[Role of thoracic radiography in the management of community-acquired pneumonia].
In patients presenting with a lower respiratory tract infection, it is generally recommended to order a chest X-ray in two circumstances: when the clinical signs suggest the diagnosis of pneumonia or in case of rather atypical symptoms suggesting a potential risk of complications. Indeed, the presence of one or more recent opacities, and more specifically, homogeneous alveolar infiltration(s) remains the gold standard criterion for the diagnosis of pneumonia. One must not however let this rule overshadow certain limitations of the chest X-ray reported in the literature: 1. the misdiagnosis of certain cases of pneumonia or bronchopneumonia seen early; 2. the extent of the infiltration gives only a very relative assessment of severity; 3. the characteristics of the infiltration are only relatively specific for etiological diagnosis. In patients with community acquired pneumonia diagnosed on the basis of clinical signs and radiographic findings, systematically performed series of follow-up X-rays have shown that the initial extension of the infiltration and the rate of its resolution contribute quite variably to the diagnosis of complications. The best indication for ordering a follow-up X-ray before 6 weeks remains an unfavorable clinical course.
Mayaud
C
C
Centre de Pneumologie et de Réanimation Respiratoire, Hôpital Tenon, Paris.
Saidi
F
F
Parrot
A
A
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001314:Auscultation; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging; D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D004630:Emergencies; D005500:Follow-Up Studies; D006801:Humans; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging; D011024:Pneumonia, Viral / Q000000981:diagnostic imaging; D011379:Prognosis; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013997:Time Factors