Abstract

Malaria-associated acute respiratory distress syndrome (ARDS) is an inflammatory disease causing alveolar-pulmonary barrier lesion and increased vascular permeability characterized by severe hypoxemia. Computed tomography (CT), among other imaging techniques, allows the morphological and quantitative identification of lung lesions during ARDS. This study aims to identify the onset of malaria-associated ARDS development in an experimental model by imaging diagnosis. Our results demonstrated that ARDS-developing mice presented decreased gaseous exchange and pulmonary insufficiency, as shown by the SPECT/CT technique. The pulmonary aeration disturbance in ARDS-developing mice on the 5th day post infection was characterized by aerated tissues decrease and nonaerated tissue accumulation, demonstrating increased vascular permeability and pleural effusion. The SPECT/CT technique allowed the early diagnosis in the experimental model, as well as the identification of the pulmonary aeration. Notwithstanding, despite the fact that this study contributes to better understand lung lesions during malaria-associated ARDS, further imaging studies are needed.

Highlights

  • Malaria-associated acute respiratory distress syndrome (ARDS) is an acute inflammatory pulmonary lesion characterized by severe hypoxia [1,2], leading to vascular permeability increase [3,4], which causes pleural effusion and lung weight enlargement [5], and reduces aerated lung tissue resulting in high mortality (30–40%) in intensive care units [6,7,8]

  • Imaging diagnosis of experimental malaria-associated acute respiratory distress syndrome analyzed by computed tomography

  • The application of the single-photon emission computed tomography (SPECT)/Computed tomography (CT) methodology in the early diagnosis of malaria-associated acute respiratory distress syndrome in humans could be impaired in malaria endemic areas due to the difficulty in accessing nuclear medicine equipment

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Summary

Introduction

Malaria-associated acute respiratory distress syndrome (ARDS) is an acute inflammatory pulmonary lesion characterized by severe hypoxia [1,2], leading to vascular permeability increase [3,4], which causes pleural effusion and lung weight enlargement [5], and reduces aerated lung tissue resulting in high mortality (30–40%) in intensive care units [6,7,8]. Seven species of Plasmodium, etiological malaria agents, have been identified as capable of infecting humans. Malaria-associated ARDS and SPECT/CT e Tecnologico: CNPq, Brazil) supported this research. TCQ (CNPq 131431/2017-0), LSO (CAPES and FAPESP 2013/20718-3), MKS (CAPES/ PNPD), CRFM (FAPESP 2016/07030-3), SE (FAPESP 2017/05782-8) received fellowship grants. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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