BACKGROUND: Blastomycosis is an uncommon granulomatous pulmonary and extrapulmonary infectious disease caused by the thermally dimorphic fungus Blastomyces dermatitidis. Diagnosis may be delayed or difficult because of varied presentation. The characteristics of blastomycosis on computed tomographic (CT) scan of the chest are not well characterized.METHODS: The images from 34 chest CT scans from patients with confirmed pulmonary blastomycosis were retrospectively reviewed.RESULTS: The most common CT findings were air bronchograms in 22 patients (65%), consolidation in 21 patients (62%), nodules (smaller than 3 cm) in 21 patients (62%) and lymph node enlargement (mediastinal and hilar nodes combined) in 12 patients (35%). Only four patients (12%) had a miliary pattern.CONCLUSIONS: A specific abnormality characteristic of pulmonary blastomycosis was not identified on CT scanning. The diagnosis can only be made in the context of a high index of clinical suspicion with histological or culture confirmation.

中文翻译：

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肺芽生菌病的计算机断层扫描评估。

背景：芽生菌病是一种罕见的肉芽肿性肺和肺外感染性疾病，由热异形性真菌皮炎芽生菌引起。. 由于不同的表现，诊断可能会延迟或困难。胸部计算机断层扫描 (CT) 扫描中芽生菌病的特征尚不明确。患者（65%），实变 21 例（62%），结节（小于 3 cm）21 例（62%），淋巴结肿大（纵隔和肺门淋巴结合并）12 例（35%）。只有 4 名患者 (12%) 有粟粒状模式。结论：CT 扫描未发现肺芽生菌病的特定异常特征。只有在临床高度怀疑并经组织学或培养证实的情况下才能做出诊断。