Acute pulmonary coccidioidomycosis: CT findings from 15 patients

Abstract

The aim of this study was to describe the CT scan abnormalities in 15 patients with acute pulmonary coccidioidomycosis. Retrospective analysis of chest CT scans from 15 patients with acute pulmonary coccidioidomycosis was performed. The final diagnosis included the finding of Coccidioides immitis in mycology and/or histopathology, complemented by serology. Two radiologists evaluated the CT scans to study the type, size, profusion and localization of the findings. The final decisions were defined by consensus. CT scans showed multiple bilateral nodules in 13 patients and solitary nodules associated with consolidation in 2 cases. The nodules had ill-defined contours, ranging from 0.5 cm to 3.0 cm in diameter, which were predominant in the lower lobes in 11 cases. Cavitation of nodules was observed in 13 cases and coalescence in 7. Nodule-associated abnormalities were found in 13 cases, comprising interlobular septal thickening (n = 7) and consolidations (n = 6). Other abnormalities included lymph node enlargement (n = 6) and small pleural effusion (n = 2). In conclusion, the main CT finding in patients with acute coccidioidomycosis was that of multiple nodules (0.5-3.0 cm) at the lungs bases; a significant proportion of the remaining cases also showed other abnormalities. A diagnosis of coccidioidomycosis must be considered in patients with multiple lung nodules that are either in, or have recently been transported to, areas of endemic mycosis.

Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006

“…Among other diseases caused by dimorphic fungi, attention should be given to histoplasmosis and coccidioidomycosis, which showed increasing mortality rates. Coccidioidomycosis has been diagnosed in the Northeastern region of Brazil, mainly in the states of Ceará and Piauí (Wanke et al 1999, Capone et al 2008. However, the DC were emitted in different regions of Brazil, probably because the affected individuals had been on vacation in endemic areas prior to disease development or looked for a specialised medical centre in places far from their homes.…”

Fungal diseases mimicking primary lung cancer: radiologic–pathologic correlation

“…Approximately 60% of human primary infections are asymptomatic; the majority of symptomatic cases are characterised by mild‐to‐severe acute pulmonary infection that generally resolves spontaneously. Progressive pulmonary coccidioidomycosis is generally chronic and develops after the first infection, with symptoms failing to resolve after 2 months …”

“…inhaled into the lung develop into thin‐walled spherules that rupture and release numerous endospores, causing a granulocytic response that is histologically non‐specific unless spherules and endospores can be recognised. As the inflammatory response progresses, an epithelioid granuloma containing large histiocytes and giant cells is formed . Central necrosis and a variable degree of fibrosis may be observed as healing occurs.…”

“…Coccidioidomycosis is a systemic mycosis caused by dimorphic fungi, endemic to arid and semiarid regions in the south-western United States and northern Mexico, and in certain areas of Central and South America. [38][39][40][41] Initially, it was thought that coccidioidomycosis was only caused by the fungus Coccidioides immitis. Based on molecular phylogeny studies, the existence of another species has been recently demonstrated.…”

Diagnosis and Management of Systemic Endemic Mycoses Causing Pulmonary Disease

“…The disease can spread from the lungs hematogenously to bones, joints, skin, and the central nervous system. Some patients have persistent pulmonary complications including residual pulmonary nodules (coccidioidomas), fibrosis and cavities, with the concurrent risks of developing chronic pulmonary aspergillosis or pulmonary abscesses, or fistulae as long-term sequelae [7,12,13]. dor, Peru, and Venezuela [14,15].…”