The Diagnostic Value of Halo and Reversed Halo Signs for Invasive Mold Infections in Compromised Hosts

The halo sign is a CT finding of ground-glass opacity surrounding a pulmonary nodule or mass. The reversed halo sign is a focal rounded area of ground-glass opacity surrounded by a crescent or complete ring of consolidation. In severely immunocompromised patients, these signs are highly suggestive o...

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Bibliographic Details
Published in:Clinical infectious diseases 2011-05, Vol.52 (9), p.1144-1155
Main Authors: Georgiadou, Sarah P., Sipsas, Nikolaos V., Marom, Edith M., Kontoyiannis, Dimitrios P.
Format: Article
Language:English
Subjects:
Adult
Aspergillosis
Biological and medical sciences
Computerized axial tomography
Diagnostic tests
Fungal infections
Hematologic neoplasms
Human mycoses
Humans
Immunocompromised Host
Immunocompromised hosts
Infection - diagnostic imaging
Infections
Infectious diseases
Invasive Pulmonary Aspergillosis - diagnostic imaging
Invasive Pulmonary Aspergillosis - pathology
Invited
Lung - diagnostic imaging
Lung - pathology
Lung Diseases, Fungal - diagnostic imaging
Lung Diseases, Fungal - pathology
Lungs
Male
Medical sciences
Miscellaneous mycoses
Mold
Mucormycosis - diagnostic imaging
Mucormycosis - pathology
Mycoses
Neoplasms - diagnostic imaging
Neutropenia
Nodules
Nonnative species
Radiology
Solitary Pulmonary Nodule - diagnostic imaging
Therapy
Tomography, X-Ray Computed
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Summary:The halo sign is a CT finding of ground-glass opacity surrounding a pulmonary nodule or mass. The reversed halo sign is a focal rounded area of ground-glass opacity surrounded by a crescent or complete ring of consolidation. In severely immunocompromised patients, these signs are highly suggestive of early infection by an angioinvasive fungus. The halo sign and reversed halo sign are most commonly associated with invasive pulmonary aspergillosis and pulmonary mucormycosis, respectively. Many other infections and noninfectious conditions, such as neoplastic and inflammatory processes, may also manifest with pulmonary nodules associated with either sign. Although nonspecific, both signs can be useful for preemptive initiation of antifungal therapy in the appropriate clinical setting. This review aims to evaluate the diagnostic value of the halo sign and reversed halo sign in immunocompromised hosts and describes the wide spectrum of diseases associated with them.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/cir122