The purpose of this study was to review the high-resolution CT findings in neutropenic patients with pulmonary infection and to determine distinguishing features among the various types of infection, which might contribute to an early diagnosis.

The high-resolution CT scans obtained in 44 immunocompromised patients with severe neutropenia who had pulmonary infection of proven etiology were reviewed retrospectively by 2 independent radiologists. All patients had underlying haematological malignancies, part of them treated by haematopoietic cell transplantation (n20). High-resolution chest CT performed in 24 hours after the onset of symptoms. The CT scans were assessed for the presence and appearance features. Relations between findings at CT and the different infectious etiologies of infiltrates and nodules were assessed by nonparametric statistics, including chi-square,...

The infectious causes included bacteria (n - 23), viruses (n -11) and fungi (n - 10). Ground-glass opacity (GGO) alone was significantly more frequent in bacterial and viral pneumonia in comparison with fungal etiology of pneumonia (61%,100% vs 10%, p<0,01, respectively) ( Fig. 1 , Fig. 2 ). Сonsolidation and GGO in combination with nodular and/or reticular pattern, principally interseptal thickening, was strongly associated with viral pneumonia (p = 0,016) ( Fig. 3 ). Multiple nodules were predominantly presented in patients with viral pneumonia сompared...

There is considerable overlap in the imaging appearance of bacterial, viral and fungal lung infections. However, some findings are helpful in the differential diagnosis of pulmonary infection in immunocompromised patients Although some overlap exists, the presence of consolidation and GGO in combination with nodular and/or reticular pattern, was is most suggestive of viral infection. Нalo sign are findings that are statistically more common in patients with angioinvasive aspergillosis.

Contact details: Dr. Anastasia Kosichkina Department of Radiology, N.N. Petrov Research Institute of Oncology 68 Leningradskaya Street Pesochny 197758 St Petersburg Russian Federation Phone: + 79215997266 Email: [email protected]

Afessa, B., Abdulai, R. M., Kremers, W. K., Hogan, W. J., Litzow, M. R., & Peters, S. G. (2012). Risk factors and outcome of pulmonary complications after autologous hematopoietic stem cell transplant. CHEST Journal, 141(2), 442-450. 2. Bommart, S., Bourdin, A., Makinson, A., Durand, G., Micheau, A., Monnin-Bares, V., ... & Kovacsik, H. (2013). Infectious chest complications in haematological malignancies. Diagnostic and interventional imaging, 94(2), 193-201. 3. Escuissato, D. L., Gasparetto, E. L., Marchiori, E., de Melo Rocha, G., Inoue, C., Pasquini, R., & Müller,...