Thoracic Paracoccidioi-domycosis: Radiographic and CT Findings

Abstract

Paracoccidioidomycosis (PCM) is the most common systemic myco sis in Latin America. Although most cases occur in developing coun tries, recent immigration patterns and an increase in travel have led to a growing number of PCM cases in the United States and Europe. PCM is caused by the dimorphic fungus Paracoccidioides brasiliensis, and the chronic form may progress to severe pulmonary involvement. Several radiologic patterns have been described for pulmonary PCM, including linear and reticular opacities, variable-sized nodules, patchy ill-defined opacities, airspace consolidation, and cavitary lesions. Fi brosis and paracicatricial emphysema are common associated findings. Chest computed tomography (CT) is the method of choice for evalu ating pulmonary PCM, with the most common CT findings being ground-glass attenuation, consolidation, small or large nodules, masses, cavitations, interlobular septal thickening, emphysema, and fibrotic le sions. PCM is also an important cause of the “reversed halo” sign at high-resolution CT and should be considered in the differential diag nosis. Awareness of the multiple radiologic manifestations of PCM as well as its epidemiologic and clinical characteristics may permit early diagnosis and initiation of specific treatment, thereby reducing associ ated morbidity and mortality.