Radiographic Studies

The chest X-ray is important, but may provide incomplete information. While patchy interstitial infiltrates or a faint localized haze may reflect pulmonary infection, more sensitive chest CT (computed tomography)

scanning may reveal small nodules, cavities, the halo sign of aspergillosis, and other signs that may not be visualized on chest X-ray. The CT can guide decisions for procedures such as bronchoscopy and lung biopsy, as well as empiric therapy.

The abdominal CT scan is helpful in patients with abdominal pain, as the physical exam may lack classic signs. The CT can reveal abscesses, adenopathy, intestinal wall thickening, or phlegmon suggestive of typhlitis, lesions of hepatosplenic candidiasis, and other conditions.8

The brain magnetic resonance imaging (MRI) (or contrast CT if MRI is not rapidly available) is important for evaluation of mental status changes, seizures, or focal neurologic signs. Brain abscesses, septic embolic infarcts, or evidence of rapidly progressive fungal infection may be found on MRI. Additional cuts of the sino-orbital region, mastoid, and ear canal should be obtained in patients with symptoms referable to those areas.

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