An update of clinical characteristics and imaging findings of pulmonary aspergillosis

Abstract

Pulmonary aspergillosis (PA) is a clinical spectrum of rapidly progressive potentially fatal opportunistic mycosis usually caused by Aspergillus organisms. In the recent years, the number of patients with invasive pulmonary aspergillosis (IPA) has increased and it remains a major cause of morbidity and mortality in immunocompromised patients. Chest CT plays an important role in the early diagnosis of IPA and should be included in the investigative protocol. Typical imaging findings of IPA include nodule, consolidation, the halo sign, the hypodense sign and the air crescent sign. CT Angiography (CTA) has a higher sensitivity for detecting angioinvasive aspergillosis. However, the diagnosis of pulmonary aspergillosis remains challenging radiologically in immunocompetent chronic obstructive pulmonary disease (COPD) and critically ill patients in intensive care unit (ICU) because of the non-specific CT findings and further studies are needed to establish the confirm diagnosis.

Chronic Pulmonary Aspergillosis in Patients with Underlying Respiratory Disorders in Cuba—A Pilot Study

“…Maghrabi and Denning report that cavities and pleural thickening are the commonest radiological feature in their patients with CPA at the United Kingdom National Aspergillosis Centre in Manchester [20]. Cavities are usually thick-walled and are located in the upper lobes of the lung but this is not an exclusive feature of CPA since there are diseases like pulmonary tuberculosis, lung cancer and other mycoses that are very similar [21,22]. Computed tomogram (CT) can be a very useful tool for recognition, management and follow-up of aspergillosis cases, providing more evidence on the characteristics of the lesions than traditional chest X-ray radiography [23].…”