title: Correlations between computed tomography findings and clinical manifestations of Streptococcus pneumoniae pneumonia.
abstract: OBJECTIVE
  The aim of this study was to characterize the imaging features and compare computed tomography (CT) findings with clinical features of patients with Streptococcus pneumoniae pneumonia.
  
  
  METHODS
  We retrospectively reviewed 75 patients (44 men, 31 women; mean age 67 years) diagnosed with S. pneumoniae pneumonia who underwent chest CT scanning at our institution between January 2007 and August 2008. Diagnoses were based on detection of the S. pneumoniae antigen in urine.
  
  
  RESULTS
  Chest CT scans revealed abnormalities in all patients. The predominant opacity patterns were an airspace pneumonia pattern (48%) and a bronchopneumonia pattern (48%), followed by an interstitial pneumonia pattern (4%). Consolidation was observed most frequently (84%) followed by ground glass opacity (82.7%), bronchial wall thickening (61.3%), and centrilobular nodules (49.3%). Airway dilatation (21.6%), pleural effusion (33.3%), lymphadenopathy (34.8%), and pulmonary emphysema (21.3%) were also observed. Pulmonary emphysema was significantly less frequent in patients with the bronchopneumonia pattern than in those without (p = 0.007). The clinical features and CT findings did not differ significantly.
  
  
  CONCLUSIONS
  CT image analysis showed that patients with S. pneumoniae pneumonia exhibited the bronchopneumonia and airspace pneumonia patterns with equal frequency. Bronchopneumonia pattern was less common in patients with preexisting emphysema.
authors.affiliation: Department of Radiology, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama 241-0811, Japan. k2yagihashi@marianna-u.ac.jp
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yagihashi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kurihara
authors.forename: Atsuko
authors.initials: A
authors.lastname: Fujikawa
authors.forename: Shin
authors.initials: S
authors.lastname: Matsuoka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000000981:diagnostic imaging* / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013296:Streptococcus pneumoniae; D014057:Tomography, X-Ray Computed / Q000379:methods*