CT OF INVASIVE PULMONARY ASPERGILLOSIS IN CHILDREN WITH CANCER

In treating cases of malignancy, the use of chemotherapy carries a hig h risk of lower respiratory tract infections, especially fungal pneumo nopathy. This complication is a major cause of mortality and is often difficult to diagnose because of non-specific clinical or radiological changes, but the early recognition of invasive fungal disease is impe rative. CT is an important non-invasive method for the detection and e valuation of opportunistic fungal infections. In these patients an imp roved survival rate can be achieved when early detection by CT leads t o the prompt institution of high-dose antifungal therapy. We illustrat e the spectrum of CT findings of invasive pulmonary aspergillosis enco untered in children with cancer. These patients had previously been tr eated with high-dose chemotherapy with or without bone marrow rescue, and underwent radiological examinations because of clinical evidence o f pneumonopathy. Representative cases demonstrate the clinical applica tions of CT in the evaluation and management of invasive fungal diseas e.