Bacterial pneumonia CT

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

Overview

CT scans are not a primary modality of testing for bacterial pneumonia. It is utilized in complex cases where the cause is unknown and when empiric antibiotic use yields no symptomatic relief. The information retrieved through CT scans can be useful in differentiating infectious and noninfectious pneumonia.

CT Scan

Type of Pneumonia	Common Organisms	CT Scan	Findings
Lobar/ Focal non-segmental	Klebsiella pneumoniae Legionella pneumophila Haemophilus influenzae	Lobar pneumonia - Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 32998 Pneumococcal Pneumonia (complication: parapneumonic effusion) - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 44224	Focal dense opacification of the majority of an entire lobe Relative sparing of the large airway Ground glass opacity appearance in a lobar or segmental pattern
Lobular/ Multifocal Bronchopneumonia	Staphylococcus aureus Klebsiella pneumoniae Haemophilus influenzae Pseudomonas aeruginosa Escherichia coli	Bronchopneumonia CT - Case courtesy of Dr Ayush Goel, Radiopaedia.org, rID: 33116 Bronchopneumonia CT (Tree in Bud) - Case courtesy of The Radswiki, Radiopaedia.org, rID: 12039 Bronchopneumonia CT (Tree in Bud: Enhanced) - Case courtesy of The Radswiki, Radiopaedia.org, rID: 12039	Multiple foci of opacity in a lobular pattern Tree in Bud appearance Larger ares of consolidation may appear as a 'patchwork quilt'
Diffuse/ Interstitial (Atypical)	Mycoplasma Chlamydophila pneumoniae Chlamydophila psittaci Legionella	Atypical pneumonia - Case courtesy of Dr Mostafa El-Feky, Radiopaedia.org, rID: 75400	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