Pulmonary fungal infection: imaging findings in immunocompetent and immunocompromised patients

Area of Science:

• Medical Mycology
• Infectious Diseases
• Pulmonology

Background:

• Endemic mycoses like histoplasmosis are prevalent in North America.
• While typically self-limiting in immunocompetent individuals, these fungal infections can lead to severe pulmonary disease.
• Ubiquitous fungi (Cryptococcus, Aspergillus, Candida, Mucorales) pose risks to immunocompromised patients.

Purpose of the Study:

• To review the clinical and imaging characteristics of endemic and opportunistic fungal infections of the lung.
• To highlight the spectrum of disease presentation based on host immune status and fungal etiology.
• To correlate specific imaging findings with causative organisms and patient conditions.

Main Methods:

• Review of relevant literature on fungal pneumonia.
• Analysis of imaging findings in various fungal infections.
• Correlation of clinical presentation with microbiological data and immune status.

Main Results:

• Histoplasmosis, coccidioidomycosis, and blastomycosis are common endemic mycoses.
• Severe pneumonitis and chronic pulmonary infections can develop in immunocompetent hosts.
• Opportunistic fungal infections (Cryptococcus, Aspergillus, Candida, Mucorales) primarily affect immunocompromised individuals.
• Imaging findings vary significantly based on the pathogen, host immunity, and post-treatment status.

Conclusions:

• Fungal pneumonias present a diverse range of clinical and radiographic manifestations.
• Understanding the interplay between host immunity, fungal species, and imaging is crucial for diagnosis.
• Prompt recognition and appropriate management are essential for improving outcomes in patients with fungal lung infections.