CTICasesViral Bronchopneumonia due to Human Metapneumovirus in an Immunosuppressed Patient
[...]. Viral Bronchopneumonia due to Human Metapneumovirus in an Immunosuppressed Patient. CTICases. Published March 30, 2018. https://cticases.com/c/2br7r
Imaging findings
In an immunosuppressed patient with multiple myeloma on chemotherapy presenting with acute respiratory illness, CT shows bronchial wall thickening with a heterogeneous, non-uniform distribution of bronchiolitis, scattered centrilobular nodules, and areas of tree-in-bud pattern; several days later, follow-up imaging shows progression to a more uniform pattern with numerous small airway-centered nodules.
Key takeaways
Viral panel testing was positive for human metapneumovirus, and the case is presented as a useful contrast to a more purely diffuse ground-glass/nodular hypersensitivity pattern, since this heterogeneous bronchitis and bronchiolitis pattern with tree-in-bud change and bronchial wall thickening is more typical of viral airway infection; basilar predominance of coarser findings can reflect aspirated secretions generated from upper-lung viral infection settling into the lower lobes.
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