Introduction: Chest imaging to revaluate community acquired pneumonia (CAP) used to be common practice.? Recently, it has been suggested that most patients do not need it routinely.
Aim: To evaluate the relevance of CAP follow-up with chest imaging.
Methods: Retrospective observational study of all patients (pts) with CAP radiological follow-up in the Pulmonology Department of a tertiary hospital, between 6/ 2018 and 6/ 2019.
Results: In the study period, 154 pts with CAP had follow-up chest imaging (57.1% male; mean age 57 (?18); 60.2% smokers or former smokers; 51% treated as inpatients).
Chest X-Ray (CXR) was requested as initial follow-up imaging in 90.3% of pts and computed tomography (CT) in the remainder 9.7%, after a period of 33 ?18 days. CT was performed in an additional 31.8% of pts after follow-up CXR (in a total of 64 pts).
The results of CXR and CT are presented in the table below:
| CXR results (n=139) | n(%) | CT results (n=64) | n(%) | |
| Total Resolution | 77(55.4) |
Without new findings |
20(31) | |
|
Micronodule(s)/nodule(s) |
16(25) | |||
|
Partial Resolution |
54(38.8) | Bronchiectasis | 10(16) | |
| No Improvement | 6(4.3) | Interstitial lung disease (ILD) | 5(8) | |
|
Lung cancer |
2(3.1) | |||
| Worsened | 2(1.4) |
Hamartoma |
2(3.1) | |
|
Other |
9(14) |
Lung cancer was diagnosed in 2 pts (1.3%) which had a mean age of 66 ?1 and were both smokers.
Conclusion: Although, as described in literature, lung cancer was only diagnosed in 1.3% of patients, other important findings, such as bronchiectasis, ILD or lung (micro)nodules, were detected with imaging follow-up in nearly 30% of pts. Therefore, to better select these patients, aditional studies concerning chest imaging after CAP should be performed.