PULMONARY MUCORMYCOSIS - RADIOLOGIC FINDINGS IN 32 CASES

OBJECTIVE, The purpose of this study was to characterize the radiologi c manifestations of pulmonary mucormycosis with clinical and pathologi c correlation. MATERIALS AND METHODS, Clinical records, pathology repo rts, chest radiographs, and CT scans of 32 cases of pathologically pro ven pulmonary mucormycosis were retrospectively reviewed. RESULTS, The study group included 20 males and 12 females with a mean age of 47 ye ars old. Clinical data were available for 29 patients. Signs and sympt oms included fever (n = 23), cough (n = 21), bloody sputum (n = 9), dy spnea (n = 7), and chest pain (n = 6). Four patients were asymptomatic . Most patients were either immunocompromised (n = 20) or had diabetes mellitus (n = 9). Sputum or bronchoalveolar lavage cultures showed no growth in 17 of 18 cases. Diagnoses were confirmed at surgery or auto psy in all cases. Abnormalities seen on chest radiographs included lob ar (n = 15) or multilobar (n = 6) consolidation, solitary (n = 7) or m ultiple (n = 1) masses, and solitary (n = 3) or multiple (n = 2) nodul es. Cavitation was seen on chest radiographs in 13 patients, and intra cavitary masses were seen in four. Associated radiographic findings in cluded hilar (n = 3) or mediastinal (n = 3) adenopathy and unilateral (n = 6) or bilateral (n = 3) pleural effusion. CT in 19 patients revea led these significant additional findings: splenic (n = 1) or renal (n = 1) involvement, bronchial occlusion (n = 1), extrapulmonary invasio n (n = 1), and pulmonary artery pseudoaneurysm (n = 1). CONCLUSION, In our study, pulmonary mucormycosis typically was manifested in immunoc ompromised or diabetic patients by consolidation on chest radiographs; cavitation was seen in 40% of patients. CT revealed significant unsus pected abnormalities in 26% of patients. Definitive diagnosis required pathologic demonstration of the organism in affected tissue because c ultures from our patients rarely showed growth.