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February 20, 1978

Influenza A Infection Should Not Simulate Pulmonary Embolism

Author Affiliations

Roseville, Calif

JAMA. 1978;239(8):725. doi:10.1001/jama.1978.03280350049010

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To the Editor.—  The article by Lynn et al (238:1166, 1977), entitled "Influenza A Infection Simulating Pulmonary Embolism" is misleading. The article states, "Pulmonary perfusion scans may demonstrate segmental, subsegmental, or nonspecific defects that represent relative reduction of regional pulmonary blood flow. These defects could be secondary to obstructive airway disease, pneumonia, atelectasis, effusion, and other acute or chronic pulmonary disease processes. In the absence of these concurrent abnormalities, the diagnosis of PE [pulmonary embolism] is established by perfusion defects demonstrated by pulmonary perfusion scan with the radioisotope-labeled particles [italics added].The first two sentences are entirely correct. However, the third sentence is incorrect. Since the advent of the ventilation scan in the late 1960s, the diagnosis of pulmonary embolism is established by perfusion defects demonstrated by a pulmonary perfusion scan only when the concurrently performed ventilation scan does not show the same defects. Although the clinical absence of obstructive