Keywords:
Lung, Respiratory system, Thorax, CT-High Resolution, CT, Complications, Diagnostic procedure, Education, Abscess, Cavitation, Infection
Authors:
S. Conte, M. Scutti, L. Fabrizio, C. Valdesi, L. Mazzamurro, M. Mereu, R. L. Patea, A. R. Cotroneo; CHIETI/IT
DOI:
10.26044/esti2019/P-0105
Background
It is frequent to meet immunocompromised patients in daily clinical practice not only because of acquired immunodeficiency syndrome (AIDS),
but also for the use of immunosuppressive drugs in malignant and autoimmune diseases,
in prevention of rejection after solid organs and hematopoietic transplant.
Immunodeficiency can be further a direct consequence of hematological malignancy and caused by congenital immune defects.
Pulmonary infections are a common complication in these patients.
Early and accurate diagnosis is essential because of associated high morbidity and mortality.
Chest radiography usually is the first exam used to detect pulmonary infection,
but it has several limitations: it is difficult obtain specific diagnosis of a particular pathogen and distinguish between lung and pleural disease,
moreover its sensitivity is limited in patients with neutropenia because the host’s impaired inflammatory response determines slight radiographic alterations.
HRCT is the choice technique in diagnosis of pulmonary infection in these patients because it detects early lesions also in neutropenic subjects and suggests specific diagnosis in several disease based on specific patterns,
but it is important to remember that for a correct differential diagnosis is essential to have also clinical information.
In conclusion clinical setting,
immunological status and HRCT are the basis of a correct and early diagnosis.
HRCT is fundamental to detect precocious lesions and to suggest diagnoses based on specific findings.