Poster Presentations: Wednesday, October 26, 2011 |

Radiological Findings in Acute Haemophilus influenzae Pulmonary Infection FREE TO VIEW

Asami Ono, MD; Yumiko Ando, PhD; Fumito Okada, PhD; Tomoko Nakayama, MD; Toru Maeda, PhD; Hiromu Mori, PhD
Chest. 2011;140(4_MeetingAbstracts):646A. doi:10.1378/chest.1115504
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PURPOSE: The aim of this study was to assess the pulmonary thin-section computed tomography (CT) findings in patients with acute Haemophilus influenzae pulmonary infection.

METHODS: Thin-section CT scans obtained between January 2004 and March 2009 from 434 patients with acute Haemophilus influenzae pulmonary infection were retrospectively evaluated. Patients with concurrent infection diseases, including Streptococcus pneumoniae (n=76), Staphylococcus aureus (n=58), or multiple pathogens were excluded from this study. Thus, our study group comprised 211 patients (106 male, 105 female; age range, 16-91 years, mean, 63.9 years). Underlying diseases included cardiac disease (n=35), pulmonary emphysema (n=23), post-operative status for malignancy (n=20), or bronchial asthma (n=15). Frequencies of CT patterns and disease distribution of parenchymal abnormalities, lymph node enlargement, and pleural effusion were assessed by thin-section CT.

RESULTS: The CT findings in patients with Haemophilus influenzae pulmonary infection consisted mainly of ground-glass opacity (n=185), bronchial wall thickening (n=181), centrilobular nodules (n=137), and consolidation (n=112). These abnormalities were predominantly seen in the peripheral lung parenchyma (n=108). Pleural effusion was found in 22 patients. Two patents had mediastinal lymph node enlargement.

CONCLUSIONS: These findings in elderly patients with smoking habits, cardiac disease, or pulmonary emphysema, although nonspecific, may be characteristic CT findings of Haemophilus influenzae pulmonary infection.

CLINICAL IMPLICATIONS: Haemophilus influenzae pulmonary infection is an important type of pneumonia because these infections (1) exacerbate chronic obstructive pulmonary disease; (2) cause pneumonia, particularly in older adults; and (3) comprise a nosocomial respiratory tract pathogen. The mortality rate in patients with Haemophilus influenzae pneumonia has been reported as 10-42%. Moreover, nosocomial outbreaks caused by Haemophilus influenzae have been reported. Therefore, it is essential to identify the risk factors associated with poor outcome and to evaluate the radiological findings as quickly as possible to allow for timely initiation of appropriate management and treatment.This work might contribute to a reduction in the mortality of patients with acute Haemophilus influenzae pulmonary infection.

DISCLOSURE: The following authors have nothing to disclose: Asami Ono, Yumiko Ando, Fumito Okada, Tomoko Nakayama, Toru Maeda, Hiromu Mori

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