To the Editors:
In a recent article printed in the European Respiratory Journal, Infante et al. 1 validated a stepwise approach including oral antibiotics, follow-up computed tomography and computed tomography-guided biopsy for the differential diagnosis and management of focal pulmonary ground-glass opacities (GGOs). Although a retrospective study, their work provides critical information on discrimination and management of focal GGOs. However, some of the results in the article did not fully support their conclusions.
One of the major conclusions in the study by Infante et al. 1 was that the stepwise approach increased the diagnostic specificity and reduced time to definitive diagnosis. They recommended response to antibiotic trial as the first management step. After a course of oral antibiotics, five (12.5%) patients with inflammatory lesions were ruled out. However, six patients in their study were evaluated with lesions retrospectively visible in earlier computed tomography scans and oral antibiotics were not given. Since the patients …