CTICasesPleural Blastomycosis
Imaging findings
Contrast-enhanced chest CT shows a complicated pleural collection on the right with irregular, enhancing pleural margins, suggesting adhesions or septations. Consolidation is present in the adjacent right lower lobe, and a small, enhancing nodule is visualized along the pleural surface, mimicking an empyema or pleural malignancy.
Key takeaways
Although blastomycosis typically presents as parenchymal consolidation or nodules, it can rarely manifest with significant pleural involvement, including empyema and pleural nodularity that mimics a malignant process. Diagnosis is confirmed via pleural fluid culture, and patients typically demonstrate slow but favorable responses to long-term antifungal therapy.
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