Skip to main content
SpringerLink
Log in

Pulmonary Infections in the Normal Host

  • Chapter
  • First Online:
Clinically Oriented Pulmonary Imaging

Part of the book series: Respiratory Medicine ((RM))

Abstract

Chest radiography remains the cornerstone for imaging pulmonary infections in normal hosts. It does a good, though imperfect, job of detecting pneumonia but is less effective in monitoring the response of the infection to therapy. In clinical settings where both pneumonia and noninfectious thoracic diseases are diagnostic possibilities, the addition of CT scanning to radiography can help identify imaging patterns that favor either an infectious or an non-infectious etiology. Occasionally these CT imaging patterns can narrow the differential diagnosis of possible infectious pathogens, but rarely can imaging point toward a specific organism. In most cases CT is better relied upon to identify complications of pneumonia than to identify a pathogen. Cost and radiation dose, however, argue against its indiscriminant use in patients with community acquired pneumonia. Ultrasound provides a safe low cost alternative to CT, but its utility is limited to pleural complications of pneumonia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Boersma WG, Daniels JM, Lowenbery A, Boeve WJ, van de Jaft EJ. Reliability of radiographic findings and the relation to etiologic agents in community acquired pneumonia. Respir Med. 2006;100(5):916–32.

    Article  Google Scholar 

  2. Basi SK, Marrie TJ, Huang JQ, Majumdar SR. Patients admitted to the hospital with suspected pneumonia and normal chest radiographs: epidemiologic, microbiology and outcomes. AM J Med. 2004;117(5):305–11.

    Article  PubMed  Google Scholar 

  3. Hopstaken RM, Witbraad T, van Engelshoven JM, Dinant GJ. Inter-observer variation in the interpretation of chest radiographs for pneumonia in community acquired lower respiratory tract infections. Clin Radiol. 2004;59(8):743–52.

    Article  PubMed  CAS  Google Scholar 

  4. Woodhead W, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections. Eur Respir J. 2005;26:1138–80.

    Article  PubMed  CAS  Google Scholar 

  5. Albaum MN, Hill LC, Murphy M et al. Interobserver reliability of the chest radiograph in community acquired pneumonia. Chest 1996;110(2):343–50.

    Google Scholar 

  6. Bruns AHW, Oosterheert JJ, Prokop M, Lammers JJ, Hak E, Hoepleman AI. Patterns of resolution of chest radiograph abnormalities in adults hospitalized with severe community-acquired pneumonia. Clin Infect Dis. 2007;45:983–91.

    Article  PubMed  Google Scholar 

  7. Bruns AH, Oosterheert JJ, El Moussaoui R, Opmeer HC, Hoepelman AI, Prins JM. Pneumonia recovery; discrepancies in perspectives of the radiologist, physician and patient. J Gen Intern Med. 2009;25(3):203–6.

    Google Scholar 

  8. Choi YH, Kim SJ, Lee JY, Pai HJ, Lee KY, Lee YS. Scrub typhus: radiological and clinical findings. Clin Radiol. 2000;55(2):140–4.

    Article  PubMed  CAS  Google Scholar 

  9. Boroja M, Barrie JR, Raymond GS. Radiographic findings in 20 patients with Hantavirus pulmonary syndrome correlated with clinical outcome. Am J Roentgenol. 2002;178(1):159–63.

    CAS  Google Scholar 

  10. Akira M, Ishikawa H, Yamamoto S. Drug-induced pneumonitis:thin-section CT findings in 60 Patients. Radiology 2002;224(3):852–60.

    Google Scholar 

  11. Takatani K, Miyazaki E, Nureki S, et al. High-resolution computed tomography patterns and immunopathogenetic findings in drug-induced pneumonitis. Respir Med. 2008;102(6):892–898.

    Google Scholar 

  12. Rossi SE, Franquet T, Volpacchio M, Giménez A, Aguilar G. Tree in bud pattern at thin-section CT of the lungs: radiologic-pathologic overview. Radiographics. 2005;25(3):789–801.

    Article  PubMed  Google Scholar 

  13. Okada F, Ando Y, Yoshitake S, Ono A, et al. Clinical/pathologic correlations in 553 patients with primary centrilobular findings on high resolution CT scan of the thorax. Chest. 2007;132(6):1939–48.

    Article  PubMed  Google Scholar 

  14. Raoof S, Amchentsev A, Vlahos I, Goud A, Naidich DP. Pictorial essay: multinodular disease. A high resolution CT scan diagnostic algorithm. Chest 2006;129(3):805–15.

    Google Scholar 

  15. Shah RM, Miller W. Widespread ground glass opacity of the lung in consecutive patients undergoing CT: does lobular distribution assist diagnosis? Am J Roentgenol. 2003;180(4):965–8.

    Google Scholar 

  16. Shah RM, Friedman AC. CT angiogram sign: incidence and significance in lobar consolidations evaluated by contrast-enhanced CT. Am J Roentgenol. 1998;170(3):719–21.

    CAS  Google Scholar 

  17. Jung JI, Kim H, Park SH, et al. CT differentiation of pneumonic-type bronchoalveolar cell carcinoma and infectious pneumonia. Br J Radiol. 2001;74(882):490–4.

    Google Scholar 

  18. Kim TH, Kim SJ, Ryu YH, et al. Differentiation of CT features of infectious pneumonia versus bronchioloalveolar carcinoma (BAC) mimicking pneumonia Eur Radio. 2006;16(8):1763–8.

    Google Scholar 

  19. Anton E. A frequent error in etiology of round pneumonia. Chest. 2004;125(4):1592–3.

    Google Scholar 

  20. Revel M-P, Triki R, Chatellier G, et al. Is it possible to recognize pulmonary infarction on multisection CT images? Radiology. 2007;244(3):875–82.

    Article  PubMed  Google Scholar 

  21. Reittner P, Ward S, Heyneman L, Johkoh T, Muller NL. Pneumonia: high resolution CT findings in 114 patients. Eur Radiol. 2003;13(3):515–21.

    PubMed  Google Scholar 

  22. Lee I, Kim TS, Yoon HK. Mycoplasma pneumoniae pneumonia: CT features in 16 patients. Eur Radiol. 2006;16(3):719–25.

    Article  PubMed  Google Scholar 

  23. Ito I, Ishida T, Togashi K, Niimi A, et al. Differentiation of bacterial and non-bacterial community-acquired pneumonia by thin-section computed tomography. Eur J Radiol. 2009;72(3);388–95.

    Google Scholar 

  24. Miyashita N, Kawai Y, Yamaguchi T, Ouchi K, Oka M. A typical pathogen study group clinical potential of diagnostic methods for the rapid diagnosis of mycoplasma pneumoniae pneumonia in adults. Eur J Clin Microbiol Infect Dis. 2011;30(3):439–46.

    Google Scholar 

  25. Okada F, Ando Y, Tanoue S, et al. Radiographic findings in acute Haemophilus influenza pulmonary infection. Br J Radiol. [Epub ahead of print: 11 Jan, 2011].

    Google Scholar 

  26. Nambu A, Saito A, Araki T, et al. Chlamydia pneumonia: comparison with findings of mycoplasma pneumonia and streptococcus pneumoniae at thin-section CT. Radiology. 2006;238(1):330–8.

    Google Scholar 

  27. Jennings LC, Anderson TP, Beynon KA, et al. Incidence and characteristics of viral community acquired pneumonia in adults. Thorax. 2008;63(1):42–8.

    Article  PubMed  CAS  Google Scholar 

  28. Johansson N, Kalin M, Annika Tiveljung-Lindell A, Giske CG, Hedlund J. Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods. Clin Infect Dis. 2010;50(2):202–9.

    Google Scholar 

  29. Shiley KT, Van Deerlin VM, Miller WT Jr., Chest CT features of community-acquired respiratory viral infections in adult inpatients with lower respiratory tract infections. J Thorac Imaging. 2010;25(1):68–75.

    Article  PubMed  Google Scholar 

  30. Lewis PF, Schmidt MA, Lu X, et al. A community-based outbreak of severe respiratory illness caused by human adenovirus serotype 14. J Infect Dis. 2009;199(10):1427–34.

    Article  PubMed  CAS  Google Scholar 

  31. Ajlan A, Quiney B, Nicolaou S, Muller N. Swine-origin influenza A (H1N1) viral infection: radiographic and CT findings. Am J Roentgenol. 2009;193(6):1494–9.

    Article  Google Scholar 

  32. Elicker B, Schwartz B, Liu C, et al. Thoracic CT findings of novel influenza A (H1N1) infection in immunocompromised patients. Emerg Radiol. 2010;17(4):299–307.

    Article  PubMed  Google Scholar 

  33. Monsalvo AC, Batalle JP, Lopez MF, et al. Severe pandemic 2009 H1N1 influenza disease due to pathogenic immune complexes. Nat Med. 2011;17(2):195–9.

    Google Scholar 

  34. Im JG, Itoh H, Shim YS, et al. Pulmonary tuberculosis: CT findings–early active disease and sequential change with anti-tuberculous therapy. Radiology. 1993;186(3):656–60.

    Google Scholar 

  35. Leung AN. Pulmonary tuberculosis: the essentials. Radiology. 1999;210(2):307–32.

    Google Scholar 

  36. Jeong YJ, Lee KS. Pulmonary tuberculosis: up to date imaging and management. AM J Roentgenol. 2008;191(3):834–44.

    Article  Google Scholar 

  37. Andronikou S, Vanhoenacker FM, De Backer A. Advances in imaging chest tuberculosis: blurring of differences between children and adults. Clin Chest Med. 2009;30(4):717–44.

    Article  PubMed  Google Scholar 

  38. Lee SW, Jang YS, Park CM, et al. The role of chest CT scanning in TB outbreak investigation. Chest. 2010;137(5):1057–64.

    Article  PubMed  Google Scholar 

  39. Ors F, Deniz O, Bozlar U, et al. High resolution CT findings in patients with pulmonary tuberculosis: correlation with degree of smear positivity. J Thorac Imaging. 2007;22(2):154–9.

    Article  PubMed  Google Scholar 

  40. Martinez, S, McAdams HP, Batchu CS. The many faces of pulmonary non-tuberculous mycobacterial infection. AM J Roentgenol. 2007;189(1):177–86.

    Google Scholar 

  41. Koh WJ, Lee KS, Kwon OJ, Jeong YJ, Kwak SH, Kim TS. Bilateral bronchiectasis and bronchiolitis at thin section CT: diagnostic implications in nontuberculous mycobacterial pulmonary infection. Radiology. 2005;235(1):282–8.

    Article  PubMed  Google Scholar 

  42. Banker PD, Jain VR, Hamarati LB. Impact of chest CT on the clinical management of immuno-competent emergency department patients with chest radiographic findings of pneumonia. Emerg Radiol. 2007;14:383–8.

    Article  PubMed  Google Scholar 

  43. Johnson JL. Pleurisy, fever, and rapidly progressive pleural effusion in a healthy, 29-year-old physician. Chest. 2001;119(4):1266–9.

    Article  PubMed  CAS  Google Scholar 

  44. Kearney SE, Davies CW, Davies RJ, Gleeson FV. Computed tomography and ultrasound in parapneumonic effusions and empyema. Clin Radiol. 2000;55(7):542–7.

    Article  PubMed  CAS  Google Scholar 

  45. Heffner JE, Klein JS, Hampson C. Diagnostic utility and clinical application of imaging for pleural space infections. Chest. 2010;137(2):467–79.

    Google Scholar 

  46. Tu CY, Hsu WH, Hsia TC. Pleural effusions in febrile medical ICU patients: chest ultrasound study. Chest. 2004;126(4):1274–80.

    Article  PubMed  Google Scholar 

  47. Arenas-Jimenez J, Alonso-Charterina S, Sanchez-Paya J, Fernandez-Latorre F, Gil-Sanchez S, Lloret-Llorens M. Evaluation of CT findings for diagnosis of pleural effusions. Eur Radiol. 2000;10(4):681–90.

    Article  PubMed  CAS  Google Scholar 

  48. Smolikov A, Smolyakova R, Riesenberg K, et al. Prevalence and clinical significance of pleural microbubbles in computed tomography of thoracic empyema. Clin Radiol. 2006;61(6):513–9.

    Article  PubMed  CAS  Google Scholar 

  49. Donnelly LF, Klosterman LA. Pneumonia in children: decreased parenchymal contrast enhancement—CT sign of intense illness and impending cavitary necrosis. Radiology. 1997;205(3):817–20.

    PubMed  CAS  Google Scholar 

  50. Mody GN, Lau CL, Bhalla S, et al. Mycotoic pulmonary artery pseudoaneurysm. J Thorac Imaging. 2005;20(4):310–2.

    Article  PubMed  Google Scholar 

  51. Bartlett JG. Anaerobic bacterial infections of the lung and pleural space. Clin Infect Dis. 1993;Suppl 4:S248–55.

    Google Scholar 

  52. Hunt JP, Buechter KJ, Fakhry SM. Acinetobacter calcoaceticus pneumonia and the formation of pneumatoceles. J Trauma. 2000;48(5):964–70.

    Article  PubMed  CAS  Google Scholar 

  53. McGarry T, Giosa R, Rohman M, Huang CT. Pneumatocele formation in adult pneumonia. Chest 1987;92(4):717–20.

    Google Scholar 

  54. Stein DL, Haramati LB, Spindola-Franco H, Friedman J, Klapper PJ. Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. Chest. 2005;127(4):1271–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of New Mexico Health Science Center, MSC10 5530 1 University of New Mexico, Albuquerque, NM, 87111-0001, USA

    Loren Ketai

  2. Department of Pulmonary and Critical Care, University of New Mexico School of Medicine, MSC 10-5550 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA

    Helen Katrina Busby

Authors
  1. Loren Ketai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Helen Katrina Busby
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Loren Ketai .

Editor information

Editors and Affiliations

  1. , Cardiothoracic Radiology, University of Wisconsin Hospital and Cli, 600 Highland Ave., Madison, 53792, USA

    Jeffrey P. Kanne

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Ketai, L., Busby, H.K. (2012). Pulmonary Infections in the Normal Host. In: Kanne, J. (eds) Clinically Oriented Pulmonary Imaging. Respiratory Medicine. Humana Press. https://doi.org/10.1007/978-1-61779-542-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-61779-542-8_4

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-61779-541-1

  • Online ISBN: 978-1-61779-542-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation