Acute Chest Infections in Adults and Children: Evidence-Based Emergency Imaging

  • Sjirk J. WestraEmail author
  • Clinton Jokerst
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)


This chapter reviews the evidence base of imaging in acute respiratory illnesses (ARI) in children and adults. Chest radiography is indicated in the very young and in patients older than 40 years with ARI suspected to have community-acquired pneumonia (CAR), especially in those who are ill enough to require hospitalization. In young children, the imaging findings of viral and bacterial lung infections frequently overlap, making their differentiation difficult. Improved communication of the radiographic findings and their limitations can decrease overprescription of antibiotics by referring physicians, when no bacterial cause can be proven. CT adds value to radiography only in pulmonary infections that are complicated, recurrent, or occur in patients with an impaired immune system. Ultrasound is favored over CT to determine the need and feasibility and need for percutaneous drainage of parapneumonic effusions and empyemas in children.


Pneumonia Radiography Computed tomography Ultrasound Evidence-based imaging Cost-effectiveness of diagnostics Emergency imaging Evidence-based imaging 



Dr. Westra would like to acknowledge the work of Drs. G. Choy, P. H. Yager, and N. Noviski, his coauthors in a previous chapter on Imaging of Chest Infections in Children in Medina LS, et al., eds: Evidence-Based Imaging in Pediatrics: Improving the Quality of Imaging in Patient Care, published by Springer Science. That chapter served as a starting point for the pediatric content in this chapter, which has been thoroughly updated and revised for the topic at hand.


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric RadiologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of RadiologyMayo Clinic ArizonaPhoenixUSA

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