![]() ![]() Chest CT scan should be considered in suspected CAP patients with a negative CR, especially in bedridden patients. Conclusions: CAP patients with negative CR findings are characterized by lower blood levels of inflammatory markers, a higher incidence of aspiration pneumonia, and a lower incidence of complicated parapneumonic effusion or empyema than those with positive CR findings. Despite shorter length of hospital stay in the negative CR group, 30-day and in-hospital mortalities were similar between the two groups. On CT, the negative CR group exhibited higher rates of GGO- and bronchiolitis-predominant patterns and a lower rate of consolidation pattern. The negative CR group was characterized by a higher frequency of aspiration pneumonia, lower incidences of complicated parapneumonic effusion or empyema and pleural drainage, and lower blood levels of inflammatory markers than the control group. Negative CR findings could be attributed to the location of the lesions (e.g., those located in the dependent lung) and CT pattern with a low attenuation, such as ground-glass opacity (GGO). Results: Of 1,925 patients, 94 patients (4.9%) were included in the negative CR group. Methods: We retrospectively compared the clinical characteristics, etiological agents, treatment outcomes, and CT findings between CAP patients with negative CR and positive CT findings (negative CR group) and those with positive CR as well as CT findings (control group). Objectives: The present study aimed to investigate the clinical and radiological features of these patients. 10 Presumably the burden of bacterial disease is even less in ambulatory children with CAP.Background: Data regarding community-acquired pneumonia (CAP) identified on chest computed tomography (CT) but not on chest radiography (CR) are limited. In fact, a single-center study in the inpatient setting revealed a high rate of discontinuation of antibiotics for children who are diagnosed with CAP by the ED and admitted to the hospital (62%),without any noticeable effect seen in outcomes, such as readmissions or transfer to higher level of care. 8, 9 These findings reveal the possibility that only a small fraction of pediatric patients with CAP benefit from antibiotic therapy and, by extension, radiography. The utility of antibiotic treatment of CAP caused by M pneumoniae in children has been questioned. The breakdown of bacterial etiologies was Mycoplasma pneumoniae (8%), Streptococcus pneumonia (4%), Staphylococcus aureus (1%), and Streptococcus pyogenes (1%). 7 Researchers in that study found that of 2222 children hospitalized with radiographic evidence of pneumonia, bacteria were only found in 15%, and almost half of those had codetection of a virus. ![]() ![]() Three-quarters of the children in the current study were <6 years of age, which matches the age range of the patients in a recent large etiological study of pediatric CAP in the United States, in which a pathogen was found in 81% of children. There are several reasons to suspect that the positive predictive value of a CXR may not be as high as the NPV demonstrated in this study. ![]()
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