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European Radiology

, Volume 14, Issue 2, pp 256–271 | Cite as

Pneumonia in neutropenic patients

  • C. P. HeusselEmail author
  • H.-U. Kauczor
  • A. J. Ullmann
Chest

Abstract

Radiologists have a special role in the management of neutropenic patients. The appropriate investigational technique, frequently targeted differential diagnosis, and the special needs of these patients, need to be understood. Early detection of a focus is the major goal in febrile neutropenic patients. As pneumonia is the most common focus, chest imaging is a special radiological task. The sensitivity of chest X-ray, especially in supine position, is known to be low; therefore, the very sensitive high-resolution CT (HRCT) became gold standard in neutropenic hosts and will probably be replaced by thin-section multislice CT (MSCT) in the near future. Costs of high-resolution CT are low in comparison to antibiotics. An infiltrate needs to be localised, so that a physician can utilise this information as a guidance for invasive procedures for further microbiological work-up. The radiological characterisation of infiltrates gives a first and rapid hint to differentiate between different sorts of infectious (typical bacterial, atypical bacterial, fungal) and non-infectious aetiologies. Follow-up investigations need careful interpretation according to disease and concomitant treatment. Due to an increased incidence of fungal infiltrates even with appropriate therapy, follow-up of an infiltrate must use further parameters in addition to lesion size. Temporary exclusion of infectious involvement of the lung with high accuracy remains of special interest for clinicians.

Keywords

Pneumonia X-ray computed tomography Chest X-ray Neutropenia Infection 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of RadiologyJohannes Gutenberg UniversityMainzGermany
  2. 2.Department of Radiology, Division Innovative Cancer Diagnostics and TherapyGerman Cancer Research CentreHeidelbergGermany
  3. 3.Department of MedicineJohannes Gutenberg UniversityMainzGermany

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