CTICasesPulmonary Mucormycosis (Rhizopus microsporus)
Imaging findings
A neutropenic patient on azole prophylaxis has new bilateral, fairly symmetric dense consolidative blobs, larger on the right, with surrounding ground glass, some internal air bronchograms, and patchy lucent areas suggesting a reverse-halo/bird's-nest appearance. PCR identified Rhizopus microsporus.
Key takeaways
In a neutropenic patient, bilateral symmetric dense nodular consolidation that develops despite azole prophylaxis raises invasive mould infection, and Rhizopus microsporus (a Mucorales agent) images like other mucormycosis. This species favors decaying plant material and has a symbiotic relationship with Burkholderia that enhances host tissue necrosis; the differential for symmetric bilateral disease also includes Legionella micdadei.
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