Patients suspected of having H1N1 influenza who have certain features on chest radiography exams may have a worse prognosis, according to a study published in the April edition of Radiology.
Israeli researchers examined the chest radiography studies of 97 patients with flulike symptoms who were admitted to the emergency department of Tel Aviv Sourasky Medical Center between May and September 2009. All patients had laboratory-confirmed diagnosis of H1N1 flu, and x-ray findings were correlated with adverse patient outcomes, according to lead author Dr. Galit Aviram.
Chest radiography revealed abnormal findings for 39 patients, of whom five (12.8%) experienced adverse outcomes including death or the need for mechanical ventilation. Chest x-ray findings were normal in the other 58 patients, although in this group two patients (3.4%) experienced adverse outcomes.
"Abnormal findings in the periphery of both lungs and in multiple zones of the lungs were associated with poor clinical outcomes," Aviram said.
Aviram said that with H1N1 flu, a normal chest x-ray did not exclude the possibility of an adverse outcome, as it doesn't show abnormalities that can develop later in the course of the disease, a situation similar to seasonal influenza. Additional radiography studies should be performed in the patient's clinical course.
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