this is a ppt on various patterns of pulmonary infections with small discussion on specific infections

1. CHEST X RAY
INTERPRETATION
OF INFECTIONS
-Dr. Nidhi Aggarwal

2. LAYOUT
 TERMINOLOGY
 CLASSIFICATION
 MORPHOLOGICAL PATTERNS
 SPECIFIC ORGANISMS

3. TERMINOLOGY
– Pneumonia: An inflammation, usually due to infection by pathogenic organisms,
involving the alveoli.
– Pneumonitis tends to refer to those inflammatory processes that primarily
involve the alveolar wall
– Lung consolidation: The term “consolidation” is often used to describe
pneumonic changes on a CXR. It refers not only to infection, but to any
pathological process that distends the alveoli with either pus, blood, fluid, cell.
– Pneumonia is by far the commonest cause of an area of CXR consolidation.
– Alveolar shadowing: The generally accepted term when describing the CXR
appearances of lung consolidation . Air space shadowing = alveoolar shadowing.
The two terms are used synonymously.

4. PATHOLOGICALLY
PULMONARY
INFECTION
TRACHEOBRONCHITIS
BRONCHIOLITIS PNEUMONIA

5. MORPHOLOGICAL
CLASSIFICATION
PNEUMONIA
LOBAR PNEUMONIA
BRONCHOPNEUMONIA
INTERSTITIAL
PNEUMONIA

6. LOBAR PNEUMONIA
– Lobar pneumonia, also known as non-segmental pneumonia ?
– It is a radiological pattern associated with homogeneous and fibrinosuppurative
consolidation of one or more lobes of a lung in response to bacterial
pneumonia.

9. The most common cause of lobar pneumonia is Streptococcus
pneumoniae. Other causative organisms that may cause a lobar
pattern include 1:
– Klebsiella pneumoniae
– Legionella pneumophila
– Haemophilus influenzae
– Mycobacterium tuberculosis

10. Plain Radiography :
– Homogenous opacification in a lobar pattern
– The opacification can be sharply defined at the fissures
– There may be presence of air bronchograms

12. BRONCHOPNEUMONIA
– -Is the acute inflammation of the walls of the bronchioles
– -It is a type of pneumonia characterized by multiple foci of isolated acute
consolidation affecting one or more pulmonary lobules
– -Causative organisms include :
 Staphylococcus Aureus
 E.Coli
 Pseudomonas (hospital acquired)
 Haemophilus influenza (in children , immunocompromised
adults)

13. Plain Radiography :
– -Bronchopneumonia is characterized by multiple small nodular or
reticunodular opacities which tend to be patchy and confluent
– -This represents areas of lung where there are patches of
inflammation seperated by normal lung parenchyma
– -The distribution is often bilateral and asymmetric and predominantly
involves the lung bases

16. MORPHOLOGY
LOBAR PNEUMONIA BRONCHOPNEUMONIA
• Lobar pneumonla commences as a
localised infection of terminal air spaces.
• ln lobar pneumonia the usual
homogeneous lung opacification is limited
by fissures and affected lobes retain
normal volume and often show air
bronchograms.
• Streptococcus pneumoniae classically
causes lobar pneumonia.
• Bronchopneumonia is a multifocal process
which commences in the terminal and
respiratory bronchioles
• It tends to spread segmentally. It may also
be called lobular pneumonia, and
produces patchy consolidation.
• The commonest causes are S. aureus and
Gram-negative organisms.

18. INTERSTITIAL PNEUMONIA
– Infectious interstitial pneumonias are commonly caused by
viruses, M. pneumoniae, and Pneumocystis jirovecii
pneumonia.
– Pathologically, inflammation in interstitial pneumonia is
primarily limited to the pulmonary interstitium, although not
exclusively so.
– The typical chest radiographic appearance of interstitial
pneumonia is bilateral, symmetric, linear, or reticular
opacities.

20. PNEUMONIA

21. LUNG ABSCESS
– A lung abscess represents a localized infection that
undergoes tissue destruction and necrosis.When a
communication with the tracheobronchial tree is present,
cavitation and an air-fluid level may be evident.
– The inner wall of an abscess varies from smooth to shaggy
and irregular, and maximum wall thickness usually ranges
from 5 to 15 mm.
– Superior segment of the right lower lobe is the most
common site of infection

22. – a) Etiology :
– 1-Primary abscess :
– -Is one which develops as a result of primary infection of the lung
– -They most commonly arise from aspiration , necrotizing pneumonia or
chronic pneumonia e.g. pulmonary tuberculosis
– -More with staphylococcus , Klebsiella
– -In immunocompromised more with Candida albicans , Legionella
Pneumophilia

23. – 2-Secondary abscess :
– -Is one which develops as a result of another condition
Examples include :
a) Bronchial obstruction : Bronchogenic carcinoma, inhaled foreign body
b) Hematogeneous spread : bacterial endocarditis ,IVDU
c) Direct extension from adjacent infection : mediastinum ,
subphrenic

24. Plain Radiography :
-The classical appearance of a pulmonary
abscess is a cavity containing an air-fluid level
-Round in shape and appear similar in both frontal
and lateral projections
-3 phases :
Acute : more pus less air
Subacute : less pus & more air
Chronic : air only

26. D/D EMPYEMA

28. TILL NOW
– LOBAR
– BRONCHOPNEUMONIA
– INTERSTITIAL PN
– LUNG ABSCESS VS EMPYEMA

29. ETIOLOGICAL
CLASSIFICATION
– Bacterial pneumonia
– Atypical Pneumonia
– T.B.
– Fungal Infections
– Parasitic Infection

30. BACTERIAL PNEUMONIAS

31. Streptococcus pneumoniae
– This is a common cause of pneumonia in all age groups, and particularly in
young adults.
– Typically it produces lobar consolidation , which is often basal but may occur
anywhere in the lung.
– The volume of the consolidated lung is normal, and an air bronchogram may
be visible.
– Occasionally oedema of the interlobular septa causes septal lines.
– Pleural effusion, empyema and cavitation are unusual if the infection is
treated promptly, but may be seen in debilitated patients. Resolution is
usually complete.

33. Staphylococcus Aureus
– Pulmonary infection occurs through hematogenous spread or aspiration of
contaminated oral secretions.
– Staphylococci produce toxins causing significant tissue destruction and lung
abscesses
– The inflammatory exudate is multifocal and fills the large airways, following the
course of the tracheobronchial tree. Consolidation is usually segmental and is
characterized by segmental volume loss and the absence of air bronchograms.
– When dissemination is haematogenous the typical appearance is of multiple
poorly defined rounded nodules that develop rapidly over a few days
– Usually cavitation is evident, especially on later examinations. (PNEUMATOCELES)
– Pleural effusion, empyema and areas of atelectasis are common complications.

35. CHILDHOOD STAPHYLOCOCCAL
PNEUMONIA
– One of the most striking characteristics of the disease is the rapid change in the
roentgen findings. The picture may change from one of minimal to very extensive
involvement in a matter of hours.
– Pleural effusion or empyema is a common-indeed, almost universal-occurrence, and
its presence in a young infantis nearly pathognomonic.
– Pneumatocele formation is a regular feature in staphylococcal pneumonia and is
quite diagnostic . Pneumatoceles are thin-walled cyst-like areas which may or may
not contain air-fluid levels. They tend to appear later in the course of the disease.
– Another finding is pneumothorax or, perhaps more accurately, pyopneumothorax.

37. KlebsiellA pneumoniA
– This is due to Friedlander’s bacillus and typically occurs in elderly debilitated and alcoholic
men.
– It should be suspected when there is cavitatory pneumonia +/- a bulging fissure sign. Often
there can be extensive lobar opacification with air bronchograms.
– A helpful feature which may help to distinguish from pneumococcal pneumonia is that
Klebsiella pneumonia develops cavitation in 30-50% of cases (in comparison, cavitation is
rare in pneumococcal pneumonia). This occurs early and progresses quickly. Massive
necrosis (pulmonary gangrene) is a recognized complication.
– There is usually lobar consolidation, more often right sided, and frequently upper lobe.
– A bronchopneumonic pattern may also occur

39. Legionnaire's disease
– Caused by Gram-negative bacillus -Legionella pneumophila.
– The organism is ubiquitous in water. multiplying in water coolers , air
conditioners and showers and infection takes place from inhalation of an
aerosol mist.
– It is prone to attack smokers and the debilitated.
– Radiographically there is spreading consolidation, and although it may be
confined to one lobe initially it soon extends to others and to the opposite
lung
– There may be a middle and lower zone predominance 5.
– Another characteristic feature is the slow resolution over several weeks, but
this is usually complete.

41. Hemophilus influenzae
– This is a commensal of the upper respiratory tract, but as it is sometimes found
in large numbers in the sputum in association with chronic lung diseases .
– It is a secondary invader found in chronic bronchitis, cystic fibrosis and
debilitated states.
– It is also found in influenza and other virus infections.
– Any pulmonary opacities found in Haemophilus infection are disseminated and
bronchopneumonic; there are no characteristic radiographic appearances

42. Pseudomonas Aeruginosa and
Escherichia coli
– These are Gram-negative organisms which normally inhabit the upper
respiratory tract and gastrointestinal tract and may cause pneumonia or other
infections in debilitated and hospitalised patients.
– Gram-negative organisms are also likely to be pathogenic in patients with
chronic lung disease such as cystic fibrosis, as well as in patients who are
immunosuppressed or have diabetes
– Pneumonia normally results from inhalation, but may also be haematogenous
in origin.
– The radiographic appearances are of a bronchopneumonia which is often basal.

43. SUMMARY OF BACT
PNEUMONIA
– Pneumococcal pn- lobar consolidation
– Staphylococcal pn- bronchopn, effusion/empyema, cavitation, pneumatoceles,
and pneumothorax.
– Klebshiella pn- lobar conso +_ Bulging Fissure sign, early cavitation in debilitated
or alcoholic pt.
– H.inf , pseudomonas – immunosuppressed/ hospital acquired. No specific CXR
findings.
– Legionnaire’s pn – aerosol acquired, multifocal b/l consolidations with ML and
B/l LL predominance.

44. ATYPICAL PNEUMONIAS

45. This term was originally used to describe an acute febrile
illness characterised by acute inflammatory changes
centred within the alveolar walls and interstitium.
'Atypical' denotes the lack of the alveolar exudate evident
in most pneumonic infections.
Because of this feature the term interstitial pneumonia
has been suggested as a preferred alternative
ORGANISMS
• Mvcoplasma pneumoniae,
• viruses, especially influenza viruses types A and B, respiratory
syncytial virus and adenovirus.
• Chlamvdia psittuci (psittacosis) and Coxiella burnetti (Q f'ever).

46. Mycoplasma pneumoniae
– Although classed as bacteria these organisms are unlike other common bacterial
species, being smaller and lacking rigid cell walls containing peptidoglycan.
– As a result they are not susceptible to antibiotics that act on cell wall synthesis such
as the penicillins .
– It is relatively common in the pediatric population where it is considered the most
common community-acquired pneumonia in 5 to 20-year-olds
– It initially involves the peribronchovascular interstitium and then extends to the
adjacent alveoli.
– The earliest radiographic signs are line reticular or nodular shadows followed by
the appearance of consolidation, which may be segmental or lobar, and is usually
unilateral
– Lymph node enlargement and pleural effusion are uncommon and cavitation ls rare

47. patchy non-segmental opacities bilaterally suggestive of atypical pneumonia.

48. VIRAL PNEUMONIAS
– Viral pneumonia usually commences in distal bronchi and bronchioles as an
interstitial process with destruction of the epithelium, oedema and lymphocytic
infiltration
– The radiological appearances of a viral pneumonia are very varied. but often
include:
– Peribronchial shadowing
– Reticulonodular shadowing
– Patchy or extensive consolidation
– Viral pneumonia is uncommon in adults, unless the patient is
immunocompromised.

49. Influenza virus
 Orthomyxoviridae family-Single-stranded RNA viruses -divided
into three groups (A, B, and C) according to internal membrane
and nucleoprotein antigens.
 Influenza virus is an important pathogen that causes seasonal
upper respiratory tract infections , usually mild and restricted to
the upper respiratory tract.
 Infections usually occur as annual winter outbreaks.
 Influenza virus replicates in the respiratory epithelial cells, and
replication peaks approximately 48 hours after inoculation into
the nasopharynx.

50.  Radiographs in patients with influenza pneumonia show bilateral
reticulonodular areas of opacity with or without focal areas of
consolidation, usually in the lower lobes.
 Poorly defined patchy or nodular areas of consolidation that
become rapidly confluent and represent either diffuse alveolar
damage or superinfection are seen frequently and resolve in 3
weeks .

52. CMV PNEUMONIA
It causes an asymptomatic infection or mild flu-like
symptoms in immunocompetent patients but can
cause life-threatening pulmonary infection in
immunocompromised patients
Transplantation and long-term corticosteroid therapy
are important risk factors.
Early (30–100 days) after transplantation is the critical
time for CMV infection
The predominant radiologic findings are bilateral
asymmetric GGO, poorly defined small nodules, and
airspace consolidation

53. Herpes varicella zoster
 Varicella pneumonia occurs more often in adults than in children.
 In the acute phase of infection the chest radiograph may show
widespread nodular shadows up to I cm in diameter, and clinically
the pneumonia will be concurrent with the typical skin rash
 small, round nodules usually resolve within a week after the
disappearance of the skin lesions but may persist for months
 lesions can calcify and can persist as numerous, well-
defined, randomly scattered, 2-3 mm dense calcifications

55. TUBERCULOSIS

56. Causative agent-
Mycobacterium
Tuberculosis
Primary infection- in
unsensitized host
Post primary
infections –in
previously sensitized
host
Miliary tuberculosis –
occurs in both
primary & post
primary

57. Consolidation in primary tuberculosis, frontal chest radiograph
demonstrates consolidation in the right middle lobe (straight arrow)
with right hilar adenopathy (curved arrow)

59. Tuberculomas in primary tuberculosis, frontal radiograph of the right
lung demonstrates well-defined nodules (arrows), findings that are
consistent with tuberculomas

60. Primary Tuberculosis
 Most cases of primary pulmonary tuberculosis are subclinical.
 Organisms settle and multiply in an alveolus anywhere in the lungs, but most commonly in a
subpleural site in the well ventilated lower lobes.
 Ghon focus+enlargement of regional lymph nodes= primary complex.
 Subpleural infection may cause a serous effusion.
 Activation of the immune system usually leads to resolution, healing and fibrosis at this stage.
 Lymphadenopathy is a common feature of primary infection in children , but is rare in
post-primary tuberculosis except in the HIV-positive population.
 Cavitation is uncommon in primary TB

62. Cavitary postprimary tuberculosis, frontal radiograph demonstrates a
thick-walled cavity with smooth inner margins in the left upper lobe
(arrow)

64. Post Primary Pulmonary
Tuberculosis :
 This follows the primary infection after a latent interval, and is due to either
reactivation or reinfection.
 In the majority of cases , post-primary TB within the lungs develops in either :
 Posterior segments of the upper lobes
 Superior segments of the lower lobes
 The most typical finding of postprimary MTB is that of poorly defined areas of
consolidation which extend, coalesce, caseate and cavitate.
 Areas of cavitation are seen in 20% to 45% of patients with active
postprimary MTB on chest radiographs. Cavities may be thick or thin walled.
 Lymphadenopathy is uncommon in postprimary MTB, as are pleural
effusions.
 Small cavities that heal leave radiating fibrotic strands puckering the lung.
Large cavities become lined by columnar or squamous epithelium and are
prone to secondary infection or fungal colonization.

66. Miliary Pulmonary Tuberculosis :
-It represents hematogenous dissemination of
an uncontrolled tuberculous infection
-It is seen both in primary and post-primary
tuberculosis
-Miliary deposits appear as 1-3 mm diameter
nodules which are uniform in size and
uniformly distributed (no calcification)

67. Fungal Infections

68. -Two broad categories :
a) Endemic human mycoses (prevalent
only in certain geographic areas) :
1 Histoplasmosis
2 Coccidioidomycosis
3-Blastomycosis

69. b) Opportunistic mycoses (worldwide in
distribution) occur primarily in
immunocompromised patients (aspergillosis and
cryptococcosis may also occur in
immunocompetent hosts)
1-Aspergillosis
2-Candidiasis
3-Cryptococcosis
4-Mucormycosis

70. HISTOPLASMOSIS
 Infection with Histoplasma capsulatum is usually due to inhalation of soil or
dust contaminated by bat or bird excreta.
 Endemic in eastern USA.
 Infection is usually subclinical and heals spontaneously, sometimes leaving
small, calcified pulmonary nodules or calcified hilar or mediastinal nodes.
 Locally progressive disease may also take the form of consolidation associated
with fibrosis and cavitation , an appearance similar to tuberculosis.

72. COCCIDIOMYCOSIS
 Coccidioides immitis causes endemic disease in parts of the south
west USA.
 The commonest radiographic finding is a nodule which calcifies as
it heals.
 However C. immitis may cause a pneumonic illness, and the chest
radiograph may show patchy consolidation which may cavitate and
be associated with pleural effusion or hilar or mediastinal
adenopathy.

74. GRAPE SKIN SIGN

75. Aspergillosis
 Is a collective term used to refer to a number of conditions caused by
infection with a fungus of the Aspergillus species , usually Aspergillus
Fumigatus
 According to immune status :
1 Hypersensitivity : ABPA
2 Normal : Aspergilloma
3 Mild Suppression : Semi-invasive
4 Severe Suppression : Invasive form

76. 1-ALLERGIC BRONCHOPULMONARY
ASPERGILLOSIS(ABPA)
 ABPA represents a complex hypersensitivity reaction (type 1) to
Aspergillus occurring almost exclusively in patients with asthma and
occasionally cystic fibrosis
 The hypersensitivity initially causes bronchospasm and bronchial wall
edema (IgE mediated) , ultimately there is bronchial wall damage ,
bronchiectasis and pulmonary fibrosis
 Clinical Picture :
– Patients have atopic symptoms (especially asthma) and present with
recurrent chest infection
– They may expectorate orange-coloured mucous plug

77. ACUTE - CONSOLIDATIONS CHRONIC- BRONCHIECTASIS & FIBROSIS

78. Glove finger sign , finger like projections from hilum from bronchial mucoid
impaction

79. Typical finger-in-glove appearance of mucoid impaction

80. 2. Aspergilloma
– Mass like fungus balls that are typically composed of Aspergillus
fumigatus
– Aspergillomas occur in patients with normal immunity but
structurally abnormal lungs with pre-existing cavities such as :
1 T.B.
2 Sarcoidosis
3 Bronchiectasis
4 Other pulmonary cavities (bronchogenic cyst , pulmonary
sequestration)

81. Clinical Picture :
-Most aspergillomas are asymptomatic
-Occasionally due to surrounding reactive vascular granulation tissue ,
hemoptysis may be present
Location :
-Aspergillomas typically occur in the cavities of post-primary pulmonary
tuberculosis .Therefore they most frequently are found in the posterior
segments of the upper lobes and the superior segments of the lower lobes

82. Plain Radiography :
-Rounded or ovoid soft tissue attenuating masses
located in a surrounding cavity and outlined by a
crescent of air (AIR CRESCENT SIGN)
-Altering the position of the patient usually
demonstrates that the mass is mobile thus
confirming the diagnosis

85. 3-Semi-Invasive Aspergillosis
– This form of aspergillosis occurs in mildly immunocompromised
patients and has a pathophysiology similar to that of invasive
aspergillosis except that the disease progresses more chronically over
months
– Mortality : 30%
– Risk factors : Diabetes , alcoholism , pneumoconioses , malnutrition
and COPD

86. Radiographic Features :
-Appearance similar to that of invasive aspergillosis
-Cavitation occurs at 6 months after infection

87. 4. INVASIVE ASPERGILLOSIS
– High mortality (70%-90%) and occurs mainly in severely
immunocompromised patients (bone marrow transplants &
leukemia)
– -The infection starts with endobronchial fungal proliferation and then
leads to vascular invasion with thrombosis and infarction of lung
(angioinvasive infection)

88. Plain Radiography :
-Typical appearances are those of solitary
or multiple pulmonary nodules
-Wedge-like areas of ill-defined opacity may also
be seen most likely representing infarcts due to
invasion of proximal pulmonary vessels
-An air crescent may be visible when recovery
is beginning although it is seen earlier on CT

89. Bilateral pulmonary infiltrates (right > left) with ill-
defined cavities showing the crescent sign

90. Areas of cavitation seen within right middle lobe infiltrate

91. Protozoan infections

92. HYDATID CYST
 The lung is the second most common site of involvement with
echinococcosis granulosus in adults after the liver
 Predominantly in lower lobes ? , unilateral or bilateral
 Uncomplicated Cysts :
Multiple or solitary cystic lesion (most common) of diameter
1-20 cm , Round or oval mass with well-defined borders
 Because of their compressibility, the lungs are the only organ in
which HCs can grow so large.
 Giant HCs are frequently seen in pediatric patients ?.

93. a) Posteroanterior and
b)lateral chest radiography
showing well-defined
rounded opacities in the
right lung of a patient with
unruptured cystic
echinococcosis

94. 2-Complicated Cysts :
•signs of partially ruptured cyst in pulmonary hydatid disease 6
• crescent sign: when the hydatid cyst erodes the adjacent bronchus
or bronchiole, the trapped air between the pericyst and the
laminated membrane of the endocyst give a crescent-shaped rim of
air around the cyst 4,5
•signs of complete rupture / cyst degeneration in pulmonary hydatid disease
6
• cumbo (onion peel, double arch) sign: curvilinear membrane
outlined by air both inside the endocyst and a crescent of air
between the endocyst and pericyst
• water lily (camalote) sign: folded membranes floating at the air-fluid
interface
• empty (dry) cyst sign: air filled cyst after expectoration of
membranes and fluid

96. Air meniscus in the superior aspect of the lesion as a result of the enlarging
cyst communicating with an adjacent bronchiole

97. The perivesicular air meniscus between the host adventitia and the parasitic
endocyst (the so-called "sign of detachment") (1) is clearly seen, as is a
"cyst within a cyst" or "sign of the double arch“ , Cumbo sign (2). The
irregular wavy nature of the fluid level produced by the collapsed hydatid
membranes floating on top of the residual hydatid fluid produces the
pathognomonic "floating water lily sign" or "sign of the camalote" (3)

98. a) Posteroanterior and
b)lateral chest radiography
showing a
hydropneumothorax in a
patient with ruptured cystic
hydatidosis with discharge of
contents into the pleural
space

99. AMEBIASIS
– Amebiasis is a protozoan infection caused by Entamoeba histolytica .
– It is most frequently seen among the lower socioeconomic classes in tropical and
subtropical climates
– After liver abscesses, pleuropulmonary involvement is the most common manifestation of
extraintestinal amebiasis .
– The most common proposed route of infection is direct extension from a liver abscess to the
thorax (tertiary route), which occurs in 6%–40% of patients with hepatic compromise
– Pleural effusion is a common finding in the setting of an amebic abscess. Such effusion can
be either sterile, as in inflammatory pleural reactions, or an empyema if the hepatic abscess
ruptures and traverses the diaphragm.
– Classically, elevation of the right hemidiaphragm precedes the visualization of pleural or
pulmonary lesions. Airspace consolidation and cavitation are frequently seen.

101. LOEFFLER’S SYNDROME
– This may be caused by many parasitic worms, including Ascaris, Taenia,
Anlcylostoma and Strongyloides, all of which may lodge in or migrate
through the lungs at some stage of their life cycles.
– The term Loeffler's syndrome is now applied to almost any transient
pulmonary opacities of a predominantly eosinophilic histology associated
with a blood eosinophilia.
– Imaging- fleeting, non-segmental air space opacification which may be
unilateral or bilateral. Usually, has a predominantly peripheral distribution.
Pleural effusions and lymphadenopathy are not features.

103. PCP Infection : (Pneumocystits
Carinii Pneumonia)
 Interstitial pattern, 80% :
 CXR: bilateral perihilar or diffuse
 Progression to diffuse consolidation within days
 Normal CXR in the presence of pulmonary PCP
infection, 10%
 Multiple upper lobe air-filled cysts or
pneumatoceles (10%) causing : Pneumothorax &
Bronchopleural fistulas

105. ROLE OF IMAGING IN
PNEUMONIA
 The primary role of imaging examinations is to confirm the diagnosis of pneumonia.
 Imaging examinations also play a complementary role for the evaluation of treatment
effects of antibiotics although treatment effects may be determined based solely on
clinical findings[9].
 It is generally difficult to determine specific pathogens of infectious pneumonia based
only on the imaging findings.
 They may help choose first antibiotics, especially true for the exclusion of tuberculosis.
 Imaging examinations may also reveal underlying diseases that result in pneumonia or
complications.
 Chest radiography is usually enough to confirm the diagnosis of pneumonia and to
evaluate treatment effects, whereas computed tomography (CT) is required to suggest
causative pathogens, to exclude noninfectious pneumonia and to reveal underlying
diseases.

106. TO SUMMARIZE
•–LOBAR
•-BRONCHOPNEUMONIA
•-INTERSTITIAL PNEUMONIA
PATTERNS
•- PRIMARY
•- POST-PRIMARY
•- MILIARY
TB
•- ASPERGILLOSIS
•–COCCIDIOIDOMYCOSIS
•-HISTOPLASMOSIS
FUNGAL
INFECTIONS
•- HYDATID
•–AMEBIASIS
•–LOEFFLER SYNDROME
PROTOZOAN