CT scan findings in patients with pneumonia

Abstract

Introduction. Pneumonia is one of the most common acute respiratory infections treated in a hospital setting. In most cases, a newly recognized lung infiltrate on chest X-ray (CXR) and typical clinical findings are sufficient for diagnosis. Unfortunately, CXR has been shown to be somewhat unreliable in the definitive diagnosis of pneumonia and thoracic computed tomography (CT) scans have shown superiority in the setting of negative or non-diagnostic CXR. Furthermore, CT scan findings can lead to a different diagnosis and changes in further clinical management of the disease. Aim. The aim of this study was to assess the most prevalent CT scan findings in hospitalised patients with pneumonia; and to evaluate the significance of the association between CT scan findings and certain factors (age, gender, pneumonia type by acquisition, presence of pleural effusion (PE), chronic diseases (ChD), blood oxygen saturation (BOS) and microbiological confirmation of the bacterial agent (MC)). Methods. This retrospective observational study was conducted in the Hospital of Lithuanian University of Health Sciences (LUHS) Kaunas clinic. For our study, we reviewed medical records for hospitalised pneumonia patients that had undergone chest CT scans between 2012 and 2018. Patients that had unconfirmed pneumonia or inaccessible and/or poor quality CT scan images were excluded from the study. Patients were grouped by pneumonia acquisition (hospital acquired (HAP) or community acquired (CAP)), presence of PE (present or not), existence of ChD (present or none), BOS (³90% or <90% and/or oxygen therapy), MC (confirmed or not). The following CT scan findings were reviewed and documented as present or not: focal abnormalities (FA); abscess and/or necrosis of the lung parenchyma (A/N); consolidation of the lung; fibrous parenchymal changes; reactive and/or pathological lymph nodes; pleural thickening, adhesions; empyema; dislocation o. [...].