tetano
Editor, Senior Moderator
Br J Radiol. 2010 Jun 15. [Epub ahead of print]
Pulmonary imaging of pandemic influenza H1N1 infection: relationship between clinical presentation and disease burden on chest radiography and CT.
Abbo L, Quartin A, Morris MI, Saigal G, Ariza-Heredia E, Mariani P, Rodriguez O, Mu?oz-Price LS, Ferrada MM, Ramee E, Rosas MM, Gonzalez I, Fishman J.
Divisions of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA.
Abstract
The potential for pulmonary involvement among patients presenting to the hospital with novel influenza A virus infection (H1N1) is high. To investigate the utility of chest imaging in this setting, we correlated clinical presentation with chest X-ray (CXR) and CT findings in proven H1N1 cases. Subjects included all patients presenting with laboratory-confirmed H1N1 between 1 May and 10 September 2009 to one of three urban hospitals. Clinical information was gathered retrospectively, including symptoms, possible risk factors, treatment and hospital survival. Imaging studies were reread for study purposes, and CXR findings compared with CT scans when available. During the study period, 157 patients presented with subsequently proven H1N1. Hospital admission was necessary for 94 (60%) patients, 16 (10%) were admitted to intensive care and 6 (4%) died. An initial CXR, carried out for 123 (78%) patients, was abnormal in only 40 (33%) cases. Factors associated with increased likelihood for radiographic lung abnormalities were dyspnoea (p < 0.001), hypoxaemia (p < 0.001) and diabetes mellitus (p = 0.023). Chest CT was performed in 21 patients, and 19 (90%) showed consolidation, ground glass opacity, nodules or a combination of these findings. 4 of 21 patients had negative CXR and positive CT. Compared with CT, plain CXR was less sensitive in detecting H1N1 pulmonary disease among immunocompromised hosts than in other patients (p = 0.0072). A normal CXR is common among patients presenting to the hospital for H1N1-related symptoms without evidence of respiratory difficulties. The CXR may significantly underestimate lung involvement in the setting of immunosuppression.
PMID: 20551254 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20551254
Pulmonary imaging of pandemic influenza H1N1 infection: relationship between clinical presentation and disease burden on chest radiography and CT.
Abbo L, Quartin A, Morris MI, Saigal G, Ariza-Heredia E, Mariani P, Rodriguez O, Mu?oz-Price LS, Ferrada MM, Ramee E, Rosas MM, Gonzalez I, Fishman J.
Divisions of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA.
Abstract
The potential for pulmonary involvement among patients presenting to the hospital with novel influenza A virus infection (H1N1) is high. To investigate the utility of chest imaging in this setting, we correlated clinical presentation with chest X-ray (CXR) and CT findings in proven H1N1 cases. Subjects included all patients presenting with laboratory-confirmed H1N1 between 1 May and 10 September 2009 to one of three urban hospitals. Clinical information was gathered retrospectively, including symptoms, possible risk factors, treatment and hospital survival. Imaging studies were reread for study purposes, and CXR findings compared with CT scans when available. During the study period, 157 patients presented with subsequently proven H1N1. Hospital admission was necessary for 94 (60%) patients, 16 (10%) were admitted to intensive care and 6 (4%) died. An initial CXR, carried out for 123 (78%) patients, was abnormal in only 40 (33%) cases. Factors associated with increased likelihood for radiographic lung abnormalities were dyspnoea (p < 0.001), hypoxaemia (p < 0.001) and diabetes mellitus (p = 0.023). Chest CT was performed in 21 patients, and 19 (90%) showed consolidation, ground glass opacity, nodules or a combination of these findings. 4 of 21 patients had negative CXR and positive CT. Compared with CT, plain CXR was less sensitive in detecting H1N1 pulmonary disease among immunocompromised hosts than in other patients (p = 0.0072). A normal CXR is common among patients presenting to the hospital for H1N1-related symptoms without evidence of respiratory difficulties. The CXR may significantly underestimate lung involvement in the setting of immunosuppression.
PMID: 20551254 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20551254