Pulmonary fungal disease

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Last revised by Yuranga Weerakkody ◉ on 7 Aug 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Silverstone L, Knipe H, et al. Pulmonary fungal disease. Reference article, Radiopaedia.org (Accessed on 28 Mar 2025) https://doi.org/10.53347/rID-32147

DOI:

https://doi.org/10.53347/rID-32147

Permalink:

https://radiopaedia.org/articles/32147?iframe=true

rID:

32147

Article created:

16 Nov 2014, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

7 Aug 2024, Yuranga Weerakkody ◉

Disclosures:

At the time the article was last revised Yuranga Weerakkody had no financial relationships to ineligible companies to disclose.

View Yuranga Weerakkody's current disclosures

Revisions:

17 times, by 6 contributors - see full revision history and disclosures

Systems:

Chest

Sections:

Gamuts

Synonyms:

Fungal pneumonia
Fungal lung infection
Pulmonary fungal infection
Fungal lung infections
Fungal pneumonitis
Pulmonary fungal infections

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
- allergic bronchopulmonary aspergillosis (ABPA)
- invasive aspergillosis
  - chronic necrotizing aspergillosis (CNA) (or semi-invasive aspergillosis)
  - airway invasive aspergillosis (or bronchopneumonic aspergillosis)
  - angioinvasive aspergillosis
- obstructive bronchopulmonary aspergillosis
pulmonary candidiasis
pulmonary histoplasmosis
pulmonary blastomycosis
pulmonary cryptococcosis
pulmonary mucormycosis
pulmonary Lomentosa prolificans ¹¹ (previously known as Scedoporium prolificans) infection
pulmonary Pneumocystis jirovecii infection (now considered a form of fungus)
pulmonary cladophialophora infection

Serological markers

(1,3)-β-D-glucan serum concentrations: may have a role in detecting some situations with disseminated infection ⁹

Imaging evaluation

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.

Quiz questions

References

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10. Alexander B, Lamoth F, Heussel C et al. Guidance on Imaging for Invasive Pulmonary Aspergillosis and Mucormycosis: From the Imaging Working Group for the Revision and Update of the Consensus Definitions of Fungal Disease from the EORTC/MSGERC. Clin Infect Dis. 2021;72(Suppl 2):S79-88. doi:10.1093/cid/ciaa1855 - Pubmed
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
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Citation, DOI, disclosures and article data

Serological markers

Imaging evaluation

Quiz questions

References

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