However, MRI has been shown to be at least as sensitive as CT for detecting pleural effusions in immunocompromised patients and is superior to CT for detecting pleural adhesions/loculations [16]. Variant 5: Acute asthma exacerbation in immunocompetent patients, uncomplicated (no suspicion of pneumonia or pneumothorax). Initial imaging. Radiography Chest The incidence of PNA is exceedingly low in patients presenting with an uncomplicated asthma exacerbation. Heckerling [22] reported <2% of asthmatic patients as having pneumonic opacities. Findley and Sahn [37] observed that 99% of their patients either had normal chest radiograph examinations or showed only slightly prominent markings or hyperinflation. CT Chest Our literature search failed to identify any data that suggest that CT serves any significant role in the initial imaging of immunocompetent patients with a low pretest probability of PNA presenting with an acute asthma exacerbation. US Chest Our literature search failed to identify any data that suggest that US serves any significant role in the initial imaging of immunocompetent patients with a low pretest probability of PNA presenting with an acute asthma exacerbation. MRI Chest Our literature search failed to identify any data that suggest that MRI serves any significant role in the initial imaging of immunocompetent patients with a low pretest probability of PNA presenting with an acute asthma exacerbation. Variant 6: Acute asthma exacerbation in immunocompetent patients, complicated (suspected pneumonia or pneumothorax). Initial imaging. Radiography Chest Use of chest radiographs in patients with asthma exacerbation is controversial. Petheram et al [38] found clinically important radiographic findings in 9% of their patients and concluded that a chest radiograph is indicated. However, the incidence of PNA in patients presenting with an asthma exacerbation is low [22,37].
Acute Respiratory Illness in Immunocompetent Patients. However, MRI has been shown to be at least as sensitive as CT for detecting pleural effusions in immunocompromised patients and is superior to CT for detecting pleural adhesions/loculations [16]. Variant 5: Acute asthma exacerbation in immunocompetent patients, uncomplicated (no suspicion of pneumonia or pneumothorax). Initial imaging. Radiography Chest The incidence of PNA is exceedingly low in patients presenting with an uncomplicated asthma exacerbation. Heckerling [22] reported <2% of asthmatic patients as having pneumonic opacities. Findley and Sahn [37] observed that 99% of their patients either had normal chest radiograph examinations or showed only slightly prominent markings or hyperinflation. CT Chest Our literature search failed to identify any data that suggest that CT serves any significant role in the initial imaging of immunocompetent patients with a low pretest probability of PNA presenting with an acute asthma exacerbation. US Chest Our literature search failed to identify any data that suggest that US serves any significant role in the initial imaging of immunocompetent patients with a low pretest probability of PNA presenting with an acute asthma exacerbation. MRI Chest Our literature search failed to identify any data that suggest that MRI serves any significant role in the initial imaging of immunocompetent patients with a low pretest probability of PNA presenting with an acute asthma exacerbation. Variant 6: Acute asthma exacerbation in immunocompetent patients, complicated (suspected pneumonia or pneumothorax). Initial imaging. Radiography Chest Use of chest radiographs in patients with asthma exacerbation is controversial. Petheram et al [38] found clinically important radiographic findings in 9% of their patients and concluded that a chest radiograph is indicated. However, the incidence of PNA in patients presenting with an asthma exacerbation is low [22,37].