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Invasive Fungal Pneumonia in Immunocompromised Patients
Myrna C B Godoy1, Hanna R Ferreira Dalla Pria1, Mylene T Truong1
1Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 371, Houston, TX 77030, USA.
Abstract:
Fungal pneumonia is the most frequent presentation of invasive fungal infections (IFIs) in patients with hematologic malignancies (HM) and hematopoietic stem cell transplantation (HSCT) recipients. The most common causes include Aspergillus, Mucor, Fusarium, and Candida species. The high incidence and high morbidity and mortality rate of fungal pneumonias in HM/HSCT populations arise from severe immune dysfunction that may be caused by both the underlying disease and/or its treatment. CT is routinely used when pulmonary complications are suspected after HSCT. Appropriate image interpretation of the posttransplant patient requires a combination of pattern recognition and knowledge of the clinical setting. In this article, we provide an overview of the clinical manifestations and CT imaging features of the most common invasive fungal pneumonias (IFPs) seen in severely immunosuppressed hosts.
Insights
Fungal pneumonia is a common, serious complication in patients with hematologic malignancies and after stem cell transplants. This overview details clinical and CT imaging features of invasive fungal pneumonias in these immunocompromised patients.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Hematology
Background:
- Fungal pneumonia is the most common invasive fungal infection (IFI) in hematologic malignancy (HM) and hematopoietic stem cell transplantation (HSCT) patients.
- Severe immune dysfunction in HM/HSCT populations increases susceptibility to IFIs, leading to high morbidity and mortality.
- Common causative agents include Aspergillus, Mucor, Fusarium, and Candida species.
Purpose of the Study:
- To provide an overview of clinical manifestations and CT imaging features of invasive fungal pneumonias (IFPs).
- To aid in the interpretation of pulmonary complications in severely immunosuppressed hosts, particularly post-HSCT.
Main Methods:
- Review of clinical manifestations and computed tomography (CT) imaging features of common IFPs.
- Focus on pattern recognition combined with clinical context for post-HSCT patients.
Main Results:
- Fungal pneumonia presents frequently in HM/HSCT recipients due to profound immune suppression.
- CT is a key diagnostic tool for suspected pulmonary complications post-HSCT.
- Understanding specific imaging patterns is crucial for diagnosis.
Conclusions:
- Invasive fungal pneumonias are a significant threat to HM and HSCT patients.
- Accurate interpretation of CT findings in conjunction with clinical information is essential for timely diagnosis and management.
- This review highlights key imaging features to improve diagnostic accuracy.
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