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[High resolution computed tomography of the lung in neutropenic patients with fever]
C P Heussel1, H U Kauczor, G Matzke
1Klinik für Radiologie, Johannes Gutenberg-Universität Mainz.
Purpose:
To determine the sensitivity and clinical impact of high-resolution CT (HRCT) of the lung in febrile neutropenic patients under antibiotic therapy.
Material And Methods:
Chest X-ray and HRCT were prospectively performed to exclude pneumonia in 34 patients (53 examinations) suffering from febrile neutropenia following antitumor therapy. Diagnosis was confirmed by bronchoalveolar lavage or sputum cultures.
Results:
Chest X-ray showed pneumonia in 13/53 examinations, in 12/13 a micro-organism was found. HRCT demonstrated pneumonia in 39/53, in 31/39 a micro-organism was found. All cases with positive cultures showed suspicious HRCT findings. Changes in antibiotic treatment resulted in findings suspicious for pneumonia and evidence of a new or a just treated micro-organism (chest X-ray 8/53, HRCT 31/53); the search for the source of fever was escalated in cases without evidence of micro-organisms and without suspicion of pneumonia findings 14/53.
Conclusion:
HRCT of the lung exhibits a higher sensitivity than conventional radiographs. Findings resulted in relevant therapeutic consequences. Hence, HRCT is indicated in neutropenic patients with fever and inconspicuous chest X-ray.