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__NOTOC__
__NOTOC__
{{Bacterial pneumonia}}
{{Bacterial pneumonia}}
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz
'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]]


=Overview=
=Overview=
CT scans are not a primary modality of testing for bacterial pneumonia. It is utilized in complex cases where the cause is unknown<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }} </ref> and when empiric antibiotic use yields no symptomatic relief. The  information retrieved through CT scans can be useful in differentiating infectious and noninfectious pneumonia.<ref name="pmid10459281">{{cite journal| author=Murata K, Takahashi M, Furukawa A, Itoh R, Yamasaki M, Sho K | display-authors=etal| title=[CT findings of pulmonary infections]. | journal=Nihon Igaku Hoshasen Gakkai Zasshi | year= 1999 | volume= 59 | issue= 8 | pages= 371-9 | pmid=10459281 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10459281  }} </ref>
Although [[CT scans]] are not a primary modality of [[testing]] for [[bacterial pneumonia]], they may be utilized in complex cases where the underlying cause is unknown<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }} </ref> and/or when [[Empiric therapy|empiric antibiotic]] use yields no symptomatic relief in the patient. CT scans may be very informative and assist in differentiating infectious and noninfectious [[pneumonia]].<ref name="pmid10459281">{{cite journal| author=Murata K, Takahashi M, Furukawa A, Itoh R, Yamasaki M, Sho K | display-authors=etal| title=[CT findings of pulmonary infections]. | journal=Nihon Igaku Hoshasen Gakkai Zasshi | year= 1999 | volume= 59 | issue= 8 | pages= 371-9 | pmid=10459281 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10459281  }} </ref> Similar to [[Chest X-ray|chest x-rays]], CT findings can also be described according to the type of pneumonia including [[Lobar pneumonia|lobar]] or focal nonsegmental pneumonia, lobular or multifocal [[bronchopneumonia]], and diffuse or interstitial ([[Atypical pneumonia|atypical) pneumonia]].


=CT Scan=
=CT Scan=
{| class="wikitable"
|+
!'''Type of Pneumonia'''
!'''Common Organisms'''
!'''CT Scan'''
!'''Findings'''
|-
|[[Lobar pneumonia|Lobar]]/ Focal non-segmental<ref name="Radiopaedia Lobar">{{cite web|url=https://radiopaedia.org/articles/lobar-pneumonia}}</ref>
|[[Klebsiella pneumoniae|''Klebsiella pneumoniae'']]
[[Legionella pneumophila|''Legionella pneumophila'']]
[[Haemophilus influenzae|''Haemophilus influenzae'']]
|[[Image:Lobar-pneumonia-CT-findings.jpg|centre|300x300px|[https://radiopaedia.org/cases/lobar-pneumonia-ct-findings?lang=us Lobar pneumonia] - Case courtesy of Dr Chris O'Donnell|alt=|thumb]][[Image:Pneumococcal-pneumonia-complication-parapneumonic-effusion-1.png|centre|300x300px|[https://radiopaedia.org/cases/parapneumonic-effusion-1?lang=us Pneumococcal Pneumonia (complication: parapneumonic effusion)] - Case courtesy of Dr Henry Knipe|alt=|thumb]]
|
*Focal [[dense opacification]] of the majority of an entire lobe
*Relative sparing of the [[large airways]]
*[[Ground glass opacification on CT|Ground glass opacity]] appearance in a lobar or segmental pattern
|-
|Lobular/ Multifocal [[Bronchopneumonia]]<ref name="Radiopaedia Bronchopneumonia">{{cite web|url=https://radiopaedia.org/articles/bronchopneumonia?lang=us}}</ref>
|[[Staphylococcus aureus|''Staphylococcus aureus'']]
[[Klebsiella pneumoniae|''Klebsiella pneumoniae'']]
[[Haemophilus influenzae|''Haemophilus influenzae'']]
[[Pseudomonas aeruginosa|''Pseudomonas aeruginosa'']]
[[Escherichia coli|''Escherichia coli'']]
|[[Image:BronchopneumoniaCT.jpg|300x300px|[https://radiopaedia.org/cases/pulmonary-tuberculosis-9?lang=us Bronchopneumonia CT] - Case courtesy of Dr Ayush Goel|alt=|center|thumb]][[Image:Tree-in-bud-002.jpg|300x300px|[https://radiopaedia.org/cases/tree-in-bud-1?lang=us Bronchopneumonia CT (Tree in Bud)] - Case courtesy of The Radswiki|alt=|center|thumb]][[Image:Tree-in-bud-001.jpg|300x300px|[https://radiopaedia.org/cases/tree-in-bud-1?lang=us Bronchopneumonia CT (Tree in Bud: Enhanced)] - Case courtesy of The Radswiki|alt=|center|thumb]]
|
*Multiple foci of opacity in a [[lobular pattern]]
*[["Tree in Bud"|"Tree in Bud" appearance]]
*Larger areas of [[Consolidation (medicine)|consolidation]] may appear as 'patchwork quilt'
|-
|Diffuse/ Interstitial ([[Atypical pneumonia|Atypical]])<ref name="Radiopaedia Interstitial">{{cite web|url=https://radiopaedia.org/articles/atypical-pneumonia?lang=us}}</ref>
|''[[Mycoplasma]]''
[[Chlamydophila pneumoniae|''Chlamydophila pneumoniae'']]
[[Chlamydophila psittaci|''Chlamydophila psittaci'']]
''[[Legionella]]''
|[[Image:Atypical pneumonia.jpg|300x300px|[https://radiopaedia.org/cases/h1n1-pneumonia?lang=us Atypical pneumonia] - Case courtesy of Dr Mostafa El-Feky|alt=|center|thumb]]
|
*Focal [[Ground glass opacification on CT|ground glass]] opacity appearance (in a centrilobular pattern)
*Diffuse and bilateral (in most cases)
*[[Bronchial wall thickening]]
*Segmental [[atelectasis]] from small airway obstruction may occur
*Radiological findings are often more pronounced than the patients appearance
*[[Mycoplasma]] pneumoniae: airspace consolidation
*[[Legionella]] pneumophila: residual scarring may persist
|}


==References==
==References==
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[[Category:Pneumonia|Pneumonia]]
[[Category:Pneumonia|Pneumonia]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Up to Date]]


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Latest revision as of 00:13, 19 March 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

Although CT scans are not a primary modality of testing for bacterial pneumonia, they may be utilized in complex cases where the underlying cause is unknown[1] and/or when empiric antibiotic use yields no symptomatic relief in the patient. CT scans may be very informative and assist in differentiating infectious and noninfectious pneumonia.[2] Similar to chest x-rays, CT findings can also be described according to the type of pneumonia including lobar or focal nonsegmental pneumonia, lobular or multifocal bronchopneumonia, and diffuse or interstitial (atypical) pneumonia.

CT Scan

Type of Pneumonia Common Organisms CT Scan Findings
Lobar/ Focal non-segmental[3] Klebsiella pneumoniae

Legionella pneumophila

Haemophilus influenzae

Lobar pneumonia - Case courtesy of Dr Chris O'Donnell
Pneumococcal Pneumonia (complication: parapneumonic effusion) - Case courtesy of Dr Henry Knipe
Lobular/ Multifocal Bronchopneumonia[4] Staphylococcus aureus

Klebsiella pneumoniae

Haemophilus influenzae

Pseudomonas aeruginosa

Escherichia coli

Bronchopneumonia CT - Case courtesy of Dr Ayush Goel
Bronchopneumonia CT (Tree in Bud) - Case courtesy of The Radswiki
Bronchopneumonia CT (Tree in Bud: Enhanced) - Case courtesy of The Radswiki
Diffuse/ Interstitial (Atypical)[5] Mycoplasma

Chlamydophila pneumoniae

Chlamydophila psittaci

Legionella

Atypical pneumonia - Case courtesy of Dr Mostafa El-Feky
  • Focal ground glass opacity appearance (in a centrilobular pattern)
  • Diffuse and bilateral (in most cases)
  • Bronchial wall thickening
  • Segmental atelectasis from small airway obstruction may occur
  • Radiological findings are often more pronounced than the patients appearance
  • Mycoplasma pneumoniae: airspace consolidation
  • Legionella pneumophila: residual scarring may persist

References

  1. ↑ "StatPearls". 2021. PMID 30020693.
  2. ↑ Murata K, Takahashi M, Furukawa A, Itoh R, Yamasaki M, Sho K; et al. (1999). "[CT findings of pulmonary infections]". Nihon Igaku Hoshasen Gakkai Zasshi. 59 (8): 371–9. PMID 10459281.
  3. ↑ https://radiopaedia.org/articles/lobar-pneumonia. Missing or empty |title= (help)
  4. ↑ https://radiopaedia.org/articles/bronchopneumonia?lang=us. Missing or empty |title= (help)
  5. ↑ https://radiopaedia.org/articles/atypical-pneumonia?lang=us. Missing or empty |title= (help)

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