What is the role of radiography in the workup of fungal pneumonia?

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

Patchy infiltrate, nodules (seen in the image below), consolidation, cavitation, or pleural effusion may be observed.

Mediastinal adenopathy is common in patients with endemic fungal pneumonias. The adenopathy may be either unilateral or bilateral.

In neutropenic patients infected with aspergillosis (60%), pulmonary nodules surrounded by ground-glass opacity called “halo sign” [1, 5] is a common finding. On the other hand, lung transplant recipients present less specific patchy infiltrates. [5]

Miliary infiltration occurs in patients with disseminated disease.

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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