HIGH-RESOLUTION COMPUTED-TOMOGRAPHY OF TH E LUNG IN NEUTROPENIC FEBRILE PATIENTS

Purpose: To determine the sensitivity and clinical impact of high-reso lution CT (HRCT) of the lung in febrile neutropenic patients under ant ibiotic therapy.Material and methods: Chest X-ray and HRCT were prospe ctively performed to exclude pneumonia in 34 patients (53 examinations ) suffering from febrile neutropenia following antitumorous therapy. D iagnosis was con firmed by bronchoalveolar lavage or sputum cultures. Results: Chest X-ray showed pneumonia in 13/53 examinations, in 12/13 a micro-organism was found. HRCT demonstrated pneumonia in 39/53, in 3 1/39 a micro-organism was found. All cases with positive cultures show ed suspicious HRCT findings. Changes in antibiotical treatment resulte d in findings suspicious for pneumonia and evidence of a new or a just treated micro-organism (chest X-ray 8/53, HRCT 31/53); the search for the source of fever was escalated in cases without evidence of micro- organisms and without suspicion of pneumonia findings 14/53. Conclusio n: HRCT of the lung exhibits a higher sensitivity than conventional ra diographs. Findings resulted in relevant therapeutic consequences. Hen ce, HRCT is indicated in neutropenic patients with fever and inconspic uous chest X-ray.