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Vol. 53. Issue 2.
Pages 159-165 (January 2011)
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Vol. 53. Issue 2.
Pages 159-165 (January 2011)
Is H1N1 flu different from seasonal flu on initial plain chest films?
Gripe A ¿diferente de la gripe estacional?
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M. Martí-de-Graciaa, I. Pinillaa,
Corresponding author
i.pinilla@telefonica.net

Corresponding author.
, M. Quintana-Díazb, H. Rodríguez-Requenaa, C. Prados-Sánchezc
a Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, Spain
b Servicio de Urgencias, Hospital Universitario La Paz, Madrid, Spain
c Servicio de Neumología, Hospital Universitario La Paz, Madrid, Spain
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Abstract
Objectives

To determine whether there are differences in the findings on the initial plain chest films of patients with H1N1 influenza and those of patients with flu symptoms during the flu season.

Material and methods

All patients underwent plain-film chest radiography in the Emergency Department for flu symptoms; 95 patients had H1N1 influenza confirmed between July 2009 and December 2009 and 95 patients were attended for symptoms of seasonal flu in January 2009.

We analyzed the views obtained, the distribution and location of the radiologic findings, and patients’ age, sex, and previous disease.

Results

Patients with H1N1 influenza were younger than those with seasonal flu symptoms (mean 40.2 vs 50.9 years; p<0.001) and fewer had prior disease (48 vs. 63; p<0.001). Plain films were acquired with patients in the standing position in 75 patients in the H1N1 group and in 77 in the seasonal flu group; pathological findings were present in nearly 50% of the patients in each group. The most common findings in the H1N1 group were multifocal patchy consolidations (41.2%; p<0.001) and peribronchial-vascular opacities (16.3%), whereas in the seasonal flu group the most common finding was consolidation in a single lobe (43.9%).

Conclusion

We found significant differences between the radiologic findings of patients with H1N1 influenza (severe) and those of patients with symptoms of flu during the flu season: the incidence of multifocal patchy consolidation was greater in H1N1 patients and H1N1 patients were younger.

Keywords:
Influenza A
H1N1
Chest radiography
Resumen
Objetivos

Determinar si existen diferencias en los hallazgos de la radiografía de tórax inicial entre un grupo de pacientes con gripe A y pacientes con síntomas gripales en periodo de gripe estacional.

Material y métodos

La muestra está formada por pacientes que ingresan con síntomas gripales y a los que se les realiza radiografía de tórax en Urgencias. El grupo de estudio lo constituyen 95 pacientes con gripe A confirmada atendidos entre los meses de julio a diciembre de 2009 y el grupo control 98 pacientes con síntomas de gripe estacional atendidos en enero de 2009.

Se analizan los hallazgos radiológicos, su distribución y localización, edad, sexo, enfermedad previa y proyecciones obtenidas.

Resultados

El grupo de estudio presentó menor edad que el control (media 40,2 vs 50,9 años, p<0,001). Tienen enfermedad previa 48 pacientes del grupo de estudio y 63 del control (p<0,001). La radiografía se obtuvo en bipedestación en 75 pacientes del grupo de estudio y en 77 del control y muestra hallazgos patológicos en casi el 50% de los pacientes de cada grupo. Los hallazgos más frecuentes en el grupo de estudio son las consolidaciones parcheadas multifocales (41,2%, p<0,001) y las opacidades peribroncovasculares (16,3%). En el grupo control la lesión más frecuente es la consolidación de distribución lobar única (43,9%).

Conclusión

Encontramos diferencias significativas entre los hallazgos radiológicos en los pacientes con gripe A (grave) y aquellos con síntomas gripales en periodo de gripe estacional, con mayor incidencia de consolidación de distribución parcheada multifocal en la gripe A y en pacientes más jóvenes.

Palabras clave:
Gripe A
H1N1
Radiografía de tórax

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