Parainfluenza Virus Type 3 Pneumonia in Bone Marrow Transplant Recipients: Multiple Small Nodules in High‐Resolution Lung Computed Tomography Scans Provide a Radiological Clue to Diagnosis

Abstract

We report the findings of high-resolution chest computed tomography of 6 hematopoietic stem cell transplant recipients with parainfluenza virus type 3 pneumonia who were not infected with any other pathogens. All patients had multiple small nodules (diameter, !5 mm) without cavitation ina peribronchial distribution. Changes preceded microbiological diagnosis in 4 of 6 cases.

Chest Computed Tomographic Imaging Characteristics of Viral Acute Lower Respiratory Tract Illnesses

“…This pattern of disease has also been observed in previous series of respiratory virus infections. 3,4,7,24 The current study indicates that this pattern of disease, although a frequent manifestation of viral LRTI, is also common in other disorders that have a similar clinical presentation and is seen in 24% of both groups. As a consequence, the multifocal pneumonia pattern is not useful in discriminating viral LRTI from other diseases with a similar clinical presentation.…”

Respiratory Viral Infections in Hematopoietic Stem Cell and Solid Organ Transplant Recipients

“…79,83 Among HSCT recipients with LRTI due to PIV, the typical finding on highresolution chest computed tomography is multiple small nodules (<5 mm in diameter) without cavitations in a peribronchial distribution. 96 However, these findings can be seen with other opportunistic infections. Radiographic infiltrates are also seen but usually suggest a late phase of the infection or coinfection/superinfection.…”

Crazy-paving sign in high-resolution computed tomography in parainfluenza virus pneumonia

“…Patricia et al reported the CT findings in 6 HSCT patients with PIV pneumonia who had multiple small nodules without cavitation with a peribronchial distribution. 8 There are no previous reports, however, of CT findings of PIV pneumonia in non-immunocompromised host. This is the first report of CT findings of parainfluenza pneumonia in a non-immunocompromised hosts.…”

“…6,7 Viral pneumonia in adults may be classified into two clinical groups: so-called atypical pneumonia in otherwise healthy hosts, and viral pneumonia in immunocompromised hosts. PIV infection is the one of the leading causes of morbidity and mortality after hematopoietic stem cell transplantation (HSCT), 8,9 although PIV pneumonia is very rare in healthy adults. Early, accurate diagnosis of pulmonary complications following HSCT is important because of its high mortality and morbidity.…”