Presentation of Sonographic Features of Pulmonary Invasive Fungal Disease in Six Children with Leukemia

Alamdaran, Seyed Ali; Heidarzadeh, Hajar; Zavvar, Navid; Badiee, Zahra; Jaberi, Masoumeh; Ghasemi, Ali

doi:10.22038/ijp.2021.52657.4172

Presentation of Sonographic Features of Pulmonary Invasive Fungal Disease in Six Children with Leukemia

Authors

Seyed Ali Alamdaran ¹

Hajar Heidarzadeh ¹

Navid Zavvar ²

Zahra Badiee ²

Masoumeh Jaberi ¹

Ali Ghasemi ³

¹ Radiology Department, Mashhad University of Medical Sciences, Mashhad, Iran.

² Pediatric Department, Mashhad University of Medical Sciences, Mashhad, Iran.

³ Department of Pediatric Hematology and Oncology and Stem Cell Transplantation, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/ijp.2021.52657.4172

Abstract

Background
The early diagnosis of invasive fungal diseases is important because the therapeutic outcome depends on the prompt initiation of appropriate interventions. In this study, we present the feature of ultrasound of pulmonary fungal infection in six children with leukemia.
Method and Patients: Between June and November 2020, this cross-sectional study was conducted in the radiology department at Dr. Sheikh Children’s Hospital, Mashhad, Iran. During this period, we reviewed imaging findings of fungal lung infections in six patients with leukemia (ages 5-11 years old) who were referred for chest ultrasound and CT-scan. High-resolution computed tomography (HRCT) of patients showed multiple nodular lesions with/without ground-glass opacity (halo sign or reverse halo sign), and wedge-shape consolidations. In some patients, there were thick wall cavitary lesions with intra-cavitary fungus ball and the air-crescent sign. Ultrasound findings of the lung included the target lesion, the cavitary lesion, wedge-shape consolidation, and extra-pulmonary invasion to the chest wall or sub-diaphragm. The galactomannan test or debridement of para-nasal sinuses confirmed fungal infections; Aspergillosis or Mucormycosis.
Conclusion
Four characteristic features of pulmonary invasive fungal disease on ultrasound can help in faster diagnosis and monitoring of treatment response in these patients.

Keywords

Aspergillosis

Children

Pulmonary fungal disease

Mucormycosis

Ultrasound