ppt on fungal pneumonia

1. PULMONARY FUNGAL DISEASE

2. ● Pulmonary fungal disease is caused by various organisms of varying virulence and
varying sensitivity to antifungal drugs. Immunocompromise, particularly
neutropaenia is a major risk factor for invasive and disseminated disease.
● Pathologic fungi include:
• Pulmonary aspergillosis: pulmonary aspergillus infection considered the most
important in immunocompromised individuals 5
• Aspergilloma (saprophytic/non-invasive aspergillosis): the most common
form seen radiographically
• Allergic bronchopulmonary aspergillosis (ABPA)
• Invasive aspergillosis
• Obstructive bronchopulmonary aspergillosis
• Pulmonary candidiasis
• Pulmonary histoplasmosis
• Pulmonary blastomycosis
• Pulmonary cryptococcosis
• Pulmonary mucormycosis

3. Pulmonary mucormycosis:
● Oppurtunistic pulmonary fungal infection
● Has to distinguished from invasive pulmonary aspergillosis
● Considered rare, but encountered in patients with prolonged neutropenia or
h/o hematopoietic stem cell transplantation
● clinical features: Fever, nonproductive cough and progressive dyspnea
symptoms refractory to broad spectrum Abx
Invasiobn of major pulmonary vessels- Hemoptysis
chest pain, pleural effusion are less likely

4. ● Diagnosis: Microbiological assessment usually make diagnosis
● Radiographic features:
Can present as solitary nodule, lobular consolidation as in pneumonia, cavitatory lesion
CT: On CT, ground-glass opacities may be encountered 3. Recently the reversed halo
sign or bird's nest sign has been demonstrated as a fairly specific sign capable of
suggesting the diagnosis.
In contrast to cryptogenic organizing pneumonia (COP), the peripheral capsule in the
reversed halo sign tends to be thicker, which is highly suggestive of mucormycosis.
The presence of more than ten lung nodules or a pleural effusion was found to
discriminate mucormycosis from aspergillosis in a cancer patients

5. Reverse halo sign
There is an ovoid lesion in the right
lower lobe which demonstrates central
ground-glass density surrounded by
peripheral consolidation.

6. Bacterial pneumonia Fungal pneumonia
consolidation Segmental/subsegmental
consolidation without
GGO or nodules
Multifocal non
segmental
consolidation + GGO
and nodules
Halo sign uncommon common
Reverse halo sign Very unlikely More specific
cavitation can occur Cavitation with air
cresent sign
suggestive of ifd
Pleural effusion More common Less common

7. Pulmonary aspergillosis:
Multiple pulmonary round infiltrates with
surrounding ground-glass opacity suggesting
haemorrhage and raising the probability of
this representing fungal infection.

8. Chronic Necrotizing Aspergillosis

9. THANK YOU