Bacterial pneumonia chest x ray: Difference between revisions

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__NOTOC__
{{Bacterial pneumonia}}
{{Bacterial pneumonia}}
'''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:''' Arooj Naz<br />
'''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]]<br />


==Overview==
==Overview==


Imaging with chest x-rays remains the gold standard of diagnosis when supported with other lab findings but it is recommended that, apart from x-ray findings, the entire clinical picture be taken into consideration before treatment is started.<ref name="pmid30115336">{{cite journal| author=Grief SN, Loza JK| title=Guidelines for the Evaluation and Treatment of Pneumonia. | journal=Prim Care | year= 2018 | volume= 45 | issue= 3 | pages= 485-503 | pmid=30115336 | doi=10.1016/j.pop.2018.04.001 | pmc=7112285 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30115336  }}</ref> Patterns commonly found on imaging include lobar or focal nonsegmental pneumonia, lobular or multifocal bronchopneumonia pneumonia, and diffuse or interstitial pneumonia.<ref name="pmid30036297">{{cite journal| author=Franquet T| title=Imaging of Community-acquired Pneumonia. | journal=J Thorac Imaging | year= 2018 | volume= 33 | issue= 5 | pages= 282-294 | pmid=30036297 | doi=10.1097/RTI.0000000000000347 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30036297  }}</ref>
Imaging with [[Chest X-ray|chest x-rays]] remains as the [[Gold standard (test)|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 pneumonia|lobar]] or focal nonsegmental pneumonia, lobular or multifocal [[bronchopneumonia]], and diffuse or interstitial ([[Atypical pneumonia|atypical) pneumonia]]. [[Radiological|Radiological findings]] may take 6-12 weeks to clear.


==Chest X-Ray==
<br />
==Chest X-Ray==
==Chest X-Ray==
{| class="wikitable"
{| class="wikitable"
|+
|+
!Type of Pneumonia
!'''Type of Pneumonia<ref name="pmid300206932">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }}</ref>'''
!Typical Organism
!'''Common Organisms<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }}</ref>'''
!Chest X-Ray
!'''Chest X-Ray'''
!'''Typical Findings<ref name="pmid300206933">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }}</ref>'''
|-
|-
|Lobar/ Focal non-segmental<ref name="Radiopaedia2">{{cite web|url=https://radiopaedia.org/articles/lobar-pneumonia}}</ref>
|[[Lobar pneumonia|Lobar]]/ Focal non-segmental
|[[Klebsiella pneumoniae|''Klebsiella pneumoniae'']]
[[Legionella pneumophila|''Legionella pneumophila'']]
 
[[Haemophilus influenzae|''Haemophilus influenzae'']]
|[[Image:Middle lobe pneumonia.jpg|centre|372x372px|[https://radiopaedia.org/cases/middle-lobe-pneumonia Middle lobe pneumonia (Frontal)] - Case courtesy of Dr Roberto Schubert|alt=|thumb]][[Image:Middle-lobe-pneumonia-lateral.jpg|474x474px|[https://radiopaedia.org/cases/middle-lobe-pneumonia Middle lobe pneumonia (Lateral)] - Case courtesy of Dr Roberto Schubert|alt=|center|thumb]][[Image:Pneumococcal-pneumonia (right upper lobe).jpg|300x300px|[https://radiopaedia.org/cases/pneumococcal-pneumonia?lang=us Pneumococcal-pneumonia Right upper lobe] - Case courtesy of Dr Jeremy Jones|alt=|center|thumb]]
|
|
*''Klebsiella pneumoniae''
*Homogeneous (size may vary) opacification in a [[Lobar pneumonia|lobar]] pattern
*''Legionella pneumophila''
*May be sharply defined at the [[fissures]]
*''Haemophilus influenzae''
*Appearance of air [[bronchograms]]
|[[Image:Middle lobe pneumonia.jpg|372x372px|Middle lobe pneumonia (Frontal) - Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 16074|alt=|border|left|thumb]][[Image:Middle-lobe-pneumonia-lateral.jpg|474x474px|Middle lobe pneumonia (Lateral) - Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 16074|alt=|center|thumb]][[Image:Pneumococcal-pneumonia (right upper lobe).jpg|frame|thumb|right|500px|Pneumococcal-pneumonia Right upper lobe - Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 13553]]
|-
|-
|Lobular/ Multifocal Bronchopneumonia
|Lobular/ Multifocal [[Bronchopneumonia]]
|
|[[Staphylococcus aureus|''Staphylococcus aureus'']]
[[Klebsiella pneumoniae|''Klebsiella pneumoniae'']]
 
[[Haemophilus influenzae|''Haemophilus influenzae'']]
 
[[Pseudomonas aeruginosa|''Pseudomonas aeruginosa'']]
 
[[Escherichia coli|''Escherichia coli'']]
|[[Image:Bronchopneumonia (frontal).png|300x300px|[https://radiopaedia.org/cases/bronchopneumonia?lang=us Bronchopneumonia (Frontal)] - Case courtesy of Dr Henry Knipe|alt=|center|thumb]][[Image:Bronchopneumonia (lateral).png|380x380px|[https://radiopaedia.org/cases/bronchopneumonia?lang=us Bronchopneumonia] (Lateral) - Case courtesy of Dr Henry Knipe|alt=|center|thumb]]
|
|
*Multiple small [[nodular opacities]]
*Patchy and confluent
*Patches of inflammation separated by normal [[lung parenchyma]]
|-
|-
|Diffuse/ Interstitial
|Diffuse/ Interstitial ([[Atypical pneumonia|Atypical]])
|
|''[[Mycoplasma]]''
|
[[Chlamydophila pneumoniae|''Chlamydophila pneumoniae'']]
|}
 
{| class="wikitable"
[[Chlamydophila psittaci|''Chlamydophila psittaci'']]
|+
 
!Type of Pneumonia
''[[Legionella]]''
!Typical Organism
|[[Image:Legionella-pneumophilia.png|318x318px|[https://radiopaedia.org/cases/right-hemithorax-air-space-shadowing?lang=us Legionella Pneumophilia] - Case courtesy of Dr Jeremy Jones|alt=|center|thumb]][[Image:Chlamydia-pneumonia.png|309x309px|[https://radiopaedia.org/cases/chlamydia-pneumonia?lang=us Chlamydia Pneumoniae] - Case courtesy of Dr Andrew Dixon|alt=|center|thumb]][[Image: Atypical-pneumonia-mycoplasma.jpg |300x300px|[https://radiopaedia.org/cases/atypical-pneumonia-mycoplasma?lang=us Mycoplasma] - Case courtesy of Dr Alborz Jahangiri|alt=|center|thumb]]
!Chest X-Ray
|-
|Lobar/ Focal non-segmental<ref name="Radiopaedia">{{cite web|url=https://radiopaedia.org/articles/lobar-pneumonia}} </ref>
|
*''Klebsiella pneumoniae''
*''Legionella pneumophila''
*''Haemophilus influenzae''
|[[Image:Middle lobe pneumonia.jpg|372x372px|Middle lobe pneumonia (Frontal) - Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 16074|alt=|border|left|thumb]][[Image:Middle-lobe-pneumonia-lateral.jpg|474x474px|Middle lobe pneumonia (Lateral) - Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 16074|alt=|center|thumb]][[Image:Pneumococcal-pneumonia (right upper lobe).jpg|frame|thumb|left|500px|Pneumococcal-pneumonia Right upper lobe - Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 13553]]
|-
|Lobular/ Multifocal Bronchopneumonia
|
|
|-
|Diffuse/ Interstitial
|
|
|
*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==
==References==
{{Reflist|2}}
[[Template:WH]] [[Template:WS]]
 
<references />
[[Category:Needs content]]
[[Category:Disease]]
[[Category:Pulmonology]]
[[Category:Bacterial diseases]]
[[Category:Pneumonia|Pneumonia]]
[[Category:Emergency medicine]]


{{WH}}
[[Category:Up to Date]]
{{WS}}

Latest revision as of 01:01, 7 August 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

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

Template:WH Template:WS

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