ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2008
Limited value of chest radiography in predicting aetiology of lower respiratory tract infection in general practice.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Prevalence of Atypical Pathogens in Patients With Cough and Community-Acquired Pneumonia: A Meta-Analysis.Annals of family medicine · 2016Pooled it
- Radiological, epidemiological and clinical patterns of pulmonary viral infections.European journal of radiology · 2021Review
- Article
- Eighty-five-year-old man with mosaic attenuation on chest imaging.BMJ case reports · 2018Article
- Protective Capacity of Statins during Pneumonia Is Dependent on Etiological Agent and Obesity.Frontiers in cellular and infection microbiology · 2018Article
- Suspected community-acquired pneumonia in an ambulatory setting (CAPA): a French prospective observational cohort study in general practice.NPJ primary care respiratory medicine · 2015Observational
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
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Abstract
backgroundIn patients with lower respiratory tract infection (LRTI), changes on chest radiography are rare but poorly characterised, especially in general practice.
aimTo describe the range of findings on chest radiographs and the associations between these findings and the aetiology of LRTI. DESIGN OF STUDY: A prospective observational study.
settingGeneral practices in the Leiden region, The Netherlands.
methodAdult patients with a defined LRTI were included. Standard medical history and physical examination were performed. Sputum, blood, and throat swabs were collected for diagnostic tests. Chest X-ray findings were assessed in relation to the aetiology.
resultsAn abnormality on the chest X-ray was observed in 72 (55%) patients. Forty-five patients (35%) had changes due to infection, and 26 (20%) due to pneumonia. Pathogens were detected in 84 patients (33 single bacterial, 43 single viral, and 8 dual). Twelve (29%) patients with a bacterial infection (including dual infections) compared to four (9%) patients with viral infection had pneumonia on the chest X-ray (odds ratio [OR] = 4.0; 95% confidence interval [CI] = 1.2 to 13.8). Using the presence of pneumonia on chest X-ray as a test to predict a bacterial infection, the positive predictive value and the negative predictive value were 75% (CI = 48 to 93%) and 57% (CI = 45 to 69%), respectively.
conclusionPneumonia on the chest X-ray was found more frequently in patients with a bacterial infection than in patients with a viral infection. However, the sensitivity and the specificity are such that pneumonia on the chest X-ray is not a reliable test to discriminate between bacterial and non-bacterial LRTI in the general practice setting.
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