Prognostic significance of pathological chest radiography in transplant patients affected by cytomegalovirus and/or pneumocystis carinii.

Abstract

PURPOSE:

In order to evaluate the prognostic significance of chest film findings in connection with cytomegalovirus (CMV) and/or pneumocystis carinii infection (PC), a retrospective review was made of the pulmonary charts of 274 recipients of kidney and/or pancreatic grafts transplanted between April 1987 and December 1990.

MATERIAL, METHODS AND RESULTS:

Positive laboratory findings for CMV and/or PC were seen in 92 patients. In 77 patients only CMV was found, 13 patients had both CMV and PC, and 2 patients had only PC. In 57 patients a chest examination was performed. The films were reviewed by 2 radiologists independently. In 32 patients normal chest film findings were seen, while 25 patients demonstrated pathological changes. Of the patients with pathological changes 3 had only pleuritis while the remaining 22 demonstrated parenchymal infiltrations. No deaths occurred among patients infected with CMV and/or PC, when the chest film findings were normal or pleuritis only was seen, but there were 9 deaths in the group of patients with parenchymal infiltrations. Of the patients who died, 2 had only CMV, 5 had both CMV and PC, and 2 had only PC. The overall mortality, regardless of radiological findings, did not exceed 3% in patients with CMV only, but increased to 38% in patients with both CMV and PC. In patients with parenchymal infiltrations the corresponding mortality figures were increased to 18% and 56%, respectively.

CONCLUSION:

We conclude that a radiologically verified pneumonia related to the infectious agent influences the prognosis, and that CMV pneumonia has a better prognosis than PC pneumonia.

• Authors: B Wilczek, H E Wilczek, N Heurlin, G Tydén, P Aspelin
• Journal: Acta radiologica (Stockholm, Sweden : 1987) (Acta Radiol) Vol. 37 Issue 5 Pg. 727-31 (Sep 1996) ISSN: 0284-1851 [Print] England
• PMID: 8915284 (Publication Type: Journal Article)

Topics

• Cytomegalovirus Infections (diagnostic imaging, mortality)
• Humans
• Immunosuppression Therapy (adverse effects)
• Kidney Transplantation (diagnostic imaging)
• Pancreas Transplantation (diagnostic imaging)
• Pneumonia, Pneumocystis (diagnostic imaging, mortality)
• Pneumonia, Viral (diagnostic imaging, mortality)
• Postoperative Complications (diagnostic imaging, microbiology, mortality)
• Prognosis
• Radiography
• Retrospective Studies