In Reply: Dr Pierce raises an interesting question on the role of radiologic studies in the diagnosis of influenza. In persons with uncomplicated influenza, involvement is confined to the larynx, trachea, and/or bronchi, and chest imaging is generally not necessary.1 Most information on the frequency of influenza-related pneumonia is based on data from hospitalized patients, a group skewed toward those with more severe illness.2- 4 Outpatients whose clinical history or physical examination suggests pneumonia or another respiratory complication of influenza should have chest imaging performed because abnormal findings may result in changes in clinical management such as the initiation of antibiotic therapy.
Barry MA. Diagnosing Influenza—Reply. JAMA. 2010;304(19):2127. doi:10.1001/jama.2010.1620