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Poster Presentations: Wednesday, October 26, 2011 |

Thin-Section Computed Tomography Findings of Patients With Acute Streptococcus pneumoniae Pneumonia With and Without Concurrent Infection FREE TO VIEW

Yumiko Ando, PhD; Fumito Okada, PhD; Asami Ono, MD; Tomoko Nakayama, MD; Hiromu Mori, PhD
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Nishibeppu National Hospital, Beppushi Oita, Japan



Chest. 2011;140(4_MeetingAbstracts):641A. doi:10.1378/chest.1107825
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Abstract

PURPOSE: To compare the pulmonary thin-section computed tomography (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 clinical and thin-section CT findings among the groups.

RESULTS: Underlying health issues, such as smoking and malignancy, were significantly more frequent in patients with pneumonia caused by concurrent infection than those infected with S. pneumoniae alone. Centrilobular nodules and bronchial wall thickening were also 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 and bronchial wall thickening on CT images, concurrent infection should be considered.

CLINICAL IMPLICATIONS: When a patient with acute Streptococcus pneumoniae pneumonia who has underlying health issues, such as side effects from a smoking habit or a malignant disease, has centrilobular nodules and bronchial wall thickening on thin-section CT images, concurrent infection should be considered and intensive care and adequate antibiotic therapy should be initiated.

DISCLOSURE: The following authors have nothing to disclose: Yumiko Ando, Fumito Okada, Asami Ono, Tomoko Nakayama, Hiromu Mori

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