CHEST X-RAY FINDINGS AT PNEUMONIA PATIENTS WITH AND WITHOUT FUNGAL INFECTIONS AND NOT CURED AFTER ANTIBIOTIC THERAPY IN DR. SOETOMO HOSPITAL SURABAYA FROM JANUARY 2019 - SEPTEMBER 2020

Abstract

Background: Fungal infections are often overlooked causes of community pneumonia, posing significant problems in diagnosis and treatment. The criteria for the diagnosis of fungal pneumonia are based on clinical manifestations, radiological features, and sputum culture. Definitive diagnosis based on sputum culture results takes a long time and is limited to some health center. Patients with clinical pneumonia often receive antibiotic empiric therapy which can sometimes worsen the patient's prognosis. Characteristics of lesions on chest X-rays are expected to be an easier, cheaper, and faster choice of supporting diagnostic tools. Methods: This is a retrospective descriptive study. Researchers identified data on pneumonia patients who did not recover with antibiotic therapy who underwent chest X-ray and sputum examination. A chest X-ray was observed once without serial examination and evaluated for abnormalities in the lung, pleura, lesion site and severity category. Results: A retrospective study of chest X-ray of the pneumonia patients who did not resolve with antibiotic therapy and sputum culture (n=200) was performed in the 15-93 year age group. It was found that the most common fungal age group was 46-55 years and males (62%). Chest X-ray images obtained are non-specific lesions on the lungs and pleura (consolidation, fibrosis, cavitation, nodulation, atelectasis, pneumothorax, pleural effusion and thickening), on the right and left sides of the thorax with mild to severe degrees. Images could not be distinguished between images without fungal (n=83) and images with fungal (n=117). In the fungal group there are several comorbidities, such as malignancy, HIV, COPD, tuberculosis, COVID 19, sepsis, stroke, hypertension, diabetes mellitus, hepatitis B, liver cirrhosis, and chronic renal failure. Conclusion: There were no differences between the chest x-ray in pneumonia with or without fungal infection. The radiographic characteristics obtained in both groups were non-specific lesions on the lungs and pleura (consolidation, fibrosis, cavitation, nodulation, atelectasis, pneumothorax, pleural effusion and thickening), on the right and left sides of the thorax, as well as mild to severe degrees.