Limited Diagnostic and Therapeutic Value of Chest X-Rays in Hematological Patients With Febrile Neutropenia

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Chest X-rays are commonly used in febrile neutropenic patients to rule out pulmonary infections, but their diagnostic value is questionable.
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In a study of 412 febrile episodes, 41.4% of patients with respiratory symptoms had abnormal chest X-rays compared to 16.1% without.
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Antimicrobial treatment decisions were rarely influenced by chest X-ray results, with only 6.9% of patients in group A adjusting treatment based on X-rays.
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Chest CT scans were more likely to influence antimicrobial treatment adjustments, particularly in patients with respiratory symptoms.
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The study suggests that chest X-rays may be safely omitted in febrile neutropenic patients without respiratory symptoms.

Open Forum Infectious Diseases

by Dorine Dijkshoorn-Fokker, Madalina Marina, Ada van Bruchem-van de Scheur, Wendy Oldenmenger, Bart Rijnders, Jurjen Versluis, Nick Wlazlo
July 18, 2025

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