Computed tomographic scan evaluation of pulmonary blastomycosis
Suzanne Ronald1, Jacek Strzelczyk, Sean Moore
1School of Medicine;
Summary
Pulmonary blastomycosis diagnosis is challenging due to varied presentations. Chest CT scans show common findings like consolidation and nodules, but no single characteristic confirms blastomycosis (Blastomyces dermatitidis).
Area of Science:
- Medical Mycology
- Infectious Diseases
- Radiology
Background:
- Blastomycosis is a rare granulomatous infection caused by Blastomyces dermatitidis.
- Diagnosis can be delayed due to diverse clinical presentations.
- Chest CT characteristics of pulmonary blastomycosis are not well-defined.
Purpose of the Study:
- To describe the computed tomographic (CT) findings in patients with pulmonary blastomycosis.
- To identify characteristic imaging features that may aid in early diagnosis.
Main Methods:
- Retrospective review of 34 chest CT scans from patients with confirmed pulmonary blastomycosis.
- Analysis of common imaging findings including air bronchograms, consolidation, nodules, and lymphadenopathy.
Main Results:
- Common CT findings included air bronchograms (65%), consolidation (62%), and nodules (62%).
- Lymph node enlargement was observed in 35% of patients.
- A miliary pattern was infrequent, seen in only 12% of cases.
Conclusions:
- No specific CT abnormality definitively identifies pulmonary blastomycosis.
- Diagnosis requires a high clinical suspicion combined with histological or culture confirmation.
- CT findings are variable and may mimic other pulmonary diseases.
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