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Thoracic mycoses from opportunistic fungi: radiologic-pathologic correlation
H P McAdams1, M L Rosado-de-Christenson, P A Templeton
1Department of Radiology, Walter Reed Army Medical Center, Washington, DC, USA.
Summary
Common fungi like Aspergillus, Candida, and Cryptococcus cause serious lung infections in immunocompromised individuals. Definitive diagnosis of these opportunistic mycoses relies on tissue samples, not unreliable sputum cultures.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonology
Background:
- Opportunistic mycoses of the thorax are frequently caused by Aspergillus, Candida, Cryptococcus, and Zygomycetes.
- These fungal infections pose significant threats, particularly to immunocompromised patients, often leading to severe pneumonia.
Purpose of the Study:
- To review the epidemiology, clinical presentations, and diagnostic challenges of thoracic opportunistic mycoses.
- To emphasize the importance of accurate diagnostic methods for these fungal infections.
Main Methods:
- Review of literature on fungal pathogens causing thoracic infections.
- Discussion of clinical and radiological manifestations.
- Analysis of diagnostic limitations and reliable methods.
Main Results:
- Aspergillus, Candida, Cryptococcus, and Zygomycetes are key pathogens.
- Candidiasis and zygomycosis typically present as severe pneumonias.
- Cryptococcus neoformans infections show diverse presentations in various patient groups.
- Sputum cultures are unreliable due to normal upper respiratory tract colonization.
Conclusions:
- Accurate diagnosis of opportunistic mycoses requires understanding disease epidemiology and clinical/radiological features.
- Definitive diagnosis depends on culturing fungi from infected tissue or microscopic examination of tissue samples.