X Ray Chest in CAP Dr G R Sethi
Dec 17, 2015
Questions Does it confirm pneumonia? Is it necessary for diagnosis of CAP? What are the radiological patterns in CAP? Can we differentiate Viral from Bacterial? Can we identify individual/specific
organism? What are the mimickers of pneumonia?
Is it necessary for diagnosis of CAP?
RTI guidelines suggest that It is not necessary in all cases
particularly non severe cases It should be done if
If diagnosis is ambiguous It is a complicated pneumonia If child does not improve/deteriorates in 48
hours
What are the radiological patterns in CAP?
Airways
Air Spaces
Interstitium
Hyperaeration Br wall thickening Atelectasis Irregular aeration
Parenchymal opacity Acinar opacity Airbronchogram
Fine linear markings Interlobular septal
thickening Small nodular opacities
Can we differentiate Viral from Bacterial?
Radiographic – pathologic correlation is imperfect.
Alveolar airspace pneumonia is more likely to be bacterial
Hyperinflation with interstitial could mean viral
We can narrow down the etiologic possibilities by adding clinical and lab
Using combination of criteria
Total no. of cases of LRTI:80
Probable Viral etiology of LRTI : 65
Probable Bacterial etiology of LRTI : 05
Antibiotic added later during the course of treatment
: 10
Specific Bacterial Etiology S Pneumoniae & Kliebsella
Mycoplasma S Aureus Gram –ve bacteria
Airspace, lobar
Bronchopneumonia, lobular
Additiona findings in Kliebsella and Staph