Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients

objective: to describe the chest computed tomography findings for severe influenza h1n1 infection in a series of hospitalized neutropenic cancer patients. methods: we performed a retrospective systematic analysis of chest computed tomography scans for eight hospitalized patients with fever, neutropenia, and confirmed diagnoses of influenza h1n1. the clinical data had been prospectively collected. results: six of eight patients (75%) developed respiratory failure and required intensive care. prolonged h1n1 shedding was observed in the three mechanically ventilated patients, and overall hospital mortality in our series was 25%. the most frequent computed tomography findings were ground-glass opacity (all patients), consolidation (7/8 cases), and airspace nodules (6/8 cases) that were frequently moderate or severe. other parenchymal findings were not common. five patients had features of pneumonia, two had computed tomography findings compatible with bronchitis and/or bronchiolitis, and one had tomographic signs of chronicity. conclusion: in this series of neutropenic patients with severe influenza h1n1 infection, chest computed tomography demonstrated mainly moderate or severe parenchymatous disease, but bronchiolitis was not a common feature. these findings associated with febrile neutropenia should elicit a diagnosis of severe viral infection.