CXR and CAP

Q: It is conventionally believed that chest x-ray (CXR) improvement lags behind the clinical improvement in community-acquired pneumonia (CAP). But recent evidence speaks against it.

A) True

B) False

Answer: B

Evidences continue to show that conventional teaching is right and radiographic improvement usually lags behind the clinical response. The study has shown that by the end of one week in severe CAP, only a quarter of the patients show resolution of chest radiograph, though two-thirds of these patients clinically improved. And, by the end of the month, only half had Chest-X-Ray improvement.

Patients with multilobar pneumonia take longer to have radiologic resolution. Older age and underlying lung disease usually have a similar effect.

#pulmonary

#radiology

References:

1. Bruns AH, Oosterheert JJ, Prokop M, et al. Patterns of resolution of chest radiograph abnormalities in adults hospitalized with severe community-acquired pneumonia. Clin Infect Dis 2007; 45:983.

2. Mittl RL Jr, Schwab RJ, Duchin JS, et al. Radiographic resolution of community-acquired pneumonia. Am J Respir Crit Care Med 1994; 149:630.

3. El Solh AA, Aquilina AT, Gunen H, Ramadan F. Radiographic resolution of community-acquired bacterial pneumonia in the elderly. J Am Geriatr Soc 2004; 52:224.