Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia

Deborah L. Stein, Linda B. Haramati, Hugo Spindola-Franco, Joseph Friedman, Philip J. Klapper

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: Pneumococcal pneumonia is the most common etiology for community-acquired pneumonia. The prevalence of lymphadenopathy seen on CT scans in these patients is uncertain. The purpose of this series was to assess the prevalence of intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. Materials and methods: We retrospectively identified 35 hospitalized patients with pneumococcal pneumonia who had been evaluated with CT scanning between January 1998 and April 2002. There were 18 men and 17 women with a mean age of 56 years. The study inclusion criteria were as follows: blood culture positive for Streptococcus pneumoniae, clinical diagnosis of pneumonia, and chest CT scan. The study exclusion criteria were known causes of lymphadenopathy. Charts were reviewed for HIV status, smoking history, and comorbidities. CT scans were reviewed for the presence and degree of lymphadenopathy, and the characteristics of pneumonia. The number of enlarged lymph nodes was graded as few (one to two), moderate (three to five), or many (six or more). Pneumonias were described by location, the number of involved lobes, the presence of cavitation, and the presence of pleural effusion. Patients with different comorbidities and different imaging characteristics of pneumonia were compared. Results: Among the 35 patients with pneumococcal pneumonia, intrathoracic lymphadenopathy was present on CT scans in 54% of patients (19 of 35 patients). The lymphadenopathy was ipsilateral to the pneumonia in 100% of patients (19 of 19 patients). One patient also had contralateral lymphadenopathy. The lymphadenopathy was graded as few in 37% of patients (7 of 19 patients), moderate in 37% of patients (7 of 19 patients), and many in 26% of patients (5 of 19 patients). The pneumonia was right-sided in 26% of patients (9 of 35 patients), left-sided in 17% of patients (6 of 35 patients), and bilateral in 57% of patients (20 of 35 patients). Comorbidities included the following: HIV infection (n = 15); smoking (n = 21); emphysema (n = 5); hepatitis C (n = 5); and diabetes (n = 3). The characteristics of pneumonia included the following: multilobar (n = 25); pleural effusion (n = 25); and cavitation (n = 5). The prevalence of lymphadenopathy according to comorbidities and characteristics of pneumonia ranged from 40 to 100%. None of the differences in prevalence of lymphadenopathy among the subgroups was statistically significant. Conclusion: Lymphadenopathy is a common CT scan feature of pneumococcal pneumonia in hospitalized patients, in a variety of settings. Therefore, when a patient with pneumococcal pneumonia has lymphadenopathy seen on a CT scan, other etiologies for the lymphadenopathy need not be suspected.

Original languageEnglish (US)
Pages (from-to)1271-1275
Number of pages5
JournalChest
Volume127
Issue number4
DOIs
StatePublished - Apr 2005

Fingerprint

Pneumococcal Pneumonia
Pneumonia
Lymphadenopathy
Comorbidity
Pleural Effusion

Keywords

  • CT
  • Lymphadenopathy
  • Pneumonia
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Stein, D. L., Haramati, L. B., Spindola-Franco, H., Friedman, J., & Klapper, P. J. (2005). Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. Chest, 127(4), 1271-1275. https://doi.org/10.1378/chest.127.4.1271

Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. / Stein, Deborah L.; Haramati, Linda B.; Spindola-Franco, Hugo; Friedman, Joseph; Klapper, Philip J.

In: Chest, Vol. 127, No. 4, 04.2005, p. 1271-1275.

Research output: Contribution to journalArticle

Stein, DL, Haramati, LB, Spindola-Franco, H, Friedman, J & Klapper, PJ 2005, 'Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia', Chest, vol. 127, no. 4, pp. 1271-1275. https://doi.org/10.1378/chest.127.4.1271
Stein, Deborah L. ; Haramati, Linda B. ; Spindola-Franco, Hugo ; Friedman, Joseph ; Klapper, Philip J. / Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. In: Chest. 2005 ; Vol. 127, No. 4. pp. 1271-1275.
@article{70eec260322f4c239b40076f4616537d,
title = "Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia",
abstract = "Purpose: Pneumococcal pneumonia is the most common etiology for community-acquired pneumonia. The prevalence of lymphadenopathy seen on CT scans in these patients is uncertain. The purpose of this series was to assess the prevalence of intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. Materials and methods: We retrospectively identified 35 hospitalized patients with pneumococcal pneumonia who had been evaluated with CT scanning between January 1998 and April 2002. There were 18 men and 17 women with a mean age of 56 years. The study inclusion criteria were as follows: blood culture positive for Streptococcus pneumoniae, clinical diagnosis of pneumonia, and chest CT scan. The study exclusion criteria were known causes of lymphadenopathy. Charts were reviewed for HIV status, smoking history, and comorbidities. CT scans were reviewed for the presence and degree of lymphadenopathy, and the characteristics of pneumonia. The number of enlarged lymph nodes was graded as few (one to two), moderate (three to five), or many (six or more). Pneumonias were described by location, the number of involved lobes, the presence of cavitation, and the presence of pleural effusion. Patients with different comorbidities and different imaging characteristics of pneumonia were compared. Results: Among the 35 patients with pneumococcal pneumonia, intrathoracic lymphadenopathy was present on CT scans in 54{\%} of patients (19 of 35 patients). The lymphadenopathy was ipsilateral to the pneumonia in 100{\%} of patients (19 of 19 patients). One patient also had contralateral lymphadenopathy. The lymphadenopathy was graded as few in 37{\%} of patients (7 of 19 patients), moderate in 37{\%} of patients (7 of 19 patients), and many in 26{\%} of patients (5 of 19 patients). The pneumonia was right-sided in 26{\%} of patients (9 of 35 patients), left-sided in 17{\%} of patients (6 of 35 patients), and bilateral in 57{\%} of patients (20 of 35 patients). Comorbidities included the following: HIV infection (n = 15); smoking (n = 21); emphysema (n = 5); hepatitis C (n = 5); and diabetes (n = 3). The characteristics of pneumonia included the following: multilobar (n = 25); pleural effusion (n = 25); and cavitation (n = 5). The prevalence of lymphadenopathy according to comorbidities and characteristics of pneumonia ranged from 40 to 100{\%}. None of the differences in prevalence of lymphadenopathy among the subgroups was statistically significant. Conclusion: Lymphadenopathy is a common CT scan feature of pneumococcal pneumonia in hospitalized patients, in a variety of settings. Therefore, when a patient with pneumococcal pneumonia has lymphadenopathy seen on a CT scan, other etiologies for the lymphadenopathy need not be suspected.",
keywords = "CT, Lymphadenopathy, Pneumonia, Streptococcus pneumoniae",
author = "Stein, {Deborah L.} and Haramati, {Linda B.} and Hugo Spindola-Franco and Joseph Friedman and Klapper, {Philip J.}",
year = "2005",
month = "4",
doi = "10.1378/chest.127.4.1271",
language = "English (US)",
volume = "127",
pages = "1271--1275",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "4",

}

TY - JOUR

T1 - Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia

AU - Stein, Deborah L.

AU - Haramati, Linda B.

AU - Spindola-Franco, Hugo

AU - Friedman, Joseph

AU - Klapper, Philip J.

PY - 2005/4

Y1 - 2005/4

N2 - Purpose: Pneumococcal pneumonia is the most common etiology for community-acquired pneumonia. The prevalence of lymphadenopathy seen on CT scans in these patients is uncertain. The purpose of this series was to assess the prevalence of intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. Materials and methods: We retrospectively identified 35 hospitalized patients with pneumococcal pneumonia who had been evaluated with CT scanning between January 1998 and April 2002. There were 18 men and 17 women with a mean age of 56 years. The study inclusion criteria were as follows: blood culture positive for Streptococcus pneumoniae, clinical diagnosis of pneumonia, and chest CT scan. The study exclusion criteria were known causes of lymphadenopathy. Charts were reviewed for HIV status, smoking history, and comorbidities. CT scans were reviewed for the presence and degree of lymphadenopathy, and the characteristics of pneumonia. The number of enlarged lymph nodes was graded as few (one to two), moderate (three to five), or many (six or more). Pneumonias were described by location, the number of involved lobes, the presence of cavitation, and the presence of pleural effusion. Patients with different comorbidities and different imaging characteristics of pneumonia were compared. Results: Among the 35 patients with pneumococcal pneumonia, intrathoracic lymphadenopathy was present on CT scans in 54% of patients (19 of 35 patients). The lymphadenopathy was ipsilateral to the pneumonia in 100% of patients (19 of 19 patients). One patient also had contralateral lymphadenopathy. The lymphadenopathy was graded as few in 37% of patients (7 of 19 patients), moderate in 37% of patients (7 of 19 patients), and many in 26% of patients (5 of 19 patients). The pneumonia was right-sided in 26% of patients (9 of 35 patients), left-sided in 17% of patients (6 of 35 patients), and bilateral in 57% of patients (20 of 35 patients). Comorbidities included the following: HIV infection (n = 15); smoking (n = 21); emphysema (n = 5); hepatitis C (n = 5); and diabetes (n = 3). The characteristics of pneumonia included the following: multilobar (n = 25); pleural effusion (n = 25); and cavitation (n = 5). The prevalence of lymphadenopathy according to comorbidities and characteristics of pneumonia ranged from 40 to 100%. None of the differences in prevalence of lymphadenopathy among the subgroups was statistically significant. Conclusion: Lymphadenopathy is a common CT scan feature of pneumococcal pneumonia in hospitalized patients, in a variety of settings. Therefore, when a patient with pneumococcal pneumonia has lymphadenopathy seen on a CT scan, other etiologies for the lymphadenopathy need not be suspected.

AB - Purpose: Pneumococcal pneumonia is the most common etiology for community-acquired pneumonia. The prevalence of lymphadenopathy seen on CT scans in these patients is uncertain. The purpose of this series was to assess the prevalence of intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. Materials and methods: We retrospectively identified 35 hospitalized patients with pneumococcal pneumonia who had been evaluated with CT scanning between January 1998 and April 2002. There were 18 men and 17 women with a mean age of 56 years. The study inclusion criteria were as follows: blood culture positive for Streptococcus pneumoniae, clinical diagnosis of pneumonia, and chest CT scan. The study exclusion criteria were known causes of lymphadenopathy. Charts were reviewed for HIV status, smoking history, and comorbidities. CT scans were reviewed for the presence and degree of lymphadenopathy, and the characteristics of pneumonia. The number of enlarged lymph nodes was graded as few (one to two), moderate (three to five), or many (six or more). Pneumonias were described by location, the number of involved lobes, the presence of cavitation, and the presence of pleural effusion. Patients with different comorbidities and different imaging characteristics of pneumonia were compared. Results: Among the 35 patients with pneumococcal pneumonia, intrathoracic lymphadenopathy was present on CT scans in 54% of patients (19 of 35 patients). The lymphadenopathy was ipsilateral to the pneumonia in 100% of patients (19 of 19 patients). One patient also had contralateral lymphadenopathy. The lymphadenopathy was graded as few in 37% of patients (7 of 19 patients), moderate in 37% of patients (7 of 19 patients), and many in 26% of patients (5 of 19 patients). The pneumonia was right-sided in 26% of patients (9 of 35 patients), left-sided in 17% of patients (6 of 35 patients), and bilateral in 57% of patients (20 of 35 patients). Comorbidities included the following: HIV infection (n = 15); smoking (n = 21); emphysema (n = 5); hepatitis C (n = 5); and diabetes (n = 3). The characteristics of pneumonia included the following: multilobar (n = 25); pleural effusion (n = 25); and cavitation (n = 5). The prevalence of lymphadenopathy according to comorbidities and characteristics of pneumonia ranged from 40 to 100%. None of the differences in prevalence of lymphadenopathy among the subgroups was statistically significant. Conclusion: Lymphadenopathy is a common CT scan feature of pneumococcal pneumonia in hospitalized patients, in a variety of settings. Therefore, when a patient with pneumococcal pneumonia has lymphadenopathy seen on a CT scan, other etiologies for the lymphadenopathy need not be suspected.

KW - CT

KW - Lymphadenopathy

KW - Pneumonia

KW - Streptococcus pneumoniae

UR - http://www.scopus.com/inward/record.url?scp=19044400545&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=19044400545&partnerID=8YFLogxK

U2 - 10.1378/chest.127.4.1271

DO - 10.1378/chest.127.4.1271

M3 - Article

C2 - 15821204

AN - SCOPUS:19044400545

VL - 127

SP - 1271

EP - 1275

JO - Chest

JF - Chest

SN - 0012-3692

IS - 4

ER -