CTICasesBlastomycosis mimicking Histoplasmosis
Imaging findings
CT chest shows a solitary, small pulmonary nodule in the left lower lobe, with localized areas of decreased lung perfusion surrounding it and mild bronchopulmonary lymphadenopathy. Follow-up CT after antifungal therapy shows resolution of the nodule and adenopathy.
Key takeaways
Blastomycosis is an endemic fungal infection that classically presents as large mass-like consolidations, cavities, or diffuse nodular disease. A presentation with a small, solitary pulmonary nodule and associated hilar lymphadenopathy is atypical for blasto and closely mimics histoplasmosis, but blasto should remain in the differential for endemic regions.
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