CTICasesPulmonary Blastomycosis
Imaging findings
CT of the chest shows an area of mass-like consolidation in the right middle lobe with associated volume loss and sparse surrounding small pulmonary nodules. Air bronchograms are partially preserved but mostly obscured within the dense consolidation, and there is a notable absence of pleural effusion or mediastinal lymphadenopathy.
Key takeaways
Pulmonary blastomycosis is a soil-borne fungal infection common in the Ohio and Mississippi River valleys that frequently mimics lung cancer or tuberculosis. While histoplasmosis rarely presents as a large consolidation, blastomycosis commonly manifests as mass-like consolidation, often without significant pleural effusion or lymphadenopathy, particularly in patients presenting with unresolving community-acquired pneumonia.
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