Computed tomography of pulmonary complications of community-acquired pneumonia

Autori:

Neva Coce, Silvana Giljanović Jacmenović, Luka Filipović-Grčić, Ivana Kuhtić

Sažetak
Izvanbolnička pneumonija (IBP) jest pneumonija stečena u svakodnevnom životu. Uzročnici su bakterije ili virusi, a najčešće se liječi empirijski, budući da se uzročnik pozitivno identificira u samo 5% slučajeva. Njezin klinički tijek može varirati od blage do teške upale, čak i životno ugrožavajuće. Danas se IBP rutinski dijagnosticira klasičnim rendgenogramom srca i pluća. Kompjutorizirana tomografija (CT) koristi se kao jedna od slikovnih metoda, uz ultrazvuk toraksa, da se utvrde plućne komplikacije IBP poput pleuralnog izljeva, empijema, pneumotoraksa, pneumatokele i plućnog apscesa. Empijem i izljev se slikovno prezentiraju kao kolekcija tekućeg sadržaja u pleuralnom prostoru, a ako se kolekcija nalazi u plućnom parenhimu omeđena debelom stijenkom, radi se o apscesu. Cistična lezija plućnog parenhima ispunjena zrakom zove se pneumatokela čijom rupturom može nastati pneumotoraks, odnosno patološko nakupljanje zraka u pleuralnom prostoru. U ovom pregledom članku predstavit ćemo slikovni prikaz CT nalaza plućnih komplikacija IBP kod bolesnika s plućnim apscesom, empijemom, pneumotoraksom i pneumatokelom s bronhogenom fistulom.
Summary

Community-acquired pneumonia (CAP) is a pneumonia acquired in normal, daily life. The causes of CAP are bacteria and viruses, and the treatment is usually empiric since the pathogen is positively identified in only 5% of the cases. Its course can vary from mild to severe and even life-threatening. Today CAP is readily diagnosed by chest radiogram. Computed tomography (CT) and transthoracic ultrasound are used as imaging methods to diagnose pulmonary complications of CAP like pleural effusion, empyema, pneumothorax, pneumatocele and lung abscess. The empyema and effusion are presented as a collection of fluid in the pleural space, and if the collection is located in the pulmonary parenchyma bounded by a thick wall, it is called an abscess. An air-filled cystic lesion of the pulmonary parenchyma is called pneumocele, which can rupture to cause pneumothorax – pathological presence of air in the pleural space. In this review article we present an image series of CT findings of pulmonary complications of CAP in patients with lung abscess, empyema, pneumothorax, and pneumatocele with bronchogenic fistula.

Volumen: 3-4, 2020

Liječ Vjesn 2020;142:93–96

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