What is the role of CT scanning in the evaluation of nosocomial pneumonia?

Updated: Apr 15, 2021
  • Author: Kartika Shetty, MD, FACP; Chief Editor: John L Brusch, MD, FACP  more...
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Computed tomography (CT) scanning or spiral CT scanning may be useful in differentiating mimics from actual nosocomial pneumonia. For example, blood cultures that are positive for MSSA/MRSA in a febrile intubated patient are not diagnostic of MSSA/MRSA nosocomial pneumonia/ventilator-associated pneumonia (VAP). The diagnosis of MSSA/MRSA community-acquired pneumonia/nosocomial pneumonia is based on the clinical presence of fever, cyanosis, hypotension, and rapid cavitation of infiltrates (< 72 hours) on chest radiographs plus MSSA/MRSA in respiratory secretions.

Since only approximately 25% of changes documented on portable chest radiographs of ventilated patients represent an infectious process, follow-up CT scanning should be obtained in this situation.

Go to Imaging Atypical Pneumonia and Imaging Typical Pneumonia for more complete information on these topics.

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