Hospital-acquired pneumonia chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]


An important test for making a diagnosis of pneumonia is a chest x-ray. Chest x-rays can reveal areas of opacity (seen as white) which represent consolidation, pleural effusion, air bronchogram and/or cavitations. Pneumonia is not always seen on x-rays, either because the disease is only in its initial stages, or because it involves a part of the lung not easily seen by x-ray.

Chest X-ray

X-ray shows homogenous radio-opaque areas in bilateral lung fields. These represent areas of consolidation.
Image courtesy of Dr Aditya Shetty, Radiopedia. (original file here). Creative Commons BY-SA-NC
  • The American Thoracic Society recommends that all patients with a suspicion of nosocomial pneumonia should have a chest x-ray to confirm diagnosis and determine the severity of the disease.[1]
  • A chest X-ray also helps to determine pleural effusions or cavitations, as a possible complication.
  • Ideally, the chest X-ray should be posteroanterior and lateral, but this will depend on the patient's condition.
  • Findings include the following:[2]
  • Chest X-ray is also used to assess improvement or lack of clinical response in hospitalized patients.


  1. "Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. ISSN 1073-449X.
  2. Koenig, S. M.; Truwit, J. D. (2006). "Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention". Clinical Microbiology Reviews. 19 (4): 637–657. doi:10.1128/CMR.00051-05. ISSN 0893-8512.

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