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Chlamydia Pneumoniae: Comparison with Findings of Mycoplasma Pneumoniae and Streptococcus Pneumoniae at Thin-Section CT¹

¹ From the Departments of Radiology (A.N.) and Internal Medicine (K.O., M.A., Z.O., H.Y.), Kofu Municipal Hospital, Kofu, Yamanashi prefecture, Japan; Department of Radiology, University of Yamanashi (A.S., T.A.), Shimokawato 1110, Tamaho-cho, Nakakoma-gun, Yamanashi prefecture, Japan 400-3898; and Center for Life Science Research, Bioinformatics Support Section, Data Science Division, University of Yamanashi, Yamanashi, Japan (Y.H.). Received January 21, 2004; revision requested March 19; revision received February 5, 2005; accepted March 2. Address correspondence to A.N. (e-mail: nambu-a{at}gray.plala.or.jp).

Purpose: To retrospectively compare thin-section computed tomographic (CT) findings of Chlamydia pneumoniae pneumonia with those of Streptococcus pneumoniae pneumonia and Mycoplasma pneumoniae pneumonia.

Materials and Methods: Institutional review board and patient informed consent were not required. Twenty-four patients with C pneumoniae pneumonia (17 men, seven women; age range, 19–89 years) underwent thin-section CT; 41 patients with S pneumoniae pneumonia (28 men, 13 women; age range, 19–91 years) and 30 patients with M pneumoniae pneumonia (20 men, 10 women; age range, 16–67 years) were also enrolled. Thin-section CT scans of each patient were retrospectively and independently assessed by two chest radiologists for consolidation, ground-glass opacity (GGO), bronchovascular bundle thickening, nodules, pleural effusion, lymphadenopathy, reticular or linear opacity, airway dilatation, pulmonary emphysema, and bilateral lung involvement. Consensus was reached for disagreements. The frequency of each finding was compared among the three types of pneumonia by using the ² test.

Results: For C pneumoniae pneumonia, CT demonstrated consolidation in 20 patients, GGO in 13, bronchovascular bundle thickening in 17, nodules in 18, pleural effusion in six, lymphadenopathy in eight, reticular or linear opacity in 15, airway dilatation in nine, pulmonary emphysema in 11, and bilateral lung involvement in 12. Bronchovascular bundle thickening (P = .022) and airway dilatation (P = .034) were significantly more frequent in patients with C pneumoniae pneumonia than in those with S pneumoniae pneumonia. Reticular or linear opacity (P = .017), airway dilatation (P = .016), and associated pulmonary emphysema (P = .003) were significantly more frequent in patients with C pneumoniae pneumonia than in those with M pneumoniae pneumonia.

Conclusion: C pneumoniae pneumonia demonstrates a wide spectrum of thin-section CT findings that are similar to those of S pneumoniae pneumonia and M pneumoniae pneumonia; airway dilatation and bronchovascular thickening were significantly more frequent in patients with C pneumoniae pneumonia.

© RSNA, 2005