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Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania.

Publication ,  Journal Article
Fiorillo, SP; Diefenthal, HC; Goodman, PC; Ramadhani, HO; Njau, BN; Morrissey, AB; Maro, VP; Saganda, W; Kinabo, GD; Mwako, MS; Bartlett, JA ...
Published in: Clin Radiol
October 2013

AIM: To describe chest radiographic abnormalities and assess their usefulness for predicting causes of fever in a resource-limited setting. MATERIALS AND METHODS: Febrile patients were enrolled in Moshi, Tanzania, and chest radiographs were evaluated by radiologists in Tanzania and the United States. Radiologists were blinded to the results of extensive laboratory evaluations to determine the cause of fever. RESULTS: Of 870 febrile patients, 515 (59.2%) had a chest radiograph available; including 268 (66.5%) of the adolescents and adults, the remainder were infants and children. One hundred and nineteen (44.4%) adults and 51 (20.6%) children were human immunodeficiency virus (HIV)-infected. Among adults, radiographic abnormalities were present in 139 (51.9%), including 77 (28.7%) with homogeneous and heterogeneous lung opacities, 26 (9.7%) with lung nodules, 25 (9.3%) with pleural effusion, 23 (8.6%) with cardiomegaly, and 13 (4.9%) with lymphadenopathy. Among children, radiographic abnormalities were present in 87 (35.2%), including 76 (30.8%) with homogeneous and heterogeneous lung opacities and six (2.4%) with lymphadenopathy. Among adolescents and adults, the presence of opacities was predictive of Streptococcus pneumoniae and Coxiella burnetii, whereas the presence of pulmonary nodules was predictive of Histoplasma capsulatum and Cryptococcus neoformans. CONCLUSIONS: Chest radiograph abnormalities among febrile inpatients are common in northern Tanzania. Chest radiography is a useful adjunct for establishing an aetiologic diagnosis of febrile illness and may provide useful information for patient management, in particular for pneumococcal disease, Q fever, and fungal infections.

Duke Scholars

Published In

Clin Radiol

DOI

EISSN

1365-229X

Publication Date

October 2013

Volume

68

Issue

10

Start / End Page

1039 / 1046

Location

England

Related Subject Headings

  • Tanzania
  • Radiography, Thoracic
  • Q Fever
  • Predictive Value of Tests
  • Pneumococcal Infections
  • Nuclear Medicine & Medical Imaging
  • Mycoses
  • Middle Aged
  • Male
  • Infant
 

Citation

APA
Chicago
ICMJE
MLA
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Fiorillo, S. P., Diefenthal, H. C., Goodman, P. C., Ramadhani, H. O., Njau, B. N., Morrissey, A. B., … Crump, J. A. (2013). Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania. Clin Radiol, 68(10), 1039–1046. https://doi.org/10.1016/j.crad.2013.05.002
Fiorillo, S. P., H. C. Diefenthal, P. C. Goodman, H. O. Ramadhani, B. N. Njau, A. B. Morrissey, V. P. Maro, et al. “Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania.Clin Radiol 68, no. 10 (October 2013): 1039–46. https://doi.org/10.1016/j.crad.2013.05.002.
Fiorillo SP, Diefenthal HC, Goodman PC, Ramadhani HO, Njau BN, Morrissey AB, et al. Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania. Clin Radiol. 2013 Oct;68(10):1039–46.
Fiorillo, S. P., et al. “Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania.Clin Radiol, vol. 68, no. 10, Oct. 2013, pp. 1039–46. Pubmed, doi:10.1016/j.crad.2013.05.002.
Fiorillo SP, Diefenthal HC, Goodman PC, Ramadhani HO, Njau BN, Morrissey AB, Maro VP, Saganda W, Kinabo GD, Mwako MS, Bartlett JA, Crump JA. Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania. Clin Radiol. 2013 Oct;68(10):1039–1046.
Journal cover image

Published In

Clin Radiol

DOI

EISSN

1365-229X

Publication Date

October 2013

Volume

68

Issue

10

Start / End Page

1039 / 1046

Location

England

Related Subject Headings

  • Tanzania
  • Radiography, Thoracic
  • Q Fever
  • Predictive Value of Tests
  • Pneumococcal Infections
  • Nuclear Medicine & Medical Imaging
  • Mycoses
  • Middle Aged
  • Male
  • Infant