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Intracavitary Hematoma Simulating Mycetoma Formation

Knower, Mark T. M.D.; Kavanagh, Peter M.D.; Chin, Robert Jr. M.D.

Case Reports
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This case report details the initial radiographic findings of a patient with mixed connective-tissue disease who presented with significant hemoptysis. Several radiographic findings suggested mycetoma formation, prompting appropriate antibiotic therapy; however, the rapid resolution and subsequent reappearance of the lesion on serial images pointed toward a diagnosis of hemorrhage into a preexisting cavity. Chest radiographic and computed tomographic findings commonly described as pathognomonic for the diagnosis of mycetoma are, in fact, nonspecific and can be simulated by several other entities that result in intracavitary masses. Familiarity with these radiographic “mimickers” of mycetoma will aid in avoiding misdiagnosis and unnecessary or improper invasive interventions when the appropriate clinical history and course of disease are appreciated.

From the Section on Pulmonary and Critical Care (M.T.K., R.C) and the Department of Radiology (P.K.), the Wake Forest University School of Medicine, Winston-Salem, NC.

Address correspondence and reprint requests to Mark T. Knower, M.D., Wake Forest University School of Medicine, Section on Pulmonary and Critical Care, Medical Center Boulevard, Winston-Salem, NC 27157-1054; e-mail: mknower@wfubmc.edu

© 2002 Lippincott Williams & Wilkins, Inc.