Accuracy of Radiographic Differentiation of Bacterial from Nonbacterial Pneumonia

Abstract

The chest roentgenogram is an accepted tool for the diagnosis of pneumonia. Little information is available, however, addressing the ability of physicians to distinguish bacterial from nonbacterial pneumonias by examination of the chest roentgenogram. Five different observers evaluated 36 chest films from patients with pneumonia who had a laboratory proven etiologic diagnosis. The sensitivity of roentgenogram diagnosis of bacterial pneumonia ranged from 42-58 percent. When clinical and laboratory data were provided to the observers the sensitivity ranged from 42-92 percent. This study indicates that chest film examination is too insensitive to be useful for the selection of patients who have bacterial pneumonia from those whose pneumonia is non-bacterial.

Clinical Significance of Serum Procalcitonin in Patients with Community-acquired Lobar Pneumonia

“…In clinical practice, bacterial involvement is considered to be responsible for the appearance of alveolar infiltrates on chest radiographs; however, clinical studies have failed to confirm this finding [18][19][20]. There are no definitive findings on x-ray studies for differentiating bacterial pneumonia from viral pneumonia.…”

Mycoplasma pneumoniaeandChlamydia pneumoniaeinfections in children with pneumonia

“…The radiographic diagnosis of pneumonia is made on the basis of pulmonary perihilar opacities or infiltrates (airways disease) and/or consolidation (airspace disease) [18,27]. Like other screening tests, radiological findings are limited in terms of sensitivity, specificity and intra-or inter-observer variability.…”

Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bacterial and viral pneumonia in children

“…Bacterial pneumonia cannot be differentiated from viral pneumonia on the basis of patient characteristics or of chest radiographic findings. [1][2][3][4][5] The white blood cell count, serum C-reactive protein (CRP) value and other nonspecific laboratory findings may help to support a bacterial or viral etiology. However, most children with pneumonia are treated with antibiotics without knowledge of the causative agent.…”