Chest ImagingStaphylococcus pneumonia
Staphylococcus aureus is a Gram-positive bacterium which is a frequent cause of
bronchopneumonia. The source of
S. aureus is generally through inhalation or spread from an infected site such as valvular endocarditis or an infected
intravenous access. Clinically patients develop fever, productive cough, pleuritic pain and leukocytosis. Radiographically bronchopneumonia is represented by scattered areas of initially heterogeneous and subsequently homogeneous opacities in both lungs (
Fig.1) with occasional cavitation and frequent
parapneumonic effusion. As with other forms of bronchopneumonia,
air bronchograms are not usually identified nor is adenopathy usually seen. In children
pneumatocoeles may be noted within a few days of development of
S. aureus pneumonia. These thin-walled cavities can occasionally burst into the
pleural space resulting in a
bronchopleural fistula,
pneumothorax and
empyema. Otherwise pneumatocoeles will resolve in a matter of weeks with appropriate antibiotic therapy.
PGO
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A PA chest film demonstrates bilateral peripheral homogeneous opacities. No definite air bronchograms are identified and there is a certain degree of heterogeneity and nodularity to the opacities overlying the right costophrenic angle and left perihilar region. Bronchopneumonias such as this one caused by Staphylococcus typically do not have air bronchograms and may be slightly more nodular and heterogeneous than conventional pyogenic infections.
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Staphylococcus pneumonia, Fig.1 | |