Lung in dengue: computed tomography findings.
BACKGROUND
Dengue is the most important mosquito-borne viral disease in the world. Dengue virus infection may be asymptomatic or lead to undifferentiated fever, dengue fever with or without warning signs, or severe dengue. Lower respiratory symptoms are unusual and lung-imaging data in patients with dengue are scarce.


RESULTS
To evaluate lung changes associated with dengue infection, we retrospectively analyzed 2,020 confirmed cases of dengue. Twenty-nine of these patients (11 females and 18 males aged 16-90 years) underwent chest computed tomography (CT), which yielded abnormal findings in 17 patients: 16 patients had pleural effusion (the sole finding in six patients) and 11 patients had pulmonary abnormalities. Lung parenchyma involvement ranged from subtle to moderate unilateral and bilateral abnormalities. The most common finding was ground-glass opacity in eight patients, followed by consolidation in six patients. Less common findings were airspace nodules (two patients), interlobular septal thickening (two patients), and peribronchovascular interstitial thickening (one patient). Lung histopathological findings in four fatal cases showed thickening of the alveolar septa, hemorrhage, and interstitial edema.


CONCLUSIONS
In this largest series involving the use of chest CT to evaluate lung involvement in patients with dengue, CT findings of lower respiratory tract involvement were uncommon. When abnormalities were present, pleural effusion was the most frequent finding and lung involvement was often mild or moderate and bilateral. Extensive lung abnormalities are infrequent even in severe disease and when present should lead physicians to consider other diagnostic possibilities.
D'Or Institute for Research and Education, Rio de Janeiro/RJ, Brazil; Federal University of Rio de Janeiro, Rio de Janeiro/RJ, Brazil.
Rosana Souza
RS
Rodrigues
D'Or Institute for Research and Education, Rio de Janeiro/RJ, Brazil.
Ana Livia Garcia
AL
Brum
Biotecnology and Phisiology of Viral Infection, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil.
Marciano Viana
MV
Paes
Biotecnology and Phisiology of Viral Infection, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil.
Tiago Fajardo
TF
Póvoa
Federal University of State of Rio de Janeiro, Rio de Janeiro/RJ, Brazil.
Carlos Alberto
CA
Basilio-de-Oliveira
Federal University of Rio de Janeiro, Rio de Janeiro/RJ, Brazil.
Edson
E
Marchiori
Corpo de Bombeiros Militar do Estado do Rio de Janeiro, Rio de Janeiro/RJ, Brazil.
Danielle Provençano
DP
Borghi
D'Or Institute for Research and Education, Rio de Janeiro/RJ, Brazil; Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil.
Grazielle Viana
GV
Ramos
D'Or Institute for Research and Education, Rio de Janeiro/RJ, Brazil; Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil.
Fernando Augusto
FA
Bozza
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003715:Dengue / Q000473:pathology*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed