Chest computed tomography and chest X-ray in the diagnosis of community-acquired pneumonia: a retrospective observational study

Abstract

Objectives To compare the yield of early combined use of chest X-ray (CXR) and chest computed tomography (CT) in patients diagnosed with community-acquired pneumonia (CAP) presenting to the emergency department (ED) and assess the impact of chest CT on the initial diagnosis. Methods The medical records of 900 patients who presented to the ED and were diagnosed with CAP over a 1-year period were reviewed, and 130 patients who underwent CXR and chest CT within 48 hours were selected. CXR findings were classified as positive, negative, or inconclusive for CAP. Chest CT findings were defined as positive, negative, inconclusive, or positive with add-on to the CXR findings. CT was classified as having no benefit, large benefit, or moderate benefit based on the chest CT and CXR findings. Results Chest CT results were positive in 90.7% of patients, with 41.5% being newly diagnosed after negative or inconclusive CXR and 21.5% being diagnosed with add-on to the CXR findings. CT had large, moderate, and no benefit over CXR in diagnosing or excluding CAP in 45.3%, 21.5%, and 33.1% of patients, respectively. Conclusion Early chest CT may be used to compliment CXR in the early diagnosis of CAP among patients in the ED.

HIV-associated pneumonia: bacterial, fungal, viral

“…Чаще всего источниками развития пневмонии являются переносимые по воздуху патогены (в первую очередь бактериального, но также вирусного и грибкового происхождения) [14,15]. При наличии ВИЧ у пациентов часто выявляют сразу несколько возбудителей пневмоний (сочетание бактерий, вирусов, грибковой микрофлоры), что осложняет диагностику, клиническое течение и прогноз исхода заболевания.…”

Comparison of Virtual Non-Contrast and True Non-Contrast CT Images Obtained by Dual-Layer Spectral CT in COPD Patients

“…Intravenous contrast application has been shown to result in a higher density of lung parenchyma, thus decreasing the volume classified as emphysema in qCT [11]. However, in daily clinical practice, contrast-enhanced chest CT is performed in most patients to diagnose or exclude several vascular, pulmonary, or malignant diseases [12][13][14]. Regarding COPD patients and the named recommendations on non-contrast-enhanced scans, this would result in potential double examinations with and without contrast media.…”