TY - JOUR AU - El Majzoub, Imad AU - El Zakhem, Aline AU - Cheaito, Rola AU - Cheaito, Mohamad Ali AU - Kaddoura, Rima AU - Alkozah, Maria AU - Zgheib, Hady PY - 2020/10/31 Y2 - 2024/03/28 TI - The utility of chest X-ray vs. computed tomography in febrile neutropenia patients presenting to the emergency department JF - The Journal of Infection in Developing Countries JA - J Infect Dev Ctries VL - 14 IS - 10 SE - Original Articles DO - 10.3855/jidc.12577 UR - https://jidc.org/index.php/journal/article/view/33175714 SP - 1178-1184 AB - <p>Introduction: Pulmonary infections are not uncommon in patients with febrile neutropenia. Physicians have agreed to perform a chest X-ray (CXR) for all febrile neutropenic patients presenting with respiratory signs/symptoms. Nevertheless, they were divided into two groups when it came to asymptomatic febrile neutropenic patients (i.e. without respiratory signs/symptoms). A superior alternative to CXR is Computed Tomography (CT). CT, in comparison to CXR, was shown to have better sensitivity in detecting pulmonary foci. The aim of our study is to compare the diagnostic performance of CT and CXR in febrile neutropenic patients presenting to the emergency department, regardless of their clinical presentation. We are also interested in the predictors of pneumonia on chest imaging.</p><p>Methodology: This is a retrospective cohort study conducted on febrile neutropenic adult cancer patients presenting to the emergency department of the American University of Beirut Medical Center.</p><p>Results: 11.4% of 263 patients had pneumonia although 27.7% had respiratory signs/symptoms. 17.1% of those who were symptomatic and did a CXR were found to have pneumonia. 41.7% of those who were symptomatic and did a CT were found to have pneumonia. 30% had negative findings on CXR but pneumonia on CT.</p><p>Conclusion: Patients with positive findings of pneumonia on chest imaging mainly had solid tumors, profound neutropenia, a higher CCI and a longer LOS. The presence of respiratory signs is the main predictor of positive pneumonia on chest imaging. CT is superior to CXR in detecting pulmonary foci in the population studied.</p> ER -