Reversed halo sign in community acquired pneumonia. A case report
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Pneumonology Department of General Hospital of Serres, Greece
Antonios Antoniadis   

Pneumonology Clinic, General Hospital of Serres, Greece
Pneumon 2018;31(1):44–48
Reversed halo sign (RHS) is defined as central annular ground-glass opacity surrounded by a ring of denser consolidation at least 2mm thickness. It was first described by Voludaki et al. in a case report of two COP cases and later concluded that it was specific to cryptogenic organizing pneumonia. Since then, the RHS was associated with a wide range of pulmonary diseases: pulmonary fungal infections, tuberculosis, community – acquired pneumonia, sarcoidosis, pulmonary neoplasms, Wegener granulomatosis, pulmonary infraction and other diseases. We report a patient case of community-acquired pneumonia with of RHS on HRCT, and we review the literature on this radiological sign. We present a 70 years-old male, who was admitted to emergency department with lower tract respiratory infection symptoms, HRCT was performed and revealed multiple round ground-glass opacities fringed with peripheral consolidation in both lungs. The patient was diagnosed with community-acquired pneumonia and treated successfully with respiratory quinolone. Unfortunately, the infectious agent was not determined, as well as bronchoscopy with BAL was not helpful for diagnosis. At follow up, in 21 days and 4 months, the patient remained asymptomatic, and chest CT revealed a clear improvement. Finally, reversed halo sign has been reported in a wide range of conditions, and investigation of its aetiological factors is required.
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