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Pulmonary infections following bone marrow transplantation: high-resolution CT findings in 35 paediatric patients

Taisa Davaus Gasparetto1, Dante L Escuissato, Edson Marchiori

  • 1Department of Diagnostic Radiology of the Federal Universitie Fluminense, Niterói, Brazil. taisadavaus@gmail.com

European Journal of Radiology
|July 13, 2007
PubMed

Insights

High-resolution CT scans reveal common findings for pulmonary infections in pediatric bone marrow transplant (BMT) patients. Fungal infections post-BMT are often indicated by large nodules and the "halo sign".

Area of Science:

  • Radiology
  • Pediatric Pulmonology
  • Infectious Diseases

Background:

  • Pulmonary infections are a significant complication following bone marrow transplantation (BMT) in pediatric patients.
  • Differentiating the causative pathogens through imaging is crucial for timely and effective treatment.

Purpose of the Study:

  • To assess high-resolution CT (HRCT) findings in pediatric patients with pulmonary infections post-BMT.
  • To evaluate the differential diagnostic utility of HRCT for various pathogens causing pulmonary infections after BMT.

Main Methods:

  • Retrospective analysis of HRCT scans from 35 pediatric patients with documented pulmonary infections post-BMT.
  • Inclusion criteria: HRCT within 24 hours of symptom onset and confirmed diagnosis within one week.
  • Pathogen distribution: viruses (n=16), bacteria (n=9), fungi (n=9), protozoa (n=1).

Main Results:

  • Four patients with confirmed pneumonia had normal HRCT scans.
  • Viral infections: common findings included ground-glass attenuation (43.7%) and small centrilobular nodules (31.2%).
  • Bacterial infections: airspace consolidation (88.9%), small centrilobular nodules (22.2%), and ground-glass attenuation (22.2%).
  • Fungal infections: large nodules (66.7%) and the "halo sign" (n=5) were characteristic, not seen in viral infections.

Conclusions:

  • Pulmonary infections in pediatric BMT patients often present with overlapping HRCT findings.
  • Large nodules and the "halo sign" on HRCT are more indicative of fungal infections in this population.
Abstract

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