Relationship Between Clinical Features and Computed Tomographic Findings in Hospitalized Adult Patients With Community-Acquired Pneumonia

Seo, Hyewon; Cha, Seung‐Ick; Shin, Kyung-Min; Lim, Jae‐Kwang; Yoo, Seung Soo; Lee, Shin-Yup; Lee, Jaehee; Kim, Chang‐Ho; Park, Jae Yong

doi:10.1016/j.amjms.2018.03.024

Cited by 11 publications

(10 citation statements)

References 32 publications

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“…GGO- or bronchiolitis-predominant pattern is not likely to be easily detected on CR due to lighter density, although this pattern rarely occurs in CAP patients [15]. GGO and centrilobular nodules were observed on CT scans in elderly patients with acute lower respiratory infection and negative CR findings in a previous study [22].…”

Section: Discussionmentioning

confidence: 99%

“…and J.-K.L.) independently reviewed the CT findings and classified them into three groups (the kappa statistic was 0.943) [15]. For the remaining patients, one of the two radiologists determined CT findings.…”

Section: Resultsmentioning

confidence: 99%

“…The patients were classified into three groups based on the CT pattern (Fig. 1): (1) the bronchiolitis-predominant pattern, i.e., centrilobular nodules or tree-in-bud appearance in most lesions with minimal GGO or consolidation; (2) the GGO-predominant pattern, i.e., focal or diffuse GGO with no or minimal centrilobular nodules, tree-in-bud appearance, or consolidation; and (3) the consolidation pattern, i.e., consolidation with or without variable extents of centrilobular nodules or GGO [15]. The presence of necrotizing pneumonia and the presence and extent of pleural effusion were also examined.…”

Section: Methodsmentioning

confidence: 99%

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Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

et al. 2019

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Background: Data regarding community-acquired pneumonia (CAP) identified on chest computed tomography (CT) but not on chest radiography (CR) are limited. Objectives: The present study aimed to investigate the clinical and radiological features of these patients. Methods: We retrospectively compared the clinical characteristics, etiological agents, treatment outcomes, and CT findings between CAP patients with negative CR and positive CT findings (negative CR group) and those with positive CR as well as CT findings (control group). Results: Of 1,925 patients, 94 patients (4.9%) were included in the negative CR group. Negative CR findings could be attributed to the location of the lesions (e.g., those located in the dependent lung) and CT pattern with a low attenuation, such as ground-glass opacity (GGO). The negative CR group was characterized by a higher frequency of aspiration pneumonia, lower incidences of complicated parapneumonic effusion or empyema and pleural drainage, and lower blood levels of inflammatory markers than the control group. On CT, the negative CR group exhibited higher rates of GGO- and bronchiolitis-predominant patterns and a lower rate of consolidation pattern. Despite shorter length of hospital stay in the negative CR group, 30-day and in-hospital mortalities were similar between the two groups. Conclusions: CAP patients with negative CR findings are characterized by lower blood levels of inflammatory markers, a higher incidence of aspiration pneumonia, and a lower incidence of complicated parapneumonic effusion or empyema than those with positive CR findings. Chest CT scan should be considered in suspected CAP patients with a negative CR, especially in bedridden patients.

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

et al. 2019

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“…Traditionally, causative agents of CAP were identified using conventional culture methods, so microorganisms were identified in less than 30% of CAP cases during the pre-PCV7 period [3940414243]. With advances in serological and molecular diagnostic tests, the diagnostic yield has improved by up to 40-50%, yet around 50% of CAP pathogens are still unidentified (Table 2) [744454647]. Prior antibiotic use is one of the important reasons for test-negative results.…”

Section: Etiologic Distribution Of Causative Pathogens In Community-amentioning

confidence: 99%

“…The introduction of PCVs was expected to affect the etiologic distribution of CAP; however, significant change was not observed after the introduction of the pediatric PCV7 conjugate vaccine [5495253545556]. Even in the early period of PCV13 use, S. pneumoniae still remained as the predominant agent causing CAP in South Korea, at 26.9–43.6% in the pre-PCV7 period, 23.2–69.4% in the post-PCV7 period, and 13.5–46.8% in the post-PCV13 period (Table 2) [744454647]. Similarly, in the etiology of pneumonia in the community study conducted in the United States during the early PCV13 period (2011-2012), S. pneumoniae was the most common causative pathogen of community-acquired bacterial pneumonia (30.1%, 115 cases), followed by S. aureus (9.7%, 37 cases) among the total 382 bacterial pneumonia cases [17].…”

Section: Etiologic Distribution Of Causative Pathogens In Community-amentioning

confidence: 99%

Disease Burden and Etiologic Distribution of Community-Acquired Pneumonia in Adults: Evolving Epidemiology in the Era of Pneumococcal Conjugate Vaccines

Heo

Song

2018

Infect Chemother

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Pneumonia is the leading cause of morbidity and mortality, particularly in old adults. The incidence and etiologic distribution of community-acquired pneumonia is variable both geographically and temporally, and epidemiology might evolve with the change of population characteristics and vaccine uptake rates. With the increasing prevalence of chronic medical conditions, a wide spectrum of healthcare-associated pneumonia could also affect the epidemiology of community-acquired pneumonia. Here, we provide an overview of the epidemiological changes associated with community-acquired pneumonia over the decades since pneumococcal conjugate vaccine introduction.

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Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

2020

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Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Despite important advances in prevention through vaccines, new rapid diagnostic tests and antibiotics, CAP management still has significant drawbacks. Mortality remains very high in severely ill patients presenting with respiratory failure or shock but is Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11673588. J. Ferreira-Coimbra (

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Relationship Between Clinical Features and Computed Tomographic Findings in Hospitalized Adult Patients With Community-Acquired Pneumonia

Cited by 11 publications

References 32 publications

Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

Disease Burden and Etiologic Distribution of Community-Acquired Pneumonia in Adults: Evolving Epidemiology in the Era of Pneumococcal Conjugate Vaccines

Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

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