1Department of Radiology, D'Or Institute for Research and Education, Botafogo, Rio de Janeiro, Brazil.
2Samaritano Hospital, Rio de Janeiro, Brazil.
Am J Trop Med Hyg. 2021 Apr 2;104(5):1651-1654. doi: 10.4269/ajtmh.20-0952.
This is a case report of a 37-year-old woman evaluated with 18F-fludeoxyglucose (18F-FDG) positron emission computed tomography/CT with recurrent fever after treatment with itraconazole for 6 weeks for histoplasmosis. The examination demonstrated a decrease in the dimensions of the pulmonary opacities previously identified in the left lower lobe and attributed to histoplasmosis. In addition to these pulmonary opacities, increased FDG uptake was also observed in lymph nodes present in the cervical region, mediastinum, left lung hilum, and hepatic hilum. Notably, other pulmonary opacities with ground-glass pattern that were not present in the previous computed tomography were detected in the right lower lobe, with mild 18F-FDG uptake. Nasal swab performed shortly after the examination was positive for COVID-19. In this case, the 18F-FDG positron emission computed tomography/CT study demonstrated findings consistent with active COVID-19 infection coexisting with inflammatory changes associated with histoplasmosis infection.
这是一例 37 岁女性的病例报告，该患者因组织胞浆菌病接受伊曲康唑治疗 6 周后出现发热复发，接受 18F-氟脱氧葡萄糖（18F-FDG）正电子发射计算机断层扫描/计算机断层扫描（PET/CT）检查。检查显示左肺下叶先前发现的与组织胞浆菌病相关的肺部混浊度尺寸减小。除了这些肺部混浊度外，还观察到颈部、纵隔、左肺门和肝门区域的淋巴结中 FDG 摄取增加。值得注意的是，在右侧下叶还发现了一些新的磨玻璃样混浊度，而之前的 CT 检查中并未显示这些病变，其 18F-FDG 摄取轻度增加。检查后不久进行的鼻拭子检测 COVID-19 呈阳性。在本例中，18F-FDG 正电子发射计算机断层扫描/计算机断层扫描研究显示的结果与 COVID-19 感染的活动性一致，同时存在与组织胞浆菌病感染相关的炎症变化。
