Pneumonia that is slow to resolve after appropriate antibiotic therapy can be a problem. Nonresolving pneumonia has been variously defined by Amberon in 1943, Henden in 1975, and Fein and colleagues in 1987 and 1993. In general, this entity is thought to be present when a patient does not improve clinically or when a radiographic infiltrate resolves slowly despite adequate and appropriate antibiotic therapy. About 10% of diagnostic bronchoscopy procedures and 15% of pulmonary consultations are performed to evaluate a nonresolving infiltrate.

Pneumonia; Synonyms: Pneumonitis, bronchopneumonia: A chest X-ray showing a very prominent wedge-shape area of airspace consolidation in the right lung characteristic. Chest X-Ray - Lung disease Four-Pattern Approach. Lobar pneumonia. On the chest x-ray there is an ill-defined area of increased density in the right upper lobe.

S pneumoniae pneumonia S pneumoniae causes 10-50% of all cases of community-acquired pneumonia (CAP). Radiographic consolidation of the alveoli begins in the peripheral airspaces, as in the image below. The disease usually causes a lobar or segmental pattern, and a patchy bronchopneumonic pattern involving the lower lobes is seen in the elderly.

A striking characteristic of S pneumoniae infection is its tendency to involve the pleura. Parapneumonic effusions are common in pneumococcal pneumonia. S aureus pneumonia This type of pneumonia may be seen as a complication of influenza, particularly during an epidemic. S aureus pneumonia usually begins in the peripheral airways rather than in the acini proper. In adults, patchy bronchopneumonia is more common and often bilateral, though lobar consolidation may be seen. Late development of abscesses is relatively common.

When staphylococcal pneumonia occurs as a complication of influenza, it is usually rapidly progressive with extensive bilateral pneumonia that resembles pulmonary edema. Coauthor(s) David H Posner, MD Assistant Professor of Medicine, New York University School of Medicine; Assistant Chief of Pulmonary Diseases, Instructor, Intensive Care Unit, Education Coordinator for Pulmonary Fellowship, Lenox Hill Hospital Disclosure: Nothing to disclose. Mina Farhad, MD, PhD Clinical Instructor of Radiology, New York University School of Medicine; Head of Thoracic Imaging, Department of Radiology, Lenox Hill Hospital Mina Farhad, MD, PhD is a member of the following medical societies: Disclosure: Nothing to disclose. Klaus-Dieter Lessnau, MD, FCCP Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies:,,,, Disclosure: Nothing to disclose.

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