Imaging studies for diagnosing invasive fungal pneumonia in immunocompromised patients

The aim is to review imaging advances in invasive fungal pneumonia in cancer and transplant recipients and how their use can help guide treatment.

Early chest computed tomographic (CT) imaging of immunocompromised patients with neutropenic fever leads to improved survival. Some of the typical CT findings of invasive fungal pneumonia are transitory and are most common during the first week of symptoms. The reversed halo sign, an early sign of disease, is more common in mucormycosis. During the first 10 days of infection, invasive fungal pneumonia nodules may grow on follow-up CT scans, but this does not necessarily equate to worsening disease. Because of the excessive radiation of chest CT and because pulmonary nodule size typically expands during the first few weeks of treatment, follow-up CT scans should be ordered only when therapy changes are dependent on imaging findings.

Early chest CT imaging in immunocompromised patients suspected of having invasive fungal pneumonia can help identify disease early, leading to improved outcome.