Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
Heart Lung. 2011 May-Jun;40(3):253-6. doi: 10.1016/j.hrtlng.2010.07.013.
In patients with swine influenza (H1N1) pneumonia, the admission chest film is critical to rapidly detect simultaneous bacterial pneumonia due to Staphylococcus aureus or subsequent bacterial pneumonia due to Streptococcus pneumoniae or Haemophilus influenzae by the presence of focal infiltrates. Our objective was to characterize the chest film findings in 25 adults hospitalized with H1N1 pneumonia during the pandemic and detect focal infiltrates indicative of bacterial coinfection, that is, bacterial pneumonia. Chest films were obtained on admission, after 48 hours, and thereafter as indicated throughout hospitalization. Chest film findings were classified as no infiltrates, clear with accentuated bibasilar lung markings, or focal segmental/lobar infiltrates. The presence or absence of pleural effusion and cavitation was also noted. Admitted adults with H1N1 pneumonia had negative chest films or accentuated basilar lung markings. After 48 hours, 13% of patients developed patchy bilateral interstitial infiltrates. No patients had or subsequently developed focal segmental/lobar infiltrates indicative of bacterial community-acquired pneumonia during hospitalization. The most common chest film finding was no infiltrates or an accentuation of bibasilar lung markings in hospitalized adults with H1N1 pneumonia. No patients had focal segmental/lobar infiltrates indicative of superimposed bacterial community-acquired pneumonia.
在感染猪流感（H1N1）的肺炎患者中，入院时的胸部 X 光片对于快速检测金黄色葡萄球菌或肺炎链球菌或流感嗜血杆菌引起的同时性细菌性肺炎至关重要，因为这些细菌会导致局灶性浸润。我们的目的是描述大流行期间 25 例因 H1N1 肺炎住院的成年人的胸部 X 光片表现，并发现提示细菌合并感染（即细菌性肺炎）的局灶性浸润。入院时、48 小时后以及住院期间需要时均获得胸部 X 光片。胸部 X 光片结果分类为无浸润、清晰伴基底加重的肺纹理、或局灶性/节段性浸润。还注意到胸腔积液和空洞的存在或不存在。患有 H1N1 肺炎的入院成年人的胸部 X 光片为阴性或基底肺纹理加重。48 小时后，13%的患者出现双侧斑片状间质性浸润。在住院期间，没有患者出现或随后出现提示细菌性社区获得性肺炎的局灶性/节段性浸润。最常见的胸部 X 光片表现为入院的 H1N1 肺炎患者无浸润或基底肺纹理加重。没有患者出现提示重叠性细菌性社区获得性肺炎的局灶性/节段性浸润。
