bUniversity of Southern California, Los Angeles, California. cPanel Chair, University of Chicago, Chicago, Illinois. dMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. eStanford University Medical Center, Stanford, California; The Society of Thoracic Surgeons. fThe University of Texas MD Anderson Cancer Center, Houston, Texas. gThe University of Texas MD Anderson Cancer Center, Houston, Texas. hUniversity of Kentucky, Lexington, Kentucky. iMayo Clinic, Rochester, Minnesota. jVanderbilt University Medical Center, Nashville, Tennessee, American College of Chest Physicians. kMayo Clinic Florida, Jacksonville, Florida. lDuke University School of Medicine, Durham, North Carolina; The Society of Thoracic Surgeons. mUniversity of Kansas Medical Center, Kansas City, Kansas. nSpecialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Variant 2: Acute respiratory illness in immunocompromised patients. Normal, equivocal, or nonspecific chest radiograph. Next imaging study. CT Chest Chest radiographs in immunocompromised patients with ARI may be equivocal or even normal despite a high suspicion for pulmonary disease [1]. In this setting, chest CT has been shown to confer a distinct improvement in sensitivity for detecting subtle parenchymal abnormalities [4]. In one study, CT performed in febrile neutropenic patients with normal chest radiographs showed pneumonia in 60% of cases at least 5 days before the abnormalities became visible on chest radiographs [6].
Acute Respiratory Illness in Immunocompromised Patients. bUniversity of Southern California, Los Angeles, California. cPanel Chair, University of Chicago, Chicago, Illinois. dMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. eStanford University Medical Center, Stanford, California; The Society of Thoracic Surgeons. fThe University of Texas MD Anderson Cancer Center, Houston, Texas. gThe University of Texas MD Anderson Cancer Center, Houston, Texas. hUniversity of Kentucky, Lexington, Kentucky. iMayo Clinic, Rochester, Minnesota. jVanderbilt University Medical Center, Nashville, Tennessee, American College of Chest Physicians. kMayo Clinic Florida, Jacksonville, Florida. lDuke University School of Medicine, Durham, North Carolina; The Society of Thoracic Surgeons. mUniversity of Kansas Medical Center, Kansas City, Kansas. nSpecialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Variant 2: Acute respiratory illness in immunocompromised patients. Normal, equivocal, or nonspecific chest radiograph. Next imaging study. CT Chest Chest radiographs in immunocompromised patients with ARI may be equivocal or even normal despite a high suspicion for pulmonary disease [1]. In this setting, chest CT has been shown to confer a distinct improvement in sensitivity for detecting subtle parenchymal abnormalities [4]. In one study, CT performed in febrile neutropenic patients with normal chest radiographs showed pneumonia in 60% of cases at least 5 days before the abnormalities became visible on chest radiographs [6].