A Comparative Study of Chest X-Ray in Febrile Neutropenic Patients With and Without Pulmonary Sign



Meidani M¹ ; Mahvash S² ; Adibi A³ ; Khorvash F⁴ Show Affiliations
Source: Journal of Isfahan Medical School Published:2013

Abstract

Background: Infection, especially pulmonary infection and pneumonia, is a major cause of morbidity and mortality in patients with cancer treated with chemotherapy. Chest X-ray (CXR) is an initial guide, quick, inexpensive, available and low-radiation dose widely performed when pneumonia is suspected. According to various studies, the role of routine CXR in the diagnostic evaluation of febrile neutropenic patients without pulmonary symptoms is unclear. The purpose of this study was to evaluate the diagnostic yield of routine CXR in asymptomatic pulmonary neutropenic patients. Methods: 118 neutropenic patients (59 men and 59 women) with the age of more than 18 years were studied. History, physical examination, complete blood count (CBC), blood culture, urine analysis (U/A), and urine culture (U/C) were checked. In both, symptomatic and asymptomatic patients, 2 CXRs [Posterior-Anterior (PA) and lateral] were obtained and one radiologist studied CXRs without knowing about the physical examination. Findings: The incidence of pneumonia in was 17.8% in the entire population and 6.8% in asymptomatic pulmonary group. The incidence of pneumonia was significantly higher in men than in women (P = 0.04); the incidence of pneumonia significantly increased with age increasing (P = 0.01). Conclusion: Comparing our findings to similar studies, routine CXR in febrile neutropenic men with the age of more than 50 years is recommended.