CTICasesDisseminated Alternaria Infection
Imaging findings
CT chest in a patient taking adalimumab (TNF-alpha inhibitor) shows multiple bilateral pulmonary nodules and necrotic masses with surrounding ground-glass halos and central abscess-like necrosis, associated with a pleural effusion. Biopsy grew the pigmented mold Alternaria.
Key takeaways
Alternaria is a dematiaceous (pigmented) mold that rarely causes invasive human disease. In patients undergoing tumor necrosis factor-alpha (TNF-alpha) blocker therapy, it can disseminate, presenting with necrotizing pulmonary masses and skin lesions, and requiring surgical debridement and targeted antifungals.
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