CTICasesAspergillus niger Infection (Post-Heart Transplant)
Imaging findings
Chest radiographs and subsequent CT scans in a cardiac transplant recipient show a large, cavitating nodular opacity surrounded by consolidation in the right lung. There are also beautiful, diagnostic centrilobular tree-in-bud and lobular airway-centered opacities representing bronchiolar impaction and distal alveolar spillover.
Key takeaways
Immunosuppressed patients, such as solid organ transplant recipients, are highly susceptible to opportunistic fungal infections. Aspergillus niger is a less common species than Aspergillus fumigatus but can cause identical invasive or semi-invasive pulmonary disease, which resolves with appropriate antifungal therapy. Remnants of pacemaker leads or sternal wires on chest films can serve as clues to prior transplantation.
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