Thin-section CT findings of patients with acute Streptococcus pneumoniae pneumonia with and without concurrent infection.
OBJECTIVE
The aim of this study was to compare the pulmonary thin-section CT findings of patients with acute Streptococcus pneumoniae pneumonia with and without concurrent infection.


METHODS
The study group comprised 86 patients with acute S. pneumoniae pneumonia, 36 patients with S. pneumoniae pneumonia combined with Haemophilus influenzae infection, 26 patients with S. pneumoniae pneumonia combined with Pseudomonas aeruginosa infection and 22 patients with S. pneumoniae pneumonia combined with methicillin-susceptible Staphylococcus aureus (MSSA) infection. We compared the thin-section CT findings among the groups.


RESULTS
Centrilobular nodules and bronchial wall thickening were significantly more frequent in patients with pneumonia caused by concurrent infection (H. influenzae: p<0.001 and p<0.001, P. aeruginosa: p<0.001 and p<0.001, MSSA: p<0.001 and p<0.001, respectively) than in those infected with S. pneumoniae alone. Cavity and bilateral pleural effusions were significantly more frequent in cases of S. pneumoniae pneumonia with concurrent P. aeruginosa infection than in cases of S. pneumoniae pneumonia alone (p<0.001 and p<0.001, respectively) or with concurrent H. influenzae (p<0.05 and p<0.001, respectively) or MSSA infection (p<0.05 and p<0.05, respectively).


CONCLUSIONS
When a patient with S. pneumoniae pneumonia has centrilobular nodules, bronchial wall thickening, cavity or bilateral pleural effusions on CT images, concurrent infection should be considered.
Department of Radiology, Oita University Faculty of Medicine, Oita, Japan. fumitook@med.oita-u.ac.jp
F
F
Okada
Y
Y
Ando
S
S
Matsushita
R
R
Ishii
T
T
Nakayama
K
K
Morikawa
A
A
Ono
T
T
Maeda
H
H
Mori
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006192:Haemophilus Infections / Q000150:complications / Q000000981:diagnostic imaging; D006193:Haemophilus influenzae; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000000981:diagnostic imaging*; D011379:Prognosis; D011552:Pseudomonas Infections / Q000150:complications / Q000000981:diagnostic imaging; D011550:Pseudomonas aeruginosa; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging; D013211:Staphylococcus aureus; D014057:Tomography, X-Ray Computed; D055815:Young Adult