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Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography

BACKGROUND: Chest radiography is commonly used for diagnosing community-acquired pneumonia (CAP). Computed tomography (CT) is not routinely recommended for initial assessment of CAP patients but is more sensitive and more specific than chest radiography. OBJECTIVES: To investigate characteristics of...

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Autores principales: Kitazawa, Takatoshi, Yoshihara, Hisanao, Seo, Kazunori, Yoshino, Yusuke, Ota, Yasuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034517/
https://www.ncbi.nlm.nih.gov/pubmed/32128054
http://dx.doi.org/10.1080/20009666.2020.1711639
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author Kitazawa, Takatoshi
Yoshihara, Hisanao
Seo, Kazunori
Yoshino, Yusuke
Ota, Yasuo
author_facet Kitazawa, Takatoshi
Yoshihara, Hisanao
Seo, Kazunori
Yoshino, Yusuke
Ota, Yasuo
author_sort Kitazawa, Takatoshi
collection PubMed
description BACKGROUND: Chest radiography is commonly used for diagnosing community-acquired pneumonia (CAP). Computed tomography (CT) is not routinely recommended for initial assessment of CAP patients but is more sensitive and more specific than chest radiography. OBJECTIVES: To investigate characteristics of pneumonia with negative chest radiography in cases confirmed by CT. METHODS: We included patients diagnosed with CAP in the emergency department, and chest radiography and CT were performed and sputum cultures were collected. The CR- group was defined as patients for whom infiltration of pneumonia was detected only on CT. The CR+ group was defined as patients for whom infiltration was detected on both chest radiography and CT. Data were collected retrospectively from medical records. RESULTS: A total of 138 patients were included, with 58 patients in the CR- group and 80 patients in the CR+ group. Mean age was higher in the CR- group than in the CR+ group, and white blood cell counts and C-reactive protein (CRP) levels were lower in the CR- group than in the CR+ group (8.4 × 10(3)/μL vs 12.4 × 10(3)/μL, p = 0.01; 4.7 mg/dL vs 15.6 mg/dL, p < 0.001, respectively). Laterality of the infiltrated lungs differed between groups (right:left:bilateral = 14:30:14 vs 48:20:12, p = 0.006). Multivariate logistic analysis identified leukocytosis, elevated CRP levels (odds ratio (OR) 3.57, p = 0.003), laterality (OR 2.16, p = 0.006) as predictors of pneumonia in the CR- group. CONCLUSION: In pneumonia with negative chest radiography in cases confirmed by CT, milder inflammation and infiltration in the left lung tended to be seen.
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spelling pubmed-70345172020-03-03 Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography Kitazawa, Takatoshi Yoshihara, Hisanao Seo, Kazunori Yoshino, Yusuke Ota, Yasuo J Community Hosp Intern Med Perspect Research Article BACKGROUND: Chest radiography is commonly used for diagnosing community-acquired pneumonia (CAP). Computed tomography (CT) is not routinely recommended for initial assessment of CAP patients but is more sensitive and more specific than chest radiography. OBJECTIVES: To investigate characteristics of pneumonia with negative chest radiography in cases confirmed by CT. METHODS: We included patients diagnosed with CAP in the emergency department, and chest radiography and CT were performed and sputum cultures were collected. The CR- group was defined as patients for whom infiltration of pneumonia was detected only on CT. The CR+ group was defined as patients for whom infiltration was detected on both chest radiography and CT. Data were collected retrospectively from medical records. RESULTS: A total of 138 patients were included, with 58 patients in the CR- group and 80 patients in the CR+ group. Mean age was higher in the CR- group than in the CR+ group, and white blood cell counts and C-reactive protein (CRP) levels were lower in the CR- group than in the CR+ group (8.4 × 10(3)/μL vs 12.4 × 10(3)/μL, p = 0.01; 4.7 mg/dL vs 15.6 mg/dL, p < 0.001, respectively). Laterality of the infiltrated lungs differed between groups (right:left:bilateral = 14:30:14 vs 48:20:12, p = 0.006). Multivariate logistic analysis identified leukocytosis, elevated CRP levels (odds ratio (OR) 3.57, p = 0.003), laterality (OR 2.16, p = 0.006) as predictors of pneumonia in the CR- group. CONCLUSION: In pneumonia with negative chest radiography in cases confirmed by CT, milder inflammation and infiltration in the left lung tended to be seen. Taylor & Francis 2020-01-02 /pmc/articles/PMC7034517/ /pubmed/32128054 http://dx.doi.org/10.1080/20009666.2020.1711639 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kitazawa, Takatoshi
Yoshihara, Hisanao
Seo, Kazunori
Yoshino, Yusuke
Ota, Yasuo
Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography
title Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography
title_full Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography
title_fullStr Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography
title_full_unstemmed Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography
title_short Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography
title_sort characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034517/
https://www.ncbi.nlm.nih.gov/pubmed/32128054
http://dx.doi.org/10.1080/20009666.2020.1711639
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