CTICasesSyphilitic Lung Nodules (Gummata) Mimicking Fungal Infection
Imaging findings
Chest radiography initially showed new, faint lung nodules. CT revealed multiple subpleural and peripheral lung nodules, including some in the lower lobes and lingula, with some demonstrating air bronchograms. These findings raised concern for fungal infection in an immunosuppressed patient with Hodgkin's lymphoma.
Key takeaways
Syphilitic lung nodules, known as gummata, are a rare manifestation of syphilis and can present as pulmonary nodules mimicking other granulomatous diseases or infections. The presence of air bronchograms within the nodules and a peripheral distribution can be unusual for typical fungal infections. Diagnosis often requires a high index of suspicion, especially when conventional microbiological workup is negative, and may involve advanced molecular techniques like PCR on tissue, particularly in patients with other systemic signs of syphilis (e.g., uveitis, rash). Gummata typically resolve with antibiotic treatment.
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