Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients
OBJECTIVE: To describe the chest computed tomography findings for severe influenza H1N1 infection in a series of hospitalized neutropenic cancer patients. METHODS: We performed a retrospective systematic analysis of chest computed tomography scans for eight hospitalized patients with fever, neutropenia, and confirmed diagnoses of influenza H1N1. The clinical data had been prospectively collected. RESULTS: Six of eight patients (75%) developed respiratory failure and required intensive care. Prolonged H1N1 shedding was observed in the three mechanically ventilated patients, and overall hospital mortality in our series was 25%. The most frequent computed tomography findings were ground-glass opacity (all patients), consolidation (7/8 cases), and airspace nodules (6/8 cases) that were frequently moderate or severe. Other parenchymal findings were not common. Five patients had features of pneumonia, two had computed tomography findings compatible with bronchitis and/or bronchiolitis, and one had tomographic signs of chronicity. CONCLUSION: In this series of neutropenic patients with severe influenza H1N1 infection, chest computed tomography demonstrated mainly moderate or severe parenchymatous disease, but bronchiolitis was not a common feature. These findings associated with febrile neutropenia should elicit a diagnosis of severe viral infection.
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Faculdade de Medicina / USP
2012
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oai:scielo:S1807-593220120004000032012-07-23Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patientsRodrigues,Rosana SouzaMarchiori,EdsonBozza,Fernando A.Pitrowsky,Melissa TassanoVelasco,EduardoSoares,MárcioSalluh,Jorge I. F. H1N1 Viral pneumonia Neutropenia Cancer Computed tomography OBJECTIVE: To describe the chest computed tomography findings for severe influenza H1N1 infection in a series of hospitalized neutropenic cancer patients. METHODS: We performed a retrospective systematic analysis of chest computed tomography scans for eight hospitalized patients with fever, neutropenia, and confirmed diagnoses of influenza H1N1. The clinical data had been prospectively collected. RESULTS: Six of eight patients (75%) developed respiratory failure and required intensive care. Prolonged H1N1 shedding was observed in the three mechanically ventilated patients, and overall hospital mortality in our series was 25%. The most frequent computed tomography findings were ground-glass opacity (all patients), consolidation (7/8 cases), and airspace nodules (6/8 cases) that were frequently moderate or severe. Other parenchymal findings were not common. Five patients had features of pneumonia, two had computed tomography findings compatible with bronchitis and/or bronchiolitis, and one had tomographic signs of chronicity. CONCLUSION: In this series of neutropenic patients with severe influenza H1N1 infection, chest computed tomography demonstrated mainly moderate or severe parenchymatous disease, but bronchiolitis was not a common feature. These findings associated with febrile neutropenia should elicit a diagnosis of severe viral infection.info:eu-repo/semantics/openAccessFaculdade de Medicina / USPClinics v.67 n.4 20122012-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012000400003en10.6061/clinics/2012(04)03 |
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Rodrigues,Rosana Souza Marchiori,Edson Bozza,Fernando A. Pitrowsky,Melissa Tassano Velasco,Eduardo Soares,Márcio Salluh,Jorge I. F. |
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Rodrigues,Rosana Souza Marchiori,Edson Bozza,Fernando A. Pitrowsky,Melissa Tassano Velasco,Eduardo Soares,Márcio Salluh,Jorge I. F. Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients |
author_facet |
Rodrigues,Rosana Souza Marchiori,Edson Bozza,Fernando A. Pitrowsky,Melissa Tassano Velasco,Eduardo Soares,Márcio Salluh,Jorge I. F. |
author_sort |
Rodrigues,Rosana Souza |
title |
Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients |
title_short |
Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients |
title_full |
Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients |
title_fullStr |
Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients |
title_full_unstemmed |
Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients |
title_sort |
chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients |
description |
OBJECTIVE: To describe the chest computed tomography findings for severe influenza H1N1 infection in a series of hospitalized neutropenic cancer patients. METHODS: We performed a retrospective systematic analysis of chest computed tomography scans for eight hospitalized patients with fever, neutropenia, and confirmed diagnoses of influenza H1N1. The clinical data had been prospectively collected. RESULTS: Six of eight patients (75%) developed respiratory failure and required intensive care. Prolonged H1N1 shedding was observed in the three mechanically ventilated patients, and overall hospital mortality in our series was 25%. The most frequent computed tomography findings were ground-glass opacity (all patients), consolidation (7/8 cases), and airspace nodules (6/8 cases) that were frequently moderate or severe. Other parenchymal findings were not common. Five patients had features of pneumonia, two had computed tomography findings compatible with bronchitis and/or bronchiolitis, and one had tomographic signs of chronicity. CONCLUSION: In this series of neutropenic patients with severe influenza H1N1 infection, chest computed tomography demonstrated mainly moderate or severe parenchymatous disease, but bronchiolitis was not a common feature. These findings associated with febrile neutropenia should elicit a diagnosis of severe viral infection. |
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Faculdade de Medicina / USP |
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2012 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012000400003 |
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