AML-199 Radiological Aspects of Pneumonias in Neutropenic Patients

Abstract

Imaging, such as chest X-ray and chest CT scan, plays a pioneering role in the diagnosis of neutropenic patients with respiratory dysfunction. To analyze radiographic patterns of adults with prolonged neutropenia and pneumonia. An observational, descriptive, and prospective study that analyzed patients admitted to the protected unit (acute myeloid leukemia and aplastic anemia) and transplant unit of Hematology and Pediatric Oncology at August 20th Hospital in Casablanca, from May 1st, 2019 to February 29th, 2020. Patients included were 18 years of age or older receiving chemotherapy and then developed respiratory symptoms during the period of neutropenia. An exploitation form was used to acquire the data then its analysis was performed with IBM SPSS Statistics version 21. Chest X-rays were taken during 20 of the 50 episodes of pneumonia (40%). They were all pathological, including alveolar opacities (90%), excavation (5%), reticulonodular (15%), and effusion syndrome fluid (15%). Chest computed tomography (CT scan) was performed in all patients. The time of its realization from the appearance of signs call clinics was variable ranging from 0 to 8 days, with a median of 2 days. It is important to note that distinct picture radiographs can coexist on the same X-ray and in the same patient. Forty six percent of our patients had condensation hearth and micronodules, nodules (58%), ground-glass opacity (60%), fluid effusion (34%), mediastinal lymphadenopathy (30%), interstitial thickening (22%), and 16% had reticulonodular infiltrates. Eight patients (16%) in our study had Halo sign, 10% had cavity image as well as Atelectasis, 2% with tree-in-bud aspect, and 2% had centrilobular emphysema. Thoracic CT improves the quality of the diagnosis; it also contributes to better management of neutropenic patients when pneumonia is suspected.