Atypical Pneumonia

by Hetal Verma, MD

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    00:01 So let's discuss interstitial pneumonia.

    00:03 Interstitial pneumonia produces a fine reticular pattern which is different than what we see with consolidation.

    00:09 Often, this can spread to the alveoli over time and results in a more focal consolidation as well.

    00:14 This may be seen as a viral or atypical pneumonia such as mycoplasma or pneumocystis where the finding start off as an interstitial pneumonia and then eventually become consolidation.

    00:24 So let's take a good look at this case here.

    00:27 So this is an example of an interstitial pneumonia, you can see that there is no silhouette in here.

    00:32 You can see the margins of the heart clearly on both sides and you can see the margins of the diaphragm clearly on both sides as well.

    00:39 So there is no focal consolidation, however, throughout both lungs you can see this kind of hazy opacity and you can see fine interstitial markings throughout both lungs so this is an example of an interstitial pneumonia.

    00:53 What about this case? How does this look different than the other areas of consolidation that we've seen so far? So this is an example of a cavitary lesion which is a mass-like area of consolidation that has a central lucency.

    01:12 So it's different from the other consolidation because you have a normal area of consolidation with fluffy margins.

    01:19 However, right in the middle of it you have this lucency which represents the cavitation.

    01:24 This can be very thick-walled, they can vary in size, and usually they're caused by such things as an abscess, TB, or possibly a cavitary carcinoma.

    01:34 Let's take a look in this case.

    01:36 So what can you say about this patient? Is this an adult or is this a child? So we wanna take an overall look at the x-ray before we focus on the findings here.

    01:51 So if you look here, these bones are not fully developed at the shoulders so this is actually a child and then do you see an area of consolidation here? Take a look at the right lung.

    02:07 So here we have an area of round pneumonia.

    02:11 This is really most often seen in children.

    02:12 It's usually seen posteriorly within the lung and most commonly it's within the upper segments of the lower lobes.

    02:18 So this can actually look like a mass and usually needs to be followed to make sure that it goes away but when you see something like this in a child you would definitely wanna think about round pneumonia, possibly treat the child first and then do a follow-up to make sure that it resolves.

    02:33 Organisms that can cause this include H. flu, Streptococcus and Pneumococcus.

    02:38 So aspiration pneumonia is a type of pneumonia that occurs from aspiration and patients that have difficulty swallowing.

    02:45 Usually it occurs in the dependent portions of the lungs, so as you can see on this axial CT of the chest you have areas of consolidation which is what this would look like on a CT bilaterally.

    02:58 More often it's seen on the right because the right mainstem bronchus is a little bit straighter than the left is.

    03:04 Here you see it on both sides.

    03:05 So we've gone over various different examples of consolidation.

    03:09 Again, these are typical patterns that you may see as you take a look at more x-rays and hopefully this will help you recognize these patterns when you see them in the future.

    About the Lecture

    The lecture Atypical Pneumonia by Hetal Verma, MD is from the course Thoracic Radiology.

    Included Quiz Questions

    1. It is commonly seen in the lingula.
    2. It is commonly observed in the upper segments of the lower lobes within the lung.
    3. It is common in children.
    4. It appears to be mass-like.
    5. Haemophilus influenzae is often the cause.
    1. Right lower lobe
    2. Right upper lobe
    3. Left upper lobe
    4. Left middle lobe
    5. Right apex
    1. The apex of the lung is the most common site involved.
    2. It is most commonly seen in children.
    3. Pathogens include H. influenzae, Streptococcus, and Pneumococcus.
    4. It can mimic a mass.
    5. It is usually seen posteriorly within the lung.

    Author of lecture Atypical Pneumonia

     Hetal Verma, MD

    Hetal Verma, MD

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    By olanipekun o. on 19. April 2020 for Atypical Pneumonia

    very lively. I love the method of explanation, never get bored of watching interesting and well educative materials like this, thanks to the tutors here and the whole Lecturio team.