Bacterial pneumonia chest x ray

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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

Imaging with chest x-rays remains as the gold standard of diagnosis when supported with other laboratory findings. Although x-rays provide reliable findings, it is recommended that the entire clinical picture along with supporting laboratory findings be taken into consideration before treatment is started. Patterns commonly found on imaging include lobar or focal nonsegmental pneumonia, lobular or multifocal bronchopneumonia, and diffuse or interstitial (atypical) pneumonia. Radiological findings may take 6-12 weeks to clear.

Chest X-Ray

Type of Pneumonia[1] Common Organisms[2] Chest X-Ray Typical Findings[3]
Lobar/ Focal non-segmental Klebsiella pneumoniae

Legionella pneumophila

Haemophilus influenzae

Middle lobe pneumonia (Frontal) - Case courtesy of Dr Roberto Schubert
Middle lobe pneumonia (Lateral) - Case courtesy of Dr Roberto Schubert
Pneumococcal-pneumonia Right upper lobe - Case courtesy of Dr Jeremy Jones
  • Homogeneous (size may vary) opacification in a lobar pattern
  • May be sharply defined at the fissures
  • Appearance of air bronchograms
Lobular/ Multifocal Bronchopneumonia Staphylococcus aureus

Klebsiella pneumoniae

Haemophilus influenzae

Pseudomonas aeruginosa

Escherichia coli

Bronchopneumonia (Frontal) - Case courtesy of Dr Henry Knipe
Bronchopneumonia (Lateral) - Case courtesy of Dr Henry Knipe
Diffuse/ Interstitial (Atypical) Mycoplasma

Chlamydophila pneumoniae

Chlamydophila psittaci

Legionella

Legionella Pneumophilia - Case courtesy of Dr Jeremy Jones
Chlamydia Pneumoniae - Case courtesy of Dr Andrew Dixon
Mycoplasma - Case courtesy of Dr Alborz Jahangiri
  • Inflammation is limited to the pulmonary interstitium
  • Patchy reticular or reticulonodular opacities
  • Patches are more pronounced in the hilar regions
  • Segmental atelectasis from small airway obstruction may occur
  • Radiological findings are often more pronounced than the patients appearance

References

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  1. "StatPearls". 2021. PMID 30020693.
  2. "StatPearls". 2021. PMID 30020693.
  3. "StatPearls". 2021. PMID 30020693.