CTICasesKlebsiella and Aspergillus Co-infection in Cardiac Transplant
Imaging findings
Chest radiograph and CT in a cardiac transplant recipient show a large consolidation in the right upper lobe with bulging of the minor fissure (bulging fissure sign), alongside cavitating pulmonary nodules in the left lung. Cultures were positive for Klebsiella pneumoniae, Aspergillus, and CMV.
Key takeaways
Immunosuppressed transplant recipients are at high risk for opportunistic co-infections. Klebsiella pneumoniae classically causes a dense, lobar consolidation that can lead to tissue necrosis and swelling, presenting as the bulging fissure sign. Aspergillus commonly manifests as nodular lesions that undergo cavitation.
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