Pulmonary infections following bone marrow transplantation: high-resolution CT findings in 35 paediatric patients.
OBJECTIVE
The purpose of this study was to assess the high-resolution CT findings of paediatric patients who had pulmonary infections following bone marrow transplantation (BMT), and to evaluate the differential diagnosis through high-resolution CT of the various pathogens responsible for pulmonary infections after BMT.


METHODS
The study included 35 consecutive patients who had documented pulmonary infection, high-resolution CT of the chest performed within 24h of the beginning of symptoms, and proven diagnosis within 1 week of the onset of symptoms. The pulmonary infections were due to viruses (n=16), bacteria (n=9), fungi (n=9), and protozoa (n=1). Two radiologists analyzed the CT scans and reached final decisions regarding the findings by consensus.


RESULTS
Four patients with confirmed pneumonia had normal high-resolution CT scans. Regarding the viral infections, the most frequent features were areas of ground-glass attenuation (43.7%) and small centrilobular nodules (31.2%). Airspace consolidation (88.9%), small centrilobular nodules (22.2%) and ground-glass attenuation (22.2%) were the most frequent findings in patients with bacterial pneumonia following BMT. Large nodules were seen in 66.7% of the patients with fungal pneumonia, and in only one case of virus infection. The "halo sign" (n=5) was seen only in patients with fungal pneumonia.


CONCLUSIONS
In conclusion, the main causes of pulmonary infection in paediatric patients following BMT share similar high-resolution CT findings. Large nodules and "halo sign" are more common in patients with fungal infections.
Gasparetto
Taisa Davaus
TD
Department of Diagnostic Radiology of the Federal Universitie Fluminense, Niterói, Brazil. taisadavaus@gmail.com
Escuissato
Dante L
DL
Marchiori
Edson
E
D000293:Adolescent; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012141:Respiratory Tract Infections / Q000000981:diagnostic imaging* / Q000382:microbiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*