J Korean Radiol Soc.  1995 Dec;33(6):875-881.

Necrotizing Pneumonia: CT Findings & its Clinical Significance

• Im JG
• Han MC
• Yeon KM
• Ryoo JW
• Park HS

Abstract

PURPOSE
To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis.
MATERIALS AND METHODS
We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years).
RESULTS
The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was.
CONCLUSION
CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.

MeSH Terms

Actinomyces
Diagnosis
Enterobacter
Female
Fibrosis
Follow-Up Studies
Humans
Klebsiella
Male
Medical Records
Necrosis
Nocardia
Pneumonia*
Pseudomonas
Radiography, Thoracic
Retrospective Studies
Tomography, X-Ray Computed