Chest X-Rays May Predict Bird Flu Severity

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Ordinary chest X-rays may help doctors determine which cases of bird flu may be potentially fatal and require more aggressive treatment.

The results suggest that chest X-rays show distinctive patterns of bird (avian) flu in humans that are a good indicator of disease severity.

"On chest X-rays in patients with avian flu, the most common abnormality we found was multifocal consolidation, which usually represents pus and infection in patients with fever and a cough," says researcher Nagmi Qureshi, a fellow of thoracic radiology at the University of Oxford in England, in a news release. "We also discovered that the severity of these findings turned out to be a good predictor of patient mortality."

Because people have little or no immune protection from the newly emerging strains of bird flu, researchers say finding disease patterns can help doctors determine when more aggressive treatment is necessary to reduce the risk of death from the disease.

The results of the study were presented at the annual meeting of the Radiological Society of North America (RSNA) in Chicago.

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In the study, researchers studied about 100 X-rays of 14 people treated for bird flu in Vietnam. Of the 14 patients studied, nine died and five survived.

Researchers compared features commonly found in chest infections and then looked for links between X-ray findings and the risk of death.

The results showed that the lung consolidation (accumulation of pus and infection) in flu patients who died was more severe and located in more lung zones than those patients who survived.

Researchers say the chest X-rays showed patterns that were similar to those seen previously in people with SARS (severe acute respiratory syndrome).

"The appearance of multiple accumulations of infection in the lung is found in both avian flu and SARS," Qureshi says. "However, additional abnormalities we discovered in avian flu patients — including fluid in the space surrounding the lungs, enlarged lymph nodes and cavities forming in the lung tissue — were absent in patients with SARS."

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By Jennifer Warner, reviewed by Louise Chang, MD

SOURCES: Annual meeting of the Radiological Society of North America, Dec. 2, 2005, Chicago. News release, Radiological Society of North America.