The reversed halo sign as the initial radiographic sign of pulmonary zygomycosis

A. Busca, G. Limerutti, F. Locatelli, A. Barbui, F. G. De Rosa, M. Falda

Research output: Contribution to journalArticle

Abstract

Zygomycosis is an emerging fungal infection that is associated with high mortality in hematological patients and stem cell transplantation (SCT) recipients. Radiology-computed tomography (CT) imaging in particular-facilitates the detection of lung involvement at an early stage of the infection. The reversed halo sign (RHS) has previously been reported in cryptogenetic organizing pneumonia and, more recently, as a manifestation of pulmonary zygomycosis. Here we describe a case of histologically proven zygomycosis due to Rhizopus microsporus in a SCT recipient. A chest CT scan performed on day +6 due to persistent fever unresponsive to antibiotics revealed the presence of the RHS, i.e., a focal ground-glass opacity mass surrounded by a solid ring of consolidation. The patient was treated with a combination of liposomal amphotericin B, caspofungin, and deferasirox, but subsequently developed a large pneumothorax and died on day +49 due to progressive infection. This case supports earlier observations that RHS may be an early radiological sign of zygomycosis, facilitating an aggressive diagnostic strategy.

Original languageEnglish
Pages (from-to)77-80
Number of pages4
JournalInfection
Volume40
Issue number1
DOIs
Publication statusPublished - Feb 2012

Fingerprint

Zygomycosis
Lung
Stem Cell Transplantation
caspofungin
Tomography
Rhizopus
Mycoses
Pneumothorax
Infection
Radiology
Glass
Pneumonia
Fever
Thorax
Anti-Bacterial Agents
Mortality

Keywords

  • Invasive fungal infection
  • Stem cell transplantation
  • Zygomycosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

The reversed halo sign as the initial radiographic sign of pulmonary zygomycosis. / Busca, A.; Limerutti, G.; Locatelli, F.; Barbui, A.; De Rosa, F. G.; Falda, M.

In: Infection, Vol. 40, No. 1, 02.2012, p. 77-80.

Research output: Contribution to journalArticle

Busca, A, Limerutti, G, Locatelli, F, Barbui, A, De Rosa, FG & Falda, M 2012, 'The reversed halo sign as the initial radiographic sign of pulmonary zygomycosis', Infection, vol. 40, no. 1, pp. 77-80. https://doi.org/10.1007/s15010-011-0156-y
Busca, A. ; Limerutti, G. ; Locatelli, F. ; Barbui, A. ; De Rosa, F. G. ; Falda, M. / The reversed halo sign as the initial radiographic sign of pulmonary zygomycosis. In: Infection. 2012 ; Vol. 40, No. 1. pp. 77-80.
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