Ventilator-associated Pseudomonas aeruginosa pneumonia: radiographic findings.
OBJECTIVE
To characterize the radiographic features of ventilator-associated Pseudomonas aeruginosa pneumonia (PAP).


METHODS
In 56 patients (40 men and 16 women), PAP was documented with fiberoptic bronchoscopy. All patients underwent mechanical ventilation for at least 48 hours before diagnosis. The findings on chest radiographs were recorded. In eight patients in whom computed tomography (CT) was performed, results were compared with radiographic findings.


RESULTS
Twenty-six patients with adult respiratory distress syndrome (ARDS) had diffuse bilateral confluent opacities; 30 patients without ARDS had multifocal opacities. In 13 patients, cavities were detected at chest radiography, CT, or both. Seven of 29 patients with pleural abnormalities had empyema. CT provided important additional information (presence of cavities or effusions) in four cases.


CONCLUSIONS
Findings on chest radiographs are nonspecific for PAP. The frequencies of cavities and empyema are surprisingly low, perhaps owing to prompt diagnosis and therapy.
Winer-Muram
H T
HT
Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN 38101-0318.
Jennings
S G
SG
Wunderink
R G
RG
Jones
C B
CB
Leeper
K V
KV
D001999:Bronchoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000628:therapy; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D012122:Ventilators, Mechanical / Q000009:adverse effects*