How is fungal pneumonia diagnosed?

Updated: Jun 21, 2019
  • Author: Romeo A Mandanas, MD, FACP; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Answer

The diagnosis of fungal pneumonias is difficult to prove and is often made on a presumptive basis. It relies on a combination of clinical, radiologic, and microbiological factors. [4] Candida organisms and some ubiquitous filamentous fungi (Aspergillus and Scedosporium) can be isolated from oropharyngeal and respiratory tracts as colonizers without evidence of invasion or symptoms until a breakdown of tissue barriers or of the host's immune system occurs. Nonmolecular fungal markers in serum or other biological samples represent a noninvasive diagnostic tool, which can help in therapeutic decisions. [1]

The individual prognosis is often linked to the severity and outcome of the underlying disease and to whether a reversal of factors affecting the patient's immune status is possible.

Pulmonary nodules resulting from fungal infection are seen below.

Chest radiograph showing multiple pulmonary nodule Chest radiograph showing multiple pulmonary nodules. The patient was treated with corticosteroids for acute graft versus host disease following bone marrow transplantation for chronic myeloid leukemia. The patient smoked marijuana for 2 weeks prior to this chest radiograph being taken. Bronchoalveolar lavage revealed Aspergillus niger and other species on fungal cultures.

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