Chest Imaging Findings in Hospitalized Children with H1N1 Influenza

Objective: The aim was to review the radiological findings and to find new prognostic factors that determine the need for pediatric intensive care unit (PICU) in children with swine-origin influenza (H1N1) virus infection.
Methods: Chest X-ray (CXR) and computed tomography (CT) findings of 18 children with laboratory-confirmed H1N1 infection (9 boys, 9 girls) with a median age of 34 (1–216) months were retrospectively evaluated.
Results: CXRs were performed in 15 (83.3%) and thorax CT in 7 (38.8%) children. Abnormal findings were detected in 60% of the patients who underwent CXR and 85.7% of the patients who underwent thorax CT. Radiological findings were mostly diffuse, bilateral, and asymmetric. Ground-glass opacity (GGO) (66.6%) was the leading abnormality and was followed by reticulation (38.8%), nodules (27.7%), consolidation only (16.6%), tree-in-bud pattern (11.1%), consolidation with GGO (5.5%), and septal lines (5.5%). Lymphadenopathy (22.2%), air trapping (5.5%), and parenchymal band (5.5%) were other recorded findings. CXR was found to be insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. Only existence of nodules (p=0.04) affected the need for PICU admission.