Early Identification of Lung Fungal Infections in Chronic Granulomatous Disease (CGD) Using Multidetector Computer
Maria Pia Bondioni1,2, Vassilios Lougaris3, Giuseppe Di Gaetano4
1Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. mariapiabondioni@gmail.com.
Purpose:
The purpose of this study is to evaluate the possibility of early detection of pulmonary fungal infections by lung CT scan in chronic granulomatous disease (CGD).
Methods:
A retrospective study on 14 patients affected with CGD for a total of 18 infectious episodes was performed. Revision of clinical data and CT scan analysis before and after treatment was performed.
Results:
The presence of lung nodules <30 mm was evaluated in 18 infectious episodes in 14 patients. A total of 125 nodules in 18 CT scans were identified. Identification of the infectious agent through biopsy and in vitro culture resulted positive only in 3/18 cases. The remaining cases received clinical/radiologic diagnosis of suspected pulmonary fungal infection. In all cases, the introduction of empirical antifungal treatment resulted in reduction in size or complete resolution of the pulmonary lung nodules in all patients affected with CGD.
Conclusions:
Lung CT scan allows for early detection of pulmonary fungal infection in CGD. Pulmonary nodules (<30 mm), single or multiple, uni- or bilateral, with or without a halo sign may represent the first radiologic sign of pulmonary fungal infection in CGD.
Insights
Early detection of pulmonary fungal infections in chronic granulomatous disease (CGD) is possible with lung CT scans. Small pulmonary nodules identified on CT scans may indicate fungal infection in CGD patients.
Area of Science:
- Medical Imaging
- Pulmonology
- Infectious Diseases
Background:
- Chronic granulomatous disease (CGD) predisposes patients to severe infections.
- Pulmonary fungal infections are a significant concern in CGD patients.
- Early diagnosis and treatment are crucial for managing fungal infections in CGD.
Purpose of the Study:
- To evaluate the utility of lung computed tomography (CT) scans for the early detection of pulmonary fungal infections in patients with CGD.
- To identify characteristic radiologic findings associated with fungal infections in CGD.
Main Methods:
- Retrospective analysis of 14 CGD patients with 18 infectious episodes.
- Review of clinical data and CT scan findings before and after treatment.
- Evaluation of pulmonary nodules (<30 mm) on CT scans.
Main Results:
- 125 pulmonary nodules were identified across 18 CT scans.
- Fungal agents were confirmed in only 3 of 18 episodes via biopsy/culture.
- Empirical antifungal treatment led to nodule resolution in all suspected cases.
- Pulmonary nodules (<30 mm) were observed in patients with suspected fungal infections.
Conclusions:
- Lung CT scans are effective for the early detection of pulmonary fungal infections in CGD.
- Pulmonary nodules, including those with a halo sign, can be the initial radiologic indicator of fungal infection in CGD.
- CT findings, coupled with clinical suspicion, guide empirical antifungal therapy in CGD.
