title: Pulmonary high-resolution computed tomography findings in nephropathia epidemica.
abstract: OBJECTIVE
  To evaluate lung high-resolution computed tomography (HRCT) findings in patients with Puumala hantavirus-induced nephropathia epidemica (NE), and to determine if these findings correspond to chest radiograph findings.
  
  
  METHODS
  HRCT findings and clinical course were studied in 13 hospital-treated NE patients. Chest radiograph findings were studied in 12 of them.
  
  
  RESULTS
  Twelve patients (92%) showed lung parenchymal abnormalities in HRCT, while only 8 had changes in their chest radiography. Atelectasis, pleural effusion, intralobular and interlobular septal thickening were the most common HRCT findings. Ground-glass opacification (GGO) was seen in 4 and hilar and mediastinal lymphadenopathy in 3 patients. Atelectasis and pleural effusion were also mostly seen in chest radiographs, other findings only in HRCT.
  
  
  CONCLUSIONS
  Almost every NE patient showed lung parenchymal abnormalities in HRCT. The most common findings of lung involvement in NE can be defined as accumulation of pleural fluid and atelectasis and intralobular and interlobular septal thickening, most profusely in the lower parts of the lung. As a novel finding, lymphadenopathy was seen in a minority, probably related to capillary leakage and overall fluid overload. Pleural effusion is not the prominent feature in other viral pneumonias, whereas intralobular and interlobular septal thickening are characteristic of other viral pulmonary infections as well. Lung parenchymal findings in HRCT can thus be taken not to be disease-specific in NE and HRCT is useful only for scientific purposes.
authors: Medical Imaging Centre, Tampere University Hospital, 33521 Tampere, Finland. antti.paakkala@pshp.fi
authors: Antti
authors: A
authors: Paakkala
authors: Ritva
authors: R
authors: Järvenpää
authors: Satu
authors: S
authors: Mäkelä
authors: Heini
authors: H
authors: Huhtala
authors: Jukka
authors: J
authors: Mustonen
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