Presentation
Exposure to bats (Madagascar). Fever and chills.
Patient Data
Miliary opacities.
Disseminated solid nodules, perilymphatic and peribronchovascular, in a miliary pattern.
Subnormal Xray.
Numerous disseminated lung nodules, with smaller size and cental calcification in some of them.
No more symptoms at the time of this CT scan.
Case Discussion
Bronchioloalveolar lavage found fungal elements later identified as Histoplasma. The patient was treated with rapid clinical improvement. The infection left numerous small micronodules, most of them showing a punctate central calcification. This is a rare presentation of histoplasmosis. In most cases, there are no symptoms nor radiological findings.
Follow-up CT scans showed no evolution of the nodules.
Dr P. Mascarel also contributed to this case.