Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging.

Authors:
Diana Penha
Diana Penha
Heart and Chest Hospital NHS Foundation Trust
Edson Marchiori
Edson Marchiori
Federal University of Rio de Janeiro
Brazil

Expert Rev Respir Med 2019 Mar 31;13(3):263-277. Epub 2019 Jan 31.

a Department of Radiology , Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil.

Introduction: Systemic endemic mycoses are prevalent in specific geographical areas of the world and are responsible for high rates of morbidity and mortality in these populations, and in immigrants and travelers returning from endemic regions. The most common fungal infections that can affect the lungs of immunocompetent patients include histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis, sporotrichosis, aspergillosis, and cryptococcosis. Diagnosis and management of these diseases remain challenging, especially in non-endemic areas due to the lack of experience. Therefore, recognition of the various radiologic manifestations of pulmonary fungal infections associated with patients' clinical and epidemiologic history is imperative for narrowing the differential diagnosis. Areas covered: This review discusses the clinical and radiological findings of the main endemic fungal diseases affecting the lungs in immunocompetent patients. Specific topics discussed are their etiology, epidemiology, pathogenesis, clinical manifestations, methods of diagnosis, pathology and main imaging findings, especially in computed tomography. Expert commentary: Imaging plays an important role in the diagnosis and management of pulmonary fungal infection and may reveal useful signs. Although definitive diagnosis cannot be made based on imaging features alone, the use of a combination of epidemiologic, clinical and imaging findings may permit the formulation of an adequate differential diagnosis.

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Source
http://dx.doi.org/10.1080/17476348.2019.1571914DOI Listing
March 2019
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References

(Supplied by CrossRef)
Article in Respiration
Salzer HJF et al.
Respiration 2018

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