Weerakkody Y, Silverstone L, Knipe H, et al. Pulmonary fungal disease. Reference article, Radiopaedia.org (Accessed on 17 Feb 2025) https://doi.org/10.53347/rID-32147
Pulmonary fungal disease is caused by various organisms of varying virulence and varying sensitivity to antifungal drugs. Immunocompromise, particularly neutropaenia is a major risk factor for invasive and disseminated disease.
Pathologic fungi include:
pulmonary aspergillosis: pulmonary aspergillus infection considered the most important in immunocompromised individuals 5
aspergilloma (saprophytic/non-invasive aspergillosis): the most common form seen radiographically
CT chest is considered the diagnostic imaging standard although recent publications suggest some role in CT pulmonary angiography in those with only a "possible clinical diagnosis" and in those with breakthrough infection who are on prophylaxis 12.
PET-CT may have a role some cases especially in those with suspected extra-thoracic invasive fungal disease needing accurate assessments of disease response to antifungal therapy 12.
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11. Konsoula A, Tsioutis C, Markaki I, Papadakis M, Agouridis A, Spernovasilis N. Lomentospora Prolificans: An Emerging Opportunistic Fungal Pathogen. Microorganisms. 2022;10(7):1317. doi:10.3390/microorganisms10071317 - Pubmed
12. Lewis R, Stanzani M, Morana G, Sassi C. Radiology-Based Diagnosis of Fungal Pulmonary Infections in High-Risk Hematology Patients: Are We Making Progress? Curr Opin Infect Dis. 2023;36(4):250-6. doi:10.1097/QCO.0000000000000937 - Pubmed
13. Ankrah A, Lawal I, Dierckx R, Sathekge M, Glaudemans A. Imaging of Invasive Fungal Infections- The Role of PET/CT. Semin Nucl Med. 2023;53(1):57-69. doi:10.1053/j.semnuclmed.2022.07.003 - Pubmed