Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017
Objectives: Few and small studies previously examined chest CT-scan characteristics of Coxiella burnetii (Cb) community-acquired pneumonia (CAP). Larger studies are needed to guide physicians towards diagnosis of Q fever in case of pneumonia. Methods: We conducted a single-center retrospective obser...
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2024
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Online Access: | https://doi.org/10.1016/j.tmaid.2023.102679 https://doaj.org/article/d730ab55d5db4c5cbbe23f9c2c1f6f9a |
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ftdoajarticles:oai:doaj.org/article:d730ab55d5db4c5cbbe23f9c2c1f6f9a 2024-02-11T10:01:41+01:00 Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017 Clémentine de La Porte des Vaux Vincent Sainte-Rose Paul Le Turnier Félix Djossou Mathieu Nacher Magaly Zappa Loïc Epelboin 2024-01-01T00:00:00Z https://doi.org/10.1016/j.tmaid.2023.102679 https://doaj.org/article/d730ab55d5db4c5cbbe23f9c2c1f6f9a EN eng Elsevier http://www.sciencedirect.com/science/article/pii/S1477893923001394 https://doaj.org/toc/1873-0442 1873-0442 doi:10.1016/j.tmaid.2023.102679 https://doaj.org/article/d730ab55d5db4c5cbbe23f9c2c1f6f9a Travel Medicine and Infectious Disease, Vol 57, Iss , Pp 102679- (2024) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2024 ftdoajarticles https://doi.org/10.1016/j.tmaid.2023.102679 2024-01-21T01:35:56Z Objectives: Few and small studies previously examined chest CT-scan characteristics of Coxiella burnetii (Cb) community-acquired pneumonia (CAP). Larger studies are needed to guide physicians towards diagnosis of Q fever in case of pneumonia. Methods: We conducted a single-center retrospective observational study between 2013 and 2017. All patients with Cb or Streptococcus pneumoniae (Sp) CAP who had a chest CT-scan on admission at Cayenne Hospital (French Guiana) were included. Chest CT-scan were all analyzed by the same expert radiologist. Results: We included 75 patients with Cb CAP and 36 with Sp CAP. Fifty-nine percent of all patients were men (n = 66) and median age was 52 [IQR = 38–62]. Chest CT-scans of Cb CAP patients revealed 67 alveolar condensations (89 %), 52 ground-glass opacities (69 %), 30 cases of lymphadenopathy(ies) (40 %) and 25 pleural effusions (33 %). Parenchyma lesions caused by Cb were predominantly unilateral (67 %). We found high numbers of alveolar condensations in both Cb and Sp CAP (89 % and 75 %; respectively), but the presence of ground-glass opacities was significantly associated with Cb CAP (69 % versus 30 %; p < 0.01). Cb CAP were associated with more lymphadenopathies (40 % vs 17 %; p = 0.01) while Sp CAP showed more bronchial thickening (19 % versus 3 %; p < 0.01) and (micro)nodule(s) ≤1 cm (25 % vs 3 %, p < 0.01). Conclusions: This large study shows that the most typical aspect of chest CT-scan in case of Cb CAP in French Guiana is a unilateral alveolar consolidation associated with ground glass opacities and lymphadenopathies. C. burnetti and S. pneumoniae both most often cause alveolar consolidations, but present some significantly different CT-scan patterns. This could help physicians through therapeutic choices. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Travel Medicine and Infectious Disease 57 102679 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Clémentine de La Porte des Vaux Vincent Sainte-Rose Paul Le Turnier Félix Djossou Mathieu Nacher Magaly Zappa Loïc Epelboin Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017 |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Objectives: Few and small studies previously examined chest CT-scan characteristics of Coxiella burnetii (Cb) community-acquired pneumonia (CAP). Larger studies are needed to guide physicians towards diagnosis of Q fever in case of pneumonia. Methods: We conducted a single-center retrospective observational study between 2013 and 2017. All patients with Cb or Streptococcus pneumoniae (Sp) CAP who had a chest CT-scan on admission at Cayenne Hospital (French Guiana) were included. Chest CT-scan were all analyzed by the same expert radiologist. Results: We included 75 patients with Cb CAP and 36 with Sp CAP. Fifty-nine percent of all patients were men (n = 66) and median age was 52 [IQR = 38–62]. Chest CT-scans of Cb CAP patients revealed 67 alveolar condensations (89 %), 52 ground-glass opacities (69 %), 30 cases of lymphadenopathy(ies) (40 %) and 25 pleural effusions (33 %). Parenchyma lesions caused by Cb were predominantly unilateral (67 %). We found high numbers of alveolar condensations in both Cb and Sp CAP (89 % and 75 %; respectively), but the presence of ground-glass opacities was significantly associated with Cb CAP (69 % versus 30 %; p < 0.01). Cb CAP were associated with more lymphadenopathies (40 % vs 17 %; p = 0.01) while Sp CAP showed more bronchial thickening (19 % versus 3 %; p < 0.01) and (micro)nodule(s) ≤1 cm (25 % vs 3 %, p < 0.01). Conclusions: This large study shows that the most typical aspect of chest CT-scan in case of Cb CAP in French Guiana is a unilateral alveolar consolidation associated with ground glass opacities and lymphadenopathies. C. burnetti and S. pneumoniae both most often cause alveolar consolidations, but present some significantly different CT-scan patterns. This could help physicians through therapeutic choices. |
format |
Article in Journal/Newspaper |
author |
Clémentine de La Porte des Vaux Vincent Sainte-Rose Paul Le Turnier Félix Djossou Mathieu Nacher Magaly Zappa Loïc Epelboin |
author_facet |
Clémentine de La Porte des Vaux Vincent Sainte-Rose Paul Le Turnier Félix Djossou Mathieu Nacher Magaly Zappa Loïc Epelboin |
author_sort |
Clémentine de La Porte des Vaux |
title |
Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017 |
title_short |
Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017 |
title_full |
Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017 |
title_fullStr |
Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017 |
title_full_unstemmed |
Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013–2017 |
title_sort |
chest ct findings in community-acquired pneumonia due to coxiella burnetii (q fever) compared to streptococcus pneumoniae, a cross sectional study in french guiana, 2013–2017 |
publisher |
Elsevier |
publishDate |
2024 |
url |
https://doi.org/10.1016/j.tmaid.2023.102679 https://doaj.org/article/d730ab55d5db4c5cbbe23f9c2c1f6f9a |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Travel Medicine and Infectious Disease, Vol 57, Iss , Pp 102679- (2024) |
op_relation |
http://www.sciencedirect.com/science/article/pii/S1477893923001394 https://doaj.org/toc/1873-0442 1873-0442 doi:10.1016/j.tmaid.2023.102679 https://doaj.org/article/d730ab55d5db4c5cbbe23f9c2c1f6f9a |
op_doi |
https://doi.org/10.1016/j.tmaid.2023.102679 |
container_title |
Travel Medicine and Infectious Disease |
container_volume |
57 |
container_start_page |
102679 |
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1790597495005380608 |