Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Pulmonary Mucormycosis
- Radiologic Findings
- Chest AP view shows cavitary consolidation in right lower lung field and consolidation with CPA blunting in left lower lung field.
On CT scan, round consolidation with central GGO (reversed halo sign) and cavitary lesion was noted in the right lower lobe. Also bilateral pleural effusion was seen.
On bronchoscopic biopsy, fungal hyphae suggesting mucormycosis was revealed.
- Brief Review
- Mucormycosis is an opportunistic infection caused by fungi of the class Zygomycetes. Immunocompromised patients with diabetes, hematologic malignancies or undergone transplantation could be fatal. Pulmonary mucormycosis is 2nd most common manifestation, involving lung parenchyma and airways. Angioinvasion of fungi may cause thrombosis of pulmonary vessels and parenchymal necrosis. Radiologic findings of consolidation, solitary or multiple nodules with or without cavitation, halo or reversed-halo sign, pleural effusion and lymphadenopathy are shown, mostly nonspecific.
To distinguish mucormycosis from aspergillosis is important due to difference treatment by two fungal infections. Reversed-halo sign and cavitary lesion noted more frequently in pulmonary mucormycosis than invasive pulmonary aspergillosis.
The overall mortality rate of pulmonary mucormycosis is 45%, and patients treated with combined medical-surgical approach have better outcomes than those treated conservatively.
- References
- J H Chung, J D Godwen, J W Chien, et al. Pulmonary mucormycosis, Radiology 2010;256:667-670
J Jung, M Y Kim, H J Lee, et al. Cimparison of computed tomographic findings in pulmonary mucormycosis and invasive pulmonary aspergillosis. Clin Microbiol Infect 2015;21:684.el1-684.dl8
S Chong, K S Lee, C A Yi, et al. Pulmonary fungal infection: Imaging findings in immunocompetent and immunocompromised patients , EJR 2006;59:371-383
- Keywords
- Lung, Infection, Fungal infection,