Computed tomography findings in invasive pulmonary aspergillosis in non-neutropenic transplant recipients and neutropenic patients, and their prognostic value

Airway centered invasive pulmonary aspergillosis in an immunocompetent patient: case report and literature review

“…According to previous studies, CT scan showed patchy bilateral consolidation, predominantly peribronchial in location; centrilobular nodules; and, in some cases, a "tree-in-bud" appearance (2,5). Park et al suggested that the typical diagnostic findings of the airway centered invasive form are patchy peribronchial consolidation, small airway lesions including centrilobular nodules, and bronchiectasis (17). The main CT findings in our case were extensive bilateral patchy consolidation with irregularly dilated segmental or subsegmental bronchi, and centrilobular nodules with a mainly branching pattern, consistent with the CT findings of extensive airway centered invasive aspergillosis.…”

Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

“…However, they were non-specific in the groups of different fungal species. For pulmonary aspergillosis patients, it was reported that consolidation-or-mass, halo signs, and angioinvasive form were observed less often in non-neutropenic transplant recipients than in neutropenic patients (56, 26, and 32 %) versus (78, 55, and 60 %, P = 0.01, P = 0.002, and P = 0.003, respectively) [27]. Computed tomography of immunocompetent patients with pulmonary cryptococcosis most commonly demonstrated multiple, small, welldefined, and smoothly marginated pulmonary nodules in the middle and upper lung [28].…”

“…The average time from first symptoms to diagnosis for aspergillosis, cryptococcosis, and mucormycosis was 123 (4-500) days, 37 (7-150) days, and 22 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) days, respectively. The chief clinical symptoms were cough (n = 27, 77.1 %), hemoptysis (n = 17, 48.6 %), moist crackles (n = 7, 20.0 %), and fever (n = 5, 14.3 %).…”

Radiologic Imaging Techniques for the Diagnosis and Management of Invasive Fungal Disease

“…The most common CT finding of invasive fungal pneumonia is the macronodule (≥1 cm in diameter), and this is seen in 65-94 % of patients with IPA, regardless of the underlying mechanism of immunosuppression [9][10][11]. Thin-section CT may also identify angioinvasive pulmonary infection as manifested by the halo and reverse halo signs.…”

“…Whether these differences are a result of the variable timing of CT over the course of infection is unclear. In general, the incidence of the HS appears to be lower in non-neutropenic immunocompromised hosts [11], and a recent study showed that only 2.5 % of IPA patients in the ICU had the HS on CT scan [20]. The lung transplant patient population is also unique.…”