Pulmonary Computed Tomography Findings in 39 Cases of <i>Streptococcus pneumoniae</i> Pneumonia

Abstract

Objective The main objective of our study was to describe the pulmonary distribution of consolidation and ground-glass opacity (GGO) in chest computed tomography (CT) scans of Streptococcus pneumoniae pneumonia. In addition, the percentage of other pulmonary abnormalities was also reported. Methods We retrospectively evaluated chest CT examinations performed between November 2008 and January 2010 in 39 patients with S. pneumoniae pneumonia. Eight patients with Haemophilus influenzae pneumonia were also included for comparison. Patients There were 19 women and 28 men with clinical symptoms of fever and productive cough and laboratory findings of leukocytosis with markedly high C-reactive protein levels. Chest X-ray scores before and after treatment were calculated. The average score before treatment was 4. The average score after treatment was 0. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusions. The distribution of parenchymal disease was also analyzed. Results The chest CT findings in the patients with S. pneumoniae pneumonia consisted primarily of consolidation (56.4%), ground-glass opacity (71.7%), interlobular reticular opacity (69.2%), centrilobular nodules (53.8%), interlobular septal thickening (46.6%), bronchial wall thickening (46.6%), lymph node enlargement (10.2%) and pleural effusion (10.2%). Segmental distribution (65.7%) was seen more frequently than nonsegmental distribution (35.9%). Abnormal findings were noticed bilaterally in 14 patients and unilaterally in 25 patients. On both the right and left sides, predominant zonal distributions were seen in the lower lobes. In contrast, among the eight patients with H. influenzae pneumonia, one patient had both segmental and nonsegmental distributions and the remaining seven patients had only segmental distributions. Conclusion In conclusion, segmental distributions of parenchymal abnormalities are more common than non-segmental distributions on chest CT scans of patients with S. pneumoniae pneumonia.

Clinical value of chest computerized tomography scans in patients admitted with pneumonia

“…However, the authors did not attempt to evaluate improved clinical outcomes or management changes. Other investigators have tried to demonstrate unique or specific findings on CT scans compared to plain radiography for particular pathogens …”

“…Other investigators have tried to demonstrate unique or specific findings on CT scans compared to plain radiography for particular pathogens. [11][12][13] We attempted to identify specific features of patients presenting with pneumonia that could assist clinicians in the decision-making process as it relates to ordering a CT scan. CT scans were performed more frequently on subjects who were younger, had lower severity of illness, and were admitted from the community.…”

Relationship Between Clinical Features and Computed Tomographic Findings in Hospitalized Adult Patients With Community-Acquired Pneumonia

“…A variety of microbial agents, including typical and atypical pathogens, can cause CAP. A considerable number of studies on the CT findings of CAP triggered by different pathogens, including Streptococcus pneumoniae, [6][7][8] Klebsiella pneumoniae, 9,10 Mycoplasma pneumoniae, [11][12][13][14] Chlamydia pneumoniae 14,15 and Legionella pneumophila, 16,17 have been published. Patients with CAP attributed to a specific pathogen present with more than 1 CT pattern, although 1 of these patterns predominates.…”

Clinical Application of High-Resolution Computed Tomographic Imaging Features of Community-Acquired Pneumonia

“…Pathogenic bacteria reached the alveoli and multiplied, leading to inflammatory exudate. The secretions of the bacteria were mainly along the small alveolar foramina and a small airway spread to the center, thus forming a subpleural nonsegmental lobar consolidation [ 7 ]. Pneumococcal pneumonia is a very common CAP, and pathology is a fibrinous inflammation.…”

“…Pneumococcal pneumonia is a very common CAP, and pathology is a fibrinous inflammation. Results of the CT scan showed that lobar consolidation at first occurred in the visceral pleura of the lung periphery, usually close to the interlobular fissure, and gradually extended to the lung segment boundaries and spread to the center, eventually involving the entire lobe [ 7 , 8 ]. Bronchi were usually kept open, causing bronchogram in the consolidated area.…”