Date: 26 November 2013
Halo sign in IPA
Copyright: n/a
Notes:
CT scan of a neutropenia patient with leukaemia who has 2 lesions. One, on the right, is nodular, abuts on the pleura and is surrounded by a (grey) low attenuation area, referred to as the “halo” sign. This is virtually only seen in invasive fungal infections of the lung, especially early in the course of the disease, during neutropenia. The other lesion visible on this scan, posteriorly on the left, is also typical of invasive pulmonary aspergillosis in that it is pleura-based and has sharply angulated sides typical of vascular invasion and infarction of small lung segments. There is the suggestion of a “halo” sign anteriorly, but there is less confidence in this appearance (compared with the other) because it is only on one side of the lesion.
Images library
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Scanning electron micrograph of Aspergillus ochraceopetaliformis conidial heads
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Image D & E. A case of onychomycosis associated with Aspergillus ochraceopetaliformis as described in Nail infection by Aspergillus ochraceopetaliformis. Med Mycol. 2009 Mar 9:1-5, 2009, Brasch J, Varga J, Jensen JM, Egberts F & Tintelnot K
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Further details
Image 5. Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with 3 weeks off between successive pulses, for four pulses) and treatment was successful.
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This patient was 28 yr old with adult lymphocytic leukaemia. She received induction chemotherapy and this infection developed 2 days after recovering from neutropenia.
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Close-up image of the lesion on the left thigh showing a mat of hyphae over the wound.
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Eosinophilic mucin with A. flavus in the nasal cavity. Irregular crust of 2.5 cm from a patient diagnosed as allergic fungal sinusitis. Patient with allergic fungal sinusitis
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GMS stain of eosinophilic mucin reveals a darkly stained dichotomously branched A. flavus hyphae within cellular background. Patient with allergic fungal sinusitis