The imaging findings of viral pneumonia are diverse and overlap with those of other nonviral infectious and inflammatory conditions. Most pictures are taken from a CT scan where a contrast agent was used. -, Kocher K.E., Meurer W.J., Fazel R., Scott P.A., Krumholz H.M., Nallamothu B.K. CT Scan In select cases of coccidioidomycosis, CT scanning (see the images below) is more useful than other modalities in defining the morphology of the lesions that are seen on chest radiographs. National trends in use of computed tomography in the emergency department. If the address matches an existing account you will receive an email with instructions to reset your password. An H1N1 pandemic reported in more than 70 countries with 30 000 cases of infection occurred in 2009 (60). Figure 1a. Farmers and those who work in the field are the major at-risk group. An adenovirus infection occurs in 10.5% of patients undergoing hematopoietic stem cell transplantation; younger age, alternative donor grafts, and acute graft-versus-host disease are risk factors for infection (15). Patients admitted to hospital with suspected pneumonia and normal chest radiographs: epidemiology, microbiology, and outcomes. ACC metastases are commonly random spread over the lobes of the lung. Measles virus is a cause of childhood infections. But the common ones are 1. I have looked on line at different images and they look the same to me, but I am not a doctor. Overall mortality for influenza A (H5N1) is as high as 60%, and there have been outbreaks in Hong Kong. I have looked on line at different images and they look the same to me, but I am not a doctor. 3, 4 February 2020 | Radiology, Vol. However, identification of the underlying viral pathogens may not always be easy. Death: Final data for 2014. Pneumonia due to MERS coronavirus in a 27-year-old man who presented with a cough and sputum. More than 40 hantavirus species are known, and greater than 20 of these are considered pathogenic in humans. Clipboard, Search History, and several other advanced features are temporarily unavailable. Figure 12b. After the patient underwent an emergency cesarean delivery, intubation and extracorporeal membrane oxygenation were performed for acute respiratory distress syndrome. Would you like email updates of new search results? 2, 17 March 2020 | Radiology: Cardiothoracic Imaging, Vol. Moreover, rapid diagnosis can lead to early control of potential transmission, thus decreasing overall treatment costs. MERS progresses more rapidly to respiratory failure than does SARS and induces acute kidney injury. In the CT scans of his lungs, white patches can clearly be seen. Figure 9c. These findings are similar to those of HPIV pneumonia, which belongs to the same viridae. Cavitation, lymphadenopathy, or pleural effusions are not common findings (75). 2020 Feb 10;10(1):19-24. doi: 10.1080/20009666.2020.1711639. Before the development of the measles vaccine, many people with measles presented with fever, maculopapular skin rash, cough, coryza, or conjunctivitis. Until recently, Bunyaviridae was the largest group of RNA viruses, but it was replaced by Hantaviridae and Phenuiviridae. Figure 6b. Annually, more than 20 000 cases of hantavirus infection are reported globally, the majority of which occur in Asia, but increasing numbers are reported in the Americas and Europe (56,57). 2020 Nov 6;7:2049936120969607. doi: 10.1177/2049936120969607. Prolonged neutropenia is noted. It is spread by means of direct person-to-person contact between susceptible individuals and those who are asymptomatic Epstein-Barr virus shedders. Pneumonia due to MERS coronavirus in a 27-year-old man who presented with a cough and sputum. (a) Initial chest radiograph shows poorly defined nodules (arrows) and reticular areas of increased opacity in both lungs. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Intensive medical treatment was performed and the patient recovered. In a previous study, Pavia (1) suggested that biphasic patterned illness, consolidation on chest radiographs, and high inflammation markers may increase the likelihood of bacterial coinfection (1). Viruses are the most common causes of acute respiratory infections, and causative agents of lower respiratory tract infection vary according to patient age and immunity (Table 1). The risk of disseminated disease increases in patients with lymphoma and in immunocompromised or pregnant patients (23). Moreover, their appearance on radiology also depends on the degree of Pneumonia due to MERS coronavirus in a 27-year-old man who presented with a cough and sputum. Figure 8b. (a) Initial chest radiograph shows ill-defined patchy consolidation and GGO (arrows) in the left middle to lower lungs and the right lower lung zone. The differentiation between pneumonia due to CMV or Pneumocystis is difficult, especially in the early phase of the disease, when bilateral GGO is seen on CT images. Although not all patients present with typical patterns, most viral pneumonia imaging patterns share similarity on the basis of viridae, because viruses of the same viridae have a similar pathogenesis. Chest. The clinical and CT findings of numerous respiratory viral pathogens such as influenza, human parainfluenza virus (HPIV), respiratory syncytial virus (RSV), rhinovirus, and adenovirus have been described (1,2). It is usually grouped under atypical pneumonia. (a, b) Initial axial chest CT images at the main bronchial level (a) and the interlobar area level (b) show multifocal ill-defined nodular GGO lesions (arrows) along the bronchovascular bundles and mild bronchial wall thickening (arrowheads). The early stages of disease often demonstrate tracheobronchitis and neutrophilic bronchopneumonia. ■ Discuss the clinical characteristics of viral pneumonia such as patient age and immune status, seasonal variation, and community outbreak periods. (b–d) Axial CT images (3-mm section thickness) obtained on the same day at the level of the right inferior pulmonary vein (b) and the junction of the right atrium and inferior vena cava (c) and a coronal reconstruction image at the vertebral body level (d) show multifocal patchy and nodular consolidation with GGO (arrows) in both lower lobes. I can understand your situation and problem. Patients admitted with pneumonia often receive a chest computed tomography (CT) scan for a variety of reasons. (b) Pneumonia due to CMV shows diffuse ill-defined patchy GGO with interlobular septal thickening (arrowheads) in both lungs. (b, c) Axial thin-section (1-mm collimation) CT images obtained on the same day, at the lower trachea level (b) and interlobar area level (c), show ill-defined GGO nodules, interlobular septal thickening (arrowheads), and diffuse GGO (arrows) in both lungs, with a scanty amount of bilateral pleural effusion (* in c). (a) Pneumonia due to varicella-zoster virus shows multifocal 1–10-mm well-defined or ill-defined nodular opacity (arrows) with a surrounding halo or patchy GGO (arrowheads) in both lungs. Splenomegaly is common. Also, complications like early abscess formation and fluid accumulation around the lungs is easier to detect. (a) Pneumonia due to varicella-zoster virus shows multifocal 1–10-mm well-defined or ill-defined nodular opacity (arrows) with a surrounding halo or patchy GGO (arrowheads) in both lungs. The CT picks them up as tissue that is different than the surrounding area which is why they light-up white on the images and are easier to see. One study used CT scans and laboratory tests to compare the clinical features of COVID-19 pneumonia to other types of pneumonia. The first goal of this review is to indicate that there are imaging features that should raise the possibility of viral infections. Nodules are … (c) Pneumonia due to HMPV shows multiple ill-defined nodules (arrows) or GGO (arrowhead) along the bronchovascular bundles in both lungs. Approximately 20% of all virus cases were identified in health care workers and persons who come into close contact with camels (76). A subtype of adenocarcinoma is called bronchoalveolar cell carcinoma creates a pneumonia-like appearance on chest X-rays. After the patient underwent an emergency cesarean delivery, intubation and extracorporeal membrane oxygenation were performed for acute respiratory distress syndrome. In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens present, and outcomes of patients with pneumonia visualized on a CT scan but not on a concurrent chest radiograph (CT-only pneumonia) and those with pneumonia visualized on a chest radiograph. However, it can cause life-threatening pulmonary infection in immunocompromised patients owing to reactivation of the latent virus or infusion of CMV-seropositive marrow or blood products. Figure 2b. Second, to help radiologists differentiate viral infections, viruses in the same viridae that have similar pathogenesis and can have similar imaging characteristics are shown. The morbidity of hemorrhagic fever with renal syndrome is 1%–15%. However, there was no evidence of coinfection. 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