CTICasesMarijuana-Associated Aspergillus Bronchiolitis
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Imaging findings
High-resolution CT chest with MIP reconstructions demonstrates a diffuse, small airways pattern consisting of tiny centrilobular nodules and a "tree-in-bud" appearance, with positive serum and bronchoalveolar lavage galactomannan assays.
Key takeaways
Fungal spores on marijuana buds can survive combustion and be inhaled deep into the distal airways. In neutropenic or otherwise immunocompromised patients, this can lead to diffuse Aspergillus bronchiolitis rather than angioinvasive disease. Inquiring about recreational marijuana use is a crucial clinical step in patients presenting with atypical opportunistic lung infections.
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See all cases from March 25, 2016 →