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Purpose: Because of the widespread use of CT in the diagnosis of COVID 19, indeterminate presentations such as single, few or unilateral lesions amount to a considerable number. We aimed to develop a new classification and structured reporting system on CT imaging (COVID-19 S) that would facilitate the diagnosis of COVID-19 in the most accurate way., Methods: Our retrospective cohort included 803 patients with a chest CT scan upon suspicion of COVID 19. The patients' history, physical examination, CT findings, RT PCR, and other laboratory test results were reviewed, and a final diagnosis was made as COVID 19 or non-COVID 19. Chest CT scans were classified according to the COVID 19 S CT diagnosis criteria. Cohen's kappa analysis was used., Results: Final clinical diagnosis was COVID-19 in 98 patients (12%). According to the COVID-19 S CT diagnosis criteria, the number of patients in the normal, compatible with COVID 19, indeterminate and alternative diagnosis groups were 581 (72.3%), 97 (12.1%), 16 (2.0%) and 109 (13.6%). When the indeterminate group was combined with the group compatible with COVID 19, the sensitivity and specificity of COVID-19 S were 99.0% and 87.1%, with 85.8% positive predictive value (PPV) and 99.1% negative predictive value (NPV). When the indeterminate group was combined with the alternative diagnosis group, the sensitivity and specificity of COVID-19 S were 93.9% and 96.0%, with 94.8% PPV and 95.2% NPV., Conclusion: COVID-19 S CT classification system may meet the needs of radiologists in distinguishing COVID-19 from pneumonia of other etiologies and help optimize patient management and disease control in this pandemic by the use of structured reporting.

Purpose: We aimed to demonstrate the computed tomography (CT) findings observed at the initial presentation of coronavirus disease 2019 (COVID-19) pneumonia and reveal the most frequent infiltration and distribution patterns of the disease., Methods: One hundred and eighty-five patients (87 men, 98 women; mean age, 48.7 years), who underwent RT-PCR sampling and high-resolution CT examination in our hospital between March 15, 2020, and April 15, 2020, and got a definitive diagnosis of COVID-19 disease via initial or follow-up RT-PCR test, were included in the study. We comprehensively analyzed the most common and relatively rare CT imaging features (e.g., distribution pattern, density of the lesions, additional CT signs) in patients diagnosed with COVID-19 pneumonia., Results: Thirty-eight patients (20.6%) had no evidence of pneumonia on their initial high-resolution CT images. Among 147 patients (79.4%) who had parenchymal infiltration consistent with pneumonia, 10 (6.8%) had a negative baseline RT-PCR test, and positivity was detected as a result of repeated tests. Most of the patients had multifocal (89.1%) and bilateral (86.4%) lesions. The most common location, right lower lobe, was affected in 87.8% of the patients. Lesions were distributed predominantly at peripheral (87.1%) and posterior (46.3%) areas of lung parenchyma. Most of the patients had pure ground glass opacity (GGO) (82.3%) followed by GGO with consolidation (32.7%) and crazy paving pattern (21.8%). Pure consolidation, solid nodules, halo sign, reverse halo sign, vascular enlargement, subpleural line, air-bronchogram, and bronchiectasis were the other findings observed in at least 15% of the cases. Halo sign, acinar nodules, air-bubble sign, pleural thickening and effusion, mediastinal and/or hilar lymphadenopathy were seen rarely (2%-12.9%). Pericardial effusion, pneumothorax, cavitation, and tree-in-bud pattern were not detected in our study group., Conclusion: Multifocal and bilateral GGO infiltration predominantly distributed in peripheral, posterior, and lower lung areas was the most common infiltration pattern.

Objective: To investigate the value of chest ultrasound in the diagnosis of pneumonia in adults., Methods: The prospective observational cohort study was conducted at Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey, from December 1, 2015,to March 1, 2016, and comprised suspected pneumonia patients aged >18 years. Sonographic pneumonia was defined as lung consolidation with air bronchograms. Treating clinicians were blinded to lung ultrasound results. All patients who were advised to undergo thoracic computerised tomography after physical examination were subjected to posteroanterior chest X-ray before the scan. Patients in whom pneumonia was detected in the scan underwent thorax ulstasonography according to Bedside Lung Ultrasound in Emergency protocol. Follow-up was done with medical record review to obtain the final diagnosis and antibiotic usage. Data was analysed using SPSS 22., Results: Of the 125 patients, 61(48.8%) were male. The overall mean age was 73.9±14.6 years. In 97(77.6%) patients, pneumominal infiltration was detected by thorax ultrasound, and in 57(45.6%) the infiltration was detected with chest X-ray., Conclusions: Thorax ultrasound was found to be a helpful diagnostic method when performed according to the Bedside Lung Ultrasound in Emergency protocol.

Pulmonary aspergillosis is a devastating disease. Early diagnosis allowing early treatment may improve the prognosis. However, this goal remains difficult to achieve. When the diagnosis is confirmed, it is often already too late. Despite antifungal treatment, the mortality rate is high. Patients with immunosuppression show a high mortality rate. We present five patients of ages ranging between 34 and 43 years who displayed aspergillus pneumonia between 1991 and 2000. All patients received cyclosporine, azathioprine, and prednisone for maintenance immunosuppressive therapy. Their ages ranged from 34 to 43 years with the onset of infection between 1 to 25 months posttransplant. In all cases, the infection was localized to the lungs. Standard methods of fungal culture and identification were used. No coinfections with tuberculosis or other fungi or bacteria were identified. Three cases were successfully treated but two patients showed deterioration despite appropriate therapy and died. Among patients with solid organ transplantation, lung, liver, and renal transplant patients are at the highest risk of developing aspergillus lung infections. A high degree of awareness and efforts for early diagnosis and therapy may improve the poor prognosis.