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Intracavitary hematoma simulating mycetoma formation.
Mark T Knower1, Peter Kavanagh, Robert Chin
1Section on Pulmonary and Critical Care, the Wake Forest University School of Medicine, Winston-Salem, NC 27157-1054, USA. mknower@wfubmc.edu
Journal of Thoracic Imaging
|February 6, 2002
Summary
Radiographic findings suggesting fungal ball (mycetoma) in a patient with mixed connective-tissue disease were misleading. The lesion
Area of Science:
- Radiology
- Pulmonology
- Rheumatology
Background:
- Mixed connective-tissue disease (MCTD) can present with diverse pulmonary manifestations.
- Pulmonary mycetoma is a fungal infection often diagnosed via imaging.
Observation:
- A patient with MCTD presented with hemoptysis and radiographic findings suggestive of mycetoma.
- Initial antibiotic therapy for suspected mycetoma showed transient response.
Findings:
- Serial imaging revealed rapid resolution and recurrence, inconsistent with typical mycetoma.
- The clinical course suggested hemorrhage into a pre-existing cavity, mimicking mycetoma.
Implications:
- Classic radiographic signs of mycetoma are not pathognomonic and can be mimicked by intracavitary masses.
- Recognizing these radiographic 'mimickers' is crucial to avoid misdiagnosis and unnecessary invasive procedures in patients with hemoptysis.