Pulmonary Mucormycosis: Radiologic Features at Presentation and Over Time

Area of Science:

• Radiology
• Infectious Diseases
• Pulmonology

Background:

• Pulmonary mucormycosis is a severe opportunistic fungal infection.
• Early diagnosis is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the characteristic computed tomography (CT) and magnetic resonance imaging (MRI) features of pulmonary mucormycosis.

Main Methods:

• Retrospective review of 30 patients with confirmed or probable pulmonary mucormycosis (2007-2017).
• Radiologists assessed CT and MRI for specific signs: reverse halo, large ground-glass halo, peripheral distribution, and evolution of lesions.
• Precursor lesions and MRI findings were analyzed.

Main Results:

• The reverse halo sign was present in 67% of patients.
• Large ground-glass halos (>lesion) were seen in 53%, and peripheral predominance in 87%.
• Perivascular ground-glass precursor lesions were identified in 20%, and a multifocal pneumonia pattern in 17% of cases, associated with high mortality.

Conclusions:

• Pulmonary mucormycosis frequently presents with reverse halo signs or large perilesional ground-glass halos.
• Peripheral lesion predominance and early perivascular ground-glass foci are notable findings.
• A multifocal pneumonia pattern indicates severe disease and carries a high mortality risk.