title: Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients.
abstract: OBJECTIVE
  To describe the chest computed tomography findings for severe influenza H1N1 infection in a series of hospitalized neutropenic cancer patients.
  
  
  METHODS
  We performed a retrospective systematic analysis of chest computed tomography scans for eight hospitalized patients with fever, neutropenia, and confirmed diagnoses of influenza H1N1. The clinical data had been prospectively collected.
  
  
  RESULTS
  Six of eight patients (75%) developed respiratory failure and required intensive care. Prolonged H1N1 shedding was observed in the three mechanically ventilated patients, and overall hospital mortality in our series was 25%. The most frequent computed tomography findings were ground-glass opacity (all patients), consolidation (7/8 cases), and airspace nodules (6/8 cases) that were frequently moderate or severe. Other parenchymal findings were not common. Five patients had features of pneumonia, two had computed tomography findings compatible with bronchitis and/or bronchiolitis, and one had tomographic signs of chronicity.
  
  
  CONCLUSIONS
  In this series of neutropenic patients with severe influenza H1N1 infection, chest computed tomography demonstrated mainly moderate or severe parenchymatous disease, but bronchiolitis was not a common feature. These findings associated with febrile neutropenia should elicit a diagnosis of severe viral infection.
authors.affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Rosana Souza
authors.initials: RS
authors.lastname: Rodrigues
authors.forename: Edson
authors.initials: E
authors.lastname: Marchiori
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Bozza
authors.forename: Melissa Tassano
authors.initials: MT
authors.lastname: Pitrowsky
authors.forename: Eduardo
authors.initials: E
authors.lastname: Velasco
authors.forename: Márcio
authors.initials: M
authors.lastname: Soares
authors.forename: Jorge I F
authors.initials: JI
authors.lastname: Salluh
mesh_terms: D000293:Adolescent; D001991:Bronchitis / Q000000981:diagnostic imaging; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000150:complications; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000000981:diagnostic imaging*; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D011024:Pneumonia, Viral / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D017201:Virus Shedding