Case 15
History:
38 year old patient with flu symptoms
Findings:
Chest CT shows bilateral ground glass infiltrates.
Diagnosis:
H1N1 flu
Discussion:
Chest radiographs are normal in more than half of patients with H1N1. The typical pattern when present is one of bilateral alveolar disease with lower and central lung preponderance. Small pleural effusions have also been described. Follow up radiographs usually show waxing and waning of alveolar disease. Agarwal et al. have recently shown that CT was more sensitive than plain radiographs (AJR oct 2009). The CT scans showed a combination of ground glass opacities and consolidation in most patients. The distribution was diffuse without zonal predominance in seven patients.
Pulmonary emboli were also identified on CT but determined not to be related to H1N1.
