An analysis of HRCT imaging characteristics and sputum culture results in hospitalized patients with community-acquired pneumonia - an institutional observational study

Abstract

Background and Objectives. Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality worldwide. High-resolution computed tomography (HRCT) and sputum cultures are critical in diagnosing and managing CAP. This study aims to analyze HRCT imaging characteristics and sputum culture results in hospitalized patients with CAP, correlating imaging findings with specific pathogens to enhance diagnostic accuracy and treatment strategies. Materials and Methods. A retrospective analysis was conducted on 133 patients admitted with CAP at a tertiary care center in Chennai in last 12 months. HRCT scans were reviewed for specific imaging patterns, including ground-glass opacities, consolidation, interstitial patterns, and pleural effusion. Sputum samples were collected and cultured for bacterial pathogens. Data on patient demographics, HRCT findings, and sputum culture results were analyzed to identify correlations between imaging patterns and pathogens. Results. The study included 133 patients, with a mean age of 58 years, comprising 78 males (59%) and 55 females (41%). HRCT findings revealed ground-glass opacities in 68% of patients, consolidation in 54%, interstitial patterns in 32%, and pleural effusion in 21%. The most common organisms identified in sputum cultures were Klebsiella pneumoniae (20%), Pseudomonas aeruginosa (22%), Acinetobacter baumannii complex (9%), and E. coli (8%), with 25% of cultures yielding no growth. Ground-glass opacities were predominantly observed in cases with no bacterial growth, suggesting a viral etiology. Consolidation was the most common pattern associated with bacterial infections, particularly Klebsiella pneumoniae and Pseudomonas aeruginosa. Conclusions. This study highlights the importance of HRCT in diagnosing CAP and distinguishing between bacterial and viral infections. The correlation between specific HRCT patterns and pathogens can enhance diagnostic accuracy and guide treatment strategies. Future research should focus on integrating advanced diagnostic modalities and understanding the evolving patterns of CAP etiology to improve patient outcomes.