Tomographic assessment of thoracic fungal diseases: a pattern and signs approach.

Authors:
Marcelo Fouad Rabahi
Marcelo Fouad Rabahi
Federal University of Goiás School of Medicine
Brazil
Pablo Rydz Pinheiro Santana
Pablo Rydz Pinheiro Santana
Centro de Biociências
Edson Marchiori
Edson Marchiori
Federal University of Rio de Janeiro
Brazil

Radiol Bras 2018 Sep-Oct;51(5):313-321

Department of Radiology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.

Pulmonary fungal infections, which can be opportunistic or endemic, lead to considerable morbidity and mortality. Such infections have multiple clinical presentations and imaging patterns, overlapping with those of various other diseases, complicating the diagnostic approach. Given the immensity of Brazil, knowledge of the epidemiological context of pulmonary fungal infections in the various regions of the country is paramount when considering their differential diagnoses. In addition, defining the patient immunological status will facilitate the identification of opportunistic infections, such as those occurring in patients with AIDS or febrile neutropenia. Histoplasmosis, coccidioidomycosis, and paracoccidioidomycosis usually affect immunocompetent patients, whereas aspergillosis, candidiasis, cryptococcosis, and pneumocystosis tend to affect those who are immunocompromised. Ground-glass opacities, nodules, consolidations, a miliary pattern, cavitary lesions, the halo sign/reversed halo sign, and bronchiectasis are typical imaging patterns in the lungs and will be described individually, as will less common lesions such as pleural effusion, mediastinal lesions, pleural effusion, and chest wall involvement. Interpreting such tomographic patterns/signs on computed tomography scans together with the patient immunological status and epidemiological context can facilitate the differential diagnosis by narrowing the options.

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http://www.scielo.br/scielo.php?script=sci_arttext&pid=S
Publisher Site
http://dx.doi.org/10.1590/0100-3984.2017.0223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198837PMC

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October 2018
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Capítulo 2 - Coccidioidomicose
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