Aims and objectives
Introduction According to the Fleischner Society,
the term reversed halo sign (RHS) defines “a focal,
rounded area of ground-glass opacity surrounded by a more or less complete ring of consolidation” on chest-computed tomography (CT) images (figure 1),
and it resembles the opposite or “reverse” of the ‘‘halo sign’’ which is often found in angioinvasive pulmonary aspergillosis.
It also seems like the ring-shaped coral reefs surrounding a central lagoon,
thus some Authors call it atoll sign...
Methods and materials
We performed a single-center retrospective study at the Institute of Hematology “Lorenzo e Ariosto Seràgnoli”,
University of Bologna,
to evaluate the significance of the RHS in hematology patients.
The study design was approved by the institutional research committees in accordance with principles outlined in the Declaration of Helsinki. Between January 2011 and September 2017,
we identified 23 hematology patients with possible/probable/proven IMD according...
All the 23 patients with the RHS met the diagnosis of IMD,
while of the 85 patients without the RHS, 44 met the diagnosis of proven/probable IMD and 41 had a diagnosis of “no-IMD”. Of the 23 patients with the RHS,
2 (9%) were Mucormycosis and 4 (17%) were Invasive Aspergillosis (in one case by A.
Flavus associated with P.
Aeruginosa ). In 11/23 (48%) cases,
the diagnosis was probable IMD (positive GM test: BAL: 8/8; serum: 10/11),
while in 6/23 (26%) cases the diagnosis was highly possible...
DISCUSSION No study to date analyzed the correlation between the RHS and other clinical factors reflecting the underlying immune status of patients,
or the prevalence of the RHS in neutropenic patients affected by pulmonary complications other than IMD. We therefore compared the clinical and radiological findings for PM and IPA,
and also for non-IMD pulmonary complications,
in patients with hematological malignancy and typical risk factors for IMD (febrile neutropenia and pulmonary...
Antonio Bruno M.D. Dept.
Diagnostic and Specialty Medicine – DIMES, University of Bologna,
S.Orsola-Malpighi Hospital, via Giuseppe Massarenti 9,
Pulmonary Mucormycosis: Radiologic Features at Presentation and Over Time.American Journal of Roentgenology,210(4),
742-747. Da Nam B.
Pulmonary mucormycosis: serial morphologic changes on computed tomography correlate with clinical and pathologic findings.European radiology,28(2),
788-795. Cornely O.
et al (2014).
ESCMID† and ECMM‡ joint clinical guidelines for the diagnosis and management of mucormycosis 2013.Clinical Microbiology and Infection,20,...