Pulmonary zygomycosis: CT appearance.
OBJECTIVE
We describe the CT appearance of pulmonary zygomycosis (mucormycosis), an opportunistic infection typically occurring in immunocompromised patients.


METHODS
Eight patients with pulmonary zygomycosis imaged with CT were reviewed, seven at initial diagnosis and one with a subsequent complication. The appearance, number, and location of pulmonary lesions and the presence of pleural effusions and extrapulmonary involvement were assessed. Rim enhancement, air bronchograms, the halo sign, air crescent sign, cavitation, and central low attenuation suggesting necrosis were recorded.


RESULTS
There were 14 nodules and 5 areas of mass-like or wedge-shaped consolidation. Pleural effusion was present in five patients, halo sign in three, central low attenuation in two, and cavitation in one. In the affected lobe 13 of 14 nodules and all consolidations were posterior. Of 19 lesions 16 (84%) were confined to the upper lobes, with 3 in the superior segment of a lower lobe. Endobronchial disease with lobar collapse was the only manifestation in one patient. Major complications were direct spinal invasion in one patient and multiple pulmonary artery pseudoaneurysms in another patient.


CONCLUSIONS
In the appropriate clinical circumstance, nodules or mass-like or wedge-shaped consolidation, especially posteriorly in the upper lobes of the lung, should suggest zygomycosis. Endobronchial zygomycosis is less common.
Jamadar
D A
DA
Department of Radiology, University of Michigan Hospital, Ann Arbor 48109-0326, USA.
Kazerooni
E A
EA
Daly
B D
BD
White
C S
CS
Gross
B H
BH
D000328:Adult; D000368:Aged; D000388:Air; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D001995:Bronchography; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000000981:diagnostic imaging*; D009336:Necrosis; D009894:Opportunistic Infections / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000382:microbiology; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000382:microbiology; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000382:microbiology; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D014057:Tomography, X-Ray Computed