High-resolution CT findings in Streptococcus milleri pulmonary infection

• Published in: Clinical radiology 2013-06, Vol.68 (6), p.e331-e337
• Main Authors: Okada, F, Ono, A, Ando, Y, Nakayama, T, Ishii, H, Hiramatsu, K, Sato, H, Kira, A, Otabe, M, Mori, H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Lung - diagnostic imaging; Lung - microbiology; Male; Middle Aged; Pleural Effusion - etiology; Pneumonia, Bacterial - complications; Pneumonia, Bacterial - diagnostic imaging; Pneumonia, Bacterial - microbiology; Radiology; Retrospective Studies; Streptococcal Infections - complications; Streptococcal Infections - diagnostic imaging; Streptococcal Infections - microbiology; Streptococcus milleri Group; Tomography, X-Ray Computed - methods; Young Adult
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2013.01.019

Aim To assess pulmonary high-resolution computed tomography (CT) findings in patients with acute Streptococcus milleri pulmonary infection. Materials and methods Sixty consecutive patients with acute S. milleri pneumonia who had undergone high-resolution CT chest examinations between January 2004 and March 2010 were retrospectively identified. Twenty-seven patients with concurrent infections were excluded. The final study group comprised 33 patients (25 men, 8 women; aged 20–88 years, mean 63.1 years) with S. milleri infection. The patients' clinical findings were assessed. Parenchymal abnormalities, enlarged lymph nodes, and pleural effusion were evaluated on high-resolution CT. Results Underlying conditions included malignancy ( n  = 15), a smoking habit ( n  = 11), and diabetes mellitus ( n  = 8). CT images of all patients showed abnormal findings, including ground-glass opacity ( n  = 24), bronchial wall thickening ( n  = 23), consolidation ( n  = 17), and cavities ( n  = 7). Pleural effusion was found in 18 patients, and complex pleural effusions were found in seven patients. Conclusion Pulmonary infection caused by S. milleri was observed mostly in male patients with underlying conditions such as malignancy or a smoking habit. The CT findings in patients with S. milleri consisted mainly of ground-glass opacity, bronchial wall thickening, pleural effusions, and cavities.