Comparison of high-resolution computed tomography findings between Pseudomonas aeruginosa pneumonia and Cytomegalovirus pneumonia

Objective To compare pulmonary high-resolution CT (HRCT) findings in patients with Pseudomonas aeruginosa pneumonia to HRCT findings in patients with Cytomegalovirus (CMV) pneumonia. Methods We studied 124 patients (77 men, 47 women; age range, 20–89 years; mean age, 65.4 years) with P. aeruginosa pneumonia and 44 patients (22 men, 22 women; age range, 36–86 years; mean age, 63.2 years) with CMV pneumonia. Results CT findings of consolidation ( p < 0.005), bronchial wall thickening ( p < 0.001), cavity ( p < 0.05), and pleural effusion ( p < 0.001) were significantly more frequent in patients with P. aeruginosa pneumonia than in those with CMV pneumonia. Centrilobular nodules, a crazy-paving appearance, and nodules were significantly more frequent in patients with CMV pneumonia than in those with P. aeruginosa pneumonia (all p < 0.001). Conclusion Pulmonary HRCT findings, such as bronchial wall thickening, crazy-paving appearance, and nodules may be useful in distinguishing between P. aeruginosa pneumonia and CMV pneumonia. Key Points • Distinguishing Pseudomonas aeruginosa pneumonia from Cytomegalovirus pneumonia is important. • Characteristic features of underlying conditions are present in each pneumonia species. • Bronchial wall thickening and cavities are more frequent in Pseudomonas aeruginosa pneumonia. • Nodules and a crazy-paving appearance are more frequent in Cytomegalovirus pneumonia.