Official publication of Rawalpindi Medical University
Pulmonary Infections - High-Resolution Computed Tomography (HRCT) Patterns in Bone Marrow Transplant Patients
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Manal Niazi, Neelum Wahid,Naushaba Malik, Muhammad Ashraf Farooq. Pulmonary Infections - High-Resolution Computed Tomography (HRCT) Patterns in Bone Marrow Transplant Patients. JRMC [Internet]. 2016 Sep. 30 [cited 2024 Mar. 28];20(3). Available from: http://journalrmc.com/index.php/JRMC/article/view/169

Abstract

Background: To study the high-resolution
computed tomography (HRCT) findings in bone
marrow transplant patients with pulmonary
infection and to determine distinguishing features
among the different types of infections.
Methods: This study included 109 bone marrow
transplant recipients with documented pulmonary
infection. High-resolution CT (HRCT) of the chest
were performed , and diagnosis was proven soon
after onset of symptoms . Diagnosis was confirmed
by bronchoalveolar lavage, sputum cytology,
response to therapy, biopsy and autopsy.
Results: Out of 109 patients 40 were having
pulmonary infections due to fungi,38 bacteria,18
viral- cytomegalovirus (CMV), 9 pneomcystis
jiroveci pneumonia(PJP )and 4 mycobacterium
tuberculosis.Large nodules more than 1cm in
diameter were seen in 28 out of 40 patients with
fungal pneumonia(70%), 5 of total 38 patients with
bacterial pneumonia(13.1%), 3 of 18 patients with
viral infection(16.6%). The halo sign was present in
23 out of 28 patients having large nodules with
fungal pneumonia(82.1%), 3 of 31 patients with
nodular opacities in bacterial pneumonia(9.6%) ,2
patients (11.1%) with viral and none with
pneumocystis jiroveci pneumonia. There was no
significant difference in the prevalence of the other
HRCT patterns including small nodules, groundglass
attenuation, and air-space consolidation among
viral, bacterial, and fungal infections.
Conclusion: The HRCT pattern of large peripheral
nodules, nodules with cavitation,visualization of
halo sign and peripheral wedge shaped opacities are
most suggestive of fungal infection. In our study,
large peripheral nodules and the halo sign were
statistically more common in patients with fungal
infections. Other HRCT patterns are not specific and
thus not helpful in differentiating among the various
types of pulmonary infections seen in bone marrow
transplant patients.

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