Abstract
Chest computed tomography (CT) findings of nodules, ground glass opacities, and consolidations are often interpreted as representing invasive fungal infection in individuals with febrile neutropenia. We assessed whether these CT findings were present in asymptomatic individuals with acute myeloid leukemia (AML) at low risk of invasive fungal disease. A retrospective study of consecutive asymptomatic adult patients with newly diagnosed AML over a 2-year period was performed at a tertiary care oncology center. Radiology reports of baseline chest CTs were reviewed. Of 145 CT scans, the majority (88%) had pulmonary abnormalities. Many (70%) had one or both of unspecified opacities (52%) and nodules (49%). Ground glass opacities (18%) and consolidations (12%) occurred less frequently. Radiologists suggested pneumonia as a possible diagnosis in 32% (n = 47) of scans. Chest CT may result in over-diagnosis of invasive fungal disease in individuals with febrile neutropenia if interpreted without correlation to the patients’ clinical status.
Acknowledgements
This project was performed in collaboration with the Mount Sinai Hospital-University Health Network Antimicrobial Stewardship Program (MSH-UHN ASP). We are indebted to Gabriella Jacob, BSc, Laura Ovens, BSc, and Eric Lentz for their assistance with data collection. As well we are indebted, as always, to Anthony Bai, BHSc for his invaluable advice and assistance with data analysis. None of these persons received compensation for the work done.
Potential conflict of interest
Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.1080/10428194.2016.1213825.