AIM: To assess initial and follow-up CT findings of invasive pulmonary aspergillosis (IPA) in solid organ transplant (SOT) recipients using new diagnostic criteria, and to compare initial CT findings of survivors with those of patients who died. MATERIALS AND METHODS: Forty-six adult SOT patients who met the 2008 EORTC/MSG criteria for proven or probable invasive pulmonary aspergillosis were assessed. Initial CT findings of the 21 survivors and 15 patients who died of IPA-related causes were compared using the internationally recognized thoracic glossary of terms. The extents of the largest lesions in each of 18 surviving were measured and changes of those lesions were recorded. RESULTS: Consolidation or mass was the most common finding, observed in 33 of 46 patients (72%), followed by large nodules (59%), ground-glass opacity (50%), and infarcted consolidation (48%). Consolidation or mass was significantly less frequent in survivors than in patients who died (62% versus 93%). Cavitation was more common (43% versus 13%), and significantly smaller (7.5 cm(2) versus 19 cm(2), p = 0.014) in survivors. Follow-up CT in survivors showed that the halo sign resolved rapidly within 4 weeks. The extent of consolidation, infarcted consolidation, and internal low-density area decreased gradually with time to reduce to half the size in 3 weeks. Large nodules persisted for the first 7 days (84%), followed by slow regression. CONCLUSION: Consolidation or mass is the most common CT finding of IPA in SOT recipients. Absence of consolidation or mass and presence of small cavities may be associated with better prognosis. The time for resolution of each pattern after treatment varies.
AIM: To assess initial and follow-up CT findings of invasive pulmonary aspergillosis (IPA) in solid organ transplant (SOT) recipients using new diagnostic criteria, and to compare initial CT findings of survivors with those of patients who died. MATERIALS AND METHODS: Forty-six adult SOT patients who met the 2008 EORTC/MSG criteria for proven or probable invasive pulmonary aspergillosis were assessed. Initial CT findings of the 21 survivors and 15 patients who died of IPA-related causes were compared using the internationally recognized thoracic glossary of terms. The extents of the largest lesions in each of 18 surviving were measured and changes of those lesions were recorded. RESULTS: Consolidation or mass was the most common finding, observed in 33 of 46 patients (72%), followed by large nodules (59%), ground-glass opacity (50%), and infarcted consolidation (48%). Consolidation or mass was significantly less frequent in survivors than in patients who died (62% versus 93%). Cavitation was more common (43% versus 13%), and significantly smaller (7.5 cm(2) versus 19 cm(2), p = 0.014) in survivors. Follow-up CT in survivors showed that the halo sign resolved rapidly within 4 weeks. The extent of consolidation, infarcted consolidation, and internal low-density area decreased gradually with time to reduce to half the size in 3 weeks. Large nodules persisted for the first 7 days (84%), followed by slow regression. CONCLUSION: Consolidation or mass is the most common CT finding of IPA in SOT recipients. Absence of consolidation or mass and presence of small cavities may be associated with better prognosis. The time for resolution of each pattern after treatment varies.
Authors: J J Vehreschild; C P Heussel; A H Groll; M J G T Vehreschild; G Silling; G Würthwein; M Brecht; O A Cornely Journal: Eur Radiol Date: 2017-01-12 Impact factor: 5.315
Authors: Maria Pia Bondioni; Vassilios Lougaris; Giuseppe Di Gaetano; Tiziana Lorenzini; Annarosa Soresina; Francesco Laffranchi; Diego Gatta; Alessandro Plebani Journal: J Clin Immunol Date: 2016-10-21 Impact factor: 8.317
Authors: J Peter Donnelly; Sharon C Chen; Carol A Kauffman; William J Steinbach; John W Baddley; Paul E Verweij; Cornelius J Clancy; John R Wingard; Shawn R Lockhart; Andreas H Groll; Tania C Sorrell; Matteo Bassetti; Hamdi Akan; Barbara D Alexander; David Andes; Elie Azoulay; Ralf Bialek; Robert W Bradsher; Stephane Bretagne; Thierry Calandra; Angela M Caliendo; Elio Castagnola; Mario Cruciani; Manuel Cuenca-Estrella; Catherine F Decker; Sujal R Desai; Brian Fisher; Thomas Harrison; Claus Peter Heussel; Henrik E Jensen; Christopher C Kibbler; Dimitrios P Kontoyiannis; Bart-Jan Kullberg; Katrien Lagrou; Frédéric Lamoth; Thomas Lehrnbecher; Jurgen Loeffler; Olivier Lortholary; Johan Maertens; Oscar Marchetti; Kieren A Marr; Henry Masur; Jacques F Meis; C Orla Morrisey; Marcio Nucci; Luis Ostrosky-Zeichner; Livio Pagano; Thomas F Patterson; John R Perfect; Zdenek Racil; Emmanuel Roilides; Marcus Ruhnke; Cornelia Schaefer Prokop; Shmuel Shoham; Monica A Slavin; David A Stevens; George R Thompson; Jose A Vazquez; Claudio Viscoli; Thomas J Walsh; Adilia Warris; L Joseph Wheat; P Lewis White; Theoklis E Zaoutis; Peter G Pappas Journal: Clin Infect Dis Date: 2020-09-12 Impact factor: 9.079