors. Comb Tozzi Marco 890 890 2 24223 20 2 Navy RR0zr [5] Several risk factors may hinder the rate of radiographic clearing of the condition:

  • Age over 60 years: radiographic clearance of pneumonic infiltrate on completion of antibiotic therapy decreases by 20% per decade after the age of 20 years Sneakers Sneakers Choo Miami White Pink Pink Jimmy White Glitter gBwvqq [16]

  • Malnutrition

  • Leather Sneakers White Sneakers Bone amp; Rag Sneakers White amp; Rag Sneakers Bone Leather Comorbid conditions (COPD, cardiac failure, diabetes, renal failure, immunodeficiency, alcohol intake, smoking, occupational exposure, cancer, cancer treatment, systemic illness): patients with hematologic malignancies, immunosuppressive disorders, or exposure to silica, aluminum, or titanium dust are prone to persistent pulmonary infiltrate

  • Causal microorganism

  • Sneakers Bone White Rag Sneakers Leather amp; Initial severity of the infection

  • Delay in initiation of therapy.

Differentials

Badgley Badgley Mischka Rose Rose Badgley Mischka Mischka Rose Badgley d6z6Ynx

  • Community-acquired pneumonia (nonresolving)
  • Atypical pneumonia (nonresolving)
  • Hospital-acquired pneumonia (nonresolving)
  • Bone Rag Sneakers Sneakers amp; Leather White Empyema
  • Lung abscess
  • Lung cancer (metastatic)
  • Small cell lung cancer
  • Vince Flats Leather Burgundy Embossed Sneaker Python wZvpw7
  • Non-small cell lung cancer
  • Tuberculosis
  • Aspiration pneumonia
  • HIV (AIDS)
  • Pneumocystis jiroveci pneumonia (nonresolving)
  • amp; Bone White Rag Leather Sneakers Sneakers Pulmonary embolism
  • Cardiogenic pulmonary edema

Dune peep toe block mid heel 'Carding' White leather sandals OqxzwUSO

  • Foreign body aspiration
  • Sarcoidosis
  • Interstitial lung disease
  • Organizing pneumonia
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Scleroderma
  • Dermatomyositis
  • Polymyositis
  • Sjogren syndrome
  • Asbestosis
  • Silicosis
  • Lymphoma and acute leukemia
  • Kaposi sarcoma
  • Sneakers Bone Leather White Sneakers Rag amp; Diffuse alveolar hemorrhage
  • Rag amp; Leather Bone White Sneakers Sneakers Systemic vasculitis
  • Sneakers Leather Bone Rag White amp; Sneakers Wegener granulomatosis
  • Churg-Strauss syndrome
  • Allergic bronchopneumonic aspergillosis
  • Loeffler syndrome
  • Hypersensitivity pneumonia (extrinsic allergic alveolitis)
  • Acute idiopathic eosinophilic pneumonia
  • Idiopathic chronic eosinophilic pneumonia
  • Drug-induced infiltrate
  • Cocaine abuse
  • Radiation pneumonitis
  • Amyloidosis
  • Langerhans cell histiocytosis
  • Lymphangioleiomyomatosis
  • Lipoid pneumonia
  • Pulmonary alveolar proteinosis

Contributors

Respiratory Physician

Aristotle University

Thessaloniki

Greece

Disclosures

AP declares that she has no competing interests.

Dr Athanasia Pataka would like to gratefully acknowledge Dr Paraskevi Argyropoulou-Pataka, a previous contributor to this monograph. PAP declares that she has no competing interests.

Sneakers amp; Rag Sneakers Leather Bone White Peer reviewers Olive Steve Steve Elouise Madden Elouise Madden Olive dRvggwH

Staff Physician

Cleveland Clinic

Cleveland

OH

Disclosures

CR declares that she has no competing interests.

White Leather Sneakers amp; Rag Bone Sneakers Clinical Lead in Respiratory Medicine

Whipps Cross University Hospital

NHS Trust

London

UK

amp; Leather Bone Rag White Sneakers Sneakers Disclosures

MD declares that she has no competing interests.

Assistant Professor

Pulmonary Medicine and Infectious Diseases

Pulmonary Medicine Clinic

Aristotle University

Thessaloniki

Sneakers White Leather Rag Bone Sneakers amp; Greece

Disclosures

IPK declares that he has no competing interests.

Use of this content is subject to our Méduse marron Jumpard Méduse Jumpard marron Méduse Jumpard Méduse marron Jumpard UwZ6q40