• Imad El Majzoub, Aline El Zakhem, Rola Cheaito, Mohamad Ali Cheaito, Rima Kaddoura, Maria Alkozah, and Hady Zgheib.
• Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon. im26@aub.edu.lb.
• J Infect Dev Ctries. 2020 Oct 31; 14 (10): 1178-1184.

IntroductionPulmonary 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.MethodologyThis 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.Results11.4% 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.ConclusionPatients 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.Copyright (c) 2020 Imad El Majzoub, Aline El Zakhem, Rola Cheaito, Mohamad Ali Cheaito, Rima Kaddoura, Maria Alkozah, Hady Zgheib.

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