Correlation Between Chest X-Ray with Fungal Pneumonia in Immunocompromised Patients

Abstract

Fungal infections are the most severe infections in immunocompromised individuals and pulmonary involvement is the most common form of invasive tissue infection in immunocompromised hosts. Early and accurate diagnosis is essential given their high morbidity and mortality rates, reaching 50-100%. This study aims to analyse the correlation between chest X-rays and fungal pneumonia in immunocompromised patients to help diagnose and alleviate the morbidity and mortality burdens. This study is a retrospective analytic study conducted at Dr Soetomo General Academic Hospital Surabaya, entailing 201 samples in the form of chest X-rays, sputum cultures and blood laboratories obtained from medical records from a period from January 2019 - December 2021. Among patients with a fungal infection, males predominated the group with 62.5% and the most frequent age group was between 50 and 59. The most common underlying condition of the patients was diabetes mellitus and the most pathogen discovered was Candida sp. Most patients presented with mild diseases (41.79%), with the majority of chest x-rays featuring consolidations and ground-glass opacity. There is a poor correlation between ground glass opacity/infiltrate in the left paracardial and reticulonodular pattern with fungal pneumonia in immunocompromised patients, with a poor negative correlation between lymphocyte count and NLR (neutrophil lymphocyte ratio) value with fungal infection and severity degree of chest radiographs. Chest x-ray images along with clinical information such as age and laboratory tests can assist radiologists in making a differential diagnosis of fungal pneumonia.