Pulmonary Mucormycosis: Radiologic Features at Presentation and Over Time

AJR. American Journal of Roentgenology
Mark M HammerHiroto Hatabu

Abstract

Pulmonary mucormycosis is an aggressive opportunistic fungal infection. We set out to evaluate the CT and MRI features of pulmonary mucormycosis. Through a search of the electronic medical record from 2007 to 2017, we identified 30 patients with definite or probable mucormycosis. Two radiologists reviewed the initial chest CT examinations for the presence of features including the "reverse halo" sign, large ground-glass halo, and peripheral lesion distribution. Additional CT and MRI studies were reviewed to evaluate evolution over time. The majority (67%) of patients had lesions with the reverse halo sign at some point in the disease course. A ground-glass halo larger than the lesion was seen in 53% of patients. Notably, lesions had a peripheral predominance in 87% of cases. Through careful review of images, a perivascular ground-glass precursor lesion was identified in 20% of patients 1-2 weeks before a consolidation developed. In five (17%) patients, CT showed a multifocal pneumonia appearance. Finally, MRI of two patients showed T2-hypointense rims and central nonenhancement, a finding we refer to as the "black hole" sign. Large nodules or consolidations with an associated reverse halo sign or large perilesional ground-glass...Continue Reading

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Citations

Jul 24, 2018·AJR. American Journal of Roentgenology·Edson MarchioriGláucia Zanetti
Jul 24, 2018·AJR. American Journal of Roentgenology·Mark M HammerHiroto Hatabu
May 1, 2019·AJR. American Journal of Roentgenology·Richard ThomasMark M Hammer
Nov 23, 2019·AJR. American Journal of Roentgenology·Richard ThomasMark M Hammer
Mar 21, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Rishi AgrawalEric M Hart
Jul 16, 2020·Expert Review of Hematology·Livio PaganoAlessandro Busca
Jun 21, 2019·BMJ Case Reports·Pawan Kumar Singh, Puneet Saxena
Nov 11, 2020·Abdominal Radiology·Samarjit Singh GhumanSeema Sud
Jan 6, 2021·Indian Journal of Pediatrics·Ashu Seith BhallaPriyanka Naranje
Feb 4, 2021·Respirology Case Reports·Muhammad Umair KhawarVeronica Indihar
Mar 20, 2020·Respiratory Medicine Case Reports·T KakuwaH Sugiyama
May 10, 2021·Chest·Khaled M NadaAlexander Duarte
May 22, 2021·Infectious Disease Clinics of North America·Julie M Steinbrink, Marisa H Miceli
Jun 11, 2021·Tropical Doctor·Valliappan Muthu, Ritesh Agarwal

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