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Viral Chest Infection
Michael R. Aquino, MD, MHSc
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Terminology varies, can be confusing
          • Bronchiolitis (as defined by American Academy of Pediatrics): Viral lower respiratory tract infection in infants with "acute inflammation, edema, & necrosis of epithelial cells lining small airways," & ↑ mucus production
          • Lower respiratory tract infection may describe findings identical to bronchiolitis in patients ≥ 2 years old but may also refer to any infection of lower airways & parenchyma
          • Viral pneumonia may refer to viral infection of lung parenchyma ± airways infection
          • Peribronchial pneumonia sometimes used to differentiate airways infection from parenchymal involvement
          • Lower airways disease includes viral airways infection as well as asthma

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              Selected References

                              1. Jain S et al: Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 372(9):835-45, 2015
                              2. Rhedin S et al: Respiratory viruses associated with community-acquired pneumonia in children: matched case-control study. Thorax. 70(9):847-53, 2015
                              3. Ralston SL et al: Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 134(5):e1474-502, 2014
                              4. Bradley JS et al: Executive summary: the management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 53(7):617-30, 2011
                              5. Franquet T: Imaging of pulmonary viral pneumonia. Radiology. Jul;260(1):18-39, 2011
                              6. Ruuskanen O et al: Viral pneumonia. Lancet; 377(9773):1264-1275, 2011
                              7. Yoo SY et al: H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities. Clin Radiol. 66(4):334-9, 2011
                              8. Bramson RT et al: Interpretation of chest radiographs in infants with cough and fever. Radiology. 236(1):22-9, 2005
                              9. Copley SJ: Application of computed tomography in childhood respiratory infections. Br Med Bull. 61:263-79, 2002
                              10. Kim EA et al: Viral pneumonias in adults: radiologic and pathologic findings. Radiographics. 22 Spec No:S137-49, 2002
                              11. Virkki R et al: Differentiation of bacterial and viral pneumonia in children. Thorax. 57(5):438-41, 2002
                              12. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                              13. Juven T et al: Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J. 19(4):293-8, 2000
                              14. Markowitz RI et al: The spectrum of pulmonary infection in the immunocompromised child. Semin Roentgenol. 35(2):171-80, 2000
                              15. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                              16. Katz DS et al: Radiology of pneumonia. Clin Chest Med. 20(3):549-62, 1999
                              17. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                              18. Wahlgren H et al: Radiographic patterns and viral studies in childhood pneumonia at various ages. Pediatr Radiol. 25(8):627-30, 1995
                              19. Korppi M et al: Comparison of radiological findings and microbial aetiology of childhood pneumonia. Acta Paediatr. 82(4):360-3, 1993
                              20. Kirkpatrick JA: Pneumonia in children as it differs from adult pneumonia. Semin Roentgenol. 15(1):96-103, 1980
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Clinical Issues

                                    TERMINOLOGY

                                    • Definitions

                                      • Terminology varies, can be confusing
                                      • Bronchiolitis (as defined by American Academy of Pediatrics): Viral lower respiratory tract infection in infants with "acute inflammation, edema, & necrosis of epithelial cells lining small airways," & ↑ mucus production
                                      • Lower respiratory tract infection may describe findings identical to bronchiolitis in patients ≥ 2 years old but may also refer to any infection of lower airways & parenchyma
                                      • Viral pneumonia may refer to viral infection of lung parenchyma ± airways infection
                                      • Peribronchial pneumonia sometimes used to differentiate airways infection from parenchymal involvement
                                      • Lower airways disease includes viral airways infection as well as asthma

                                    IMAGING

                                    • General Features

                                      • Radiographic Findings

                                        • CT Findings

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                CLINICAL ISSUES

                                                • Presentation

                                                  • Demographics

                                                    • Natural History & Prognosis

                                                      • Treatment

                                                        DIAGNOSTIC CHECKLIST

                                                        • Consider

                                                          Selected References

                                                          1. Jain S et al: Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 372(9):835-45, 2015
                                                          2. Rhedin S et al: Respiratory viruses associated with community-acquired pneumonia in children: matched case-control study. Thorax. 70(9):847-53, 2015
                                                          3. Ralston SL et al: Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 134(5):e1474-502, 2014
                                                          4. Bradley JS et al: Executive summary: the management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 53(7):617-30, 2011
                                                          5. Franquet T: Imaging of pulmonary viral pneumonia. Radiology. Jul;260(1):18-39, 2011
                                                          6. Ruuskanen O et al: Viral pneumonia. Lancet; 377(9773):1264-1275, 2011
                                                          7. Yoo SY et al: H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities. Clin Radiol. 66(4):334-9, 2011
                                                          8. Bramson RT et al: Interpretation of chest radiographs in infants with cough and fever. Radiology. 236(1):22-9, 2005
                                                          9. Copley SJ: Application of computed tomography in childhood respiratory infections. Br Med Bull. 61:263-79, 2002
                                                          10. Kim EA et al: Viral pneumonias in adults: radiologic and pathologic findings. Radiographics. 22 Spec No:S137-49, 2002
                                                          11. Virkki R et al: Differentiation of bacterial and viral pneumonia in children. Thorax. 57(5):438-41, 2002
                                                          12. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                                                          13. Juven T et al: Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J. 19(4):293-8, 2000
                                                          14. Markowitz RI et al: The spectrum of pulmonary infection in the immunocompromised child. Semin Roentgenol. 35(2):171-80, 2000
                                                          15. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                                                          16. Katz DS et al: Radiology of pneumonia. Clin Chest Med. 20(3):549-62, 1999
                                                          17. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                                                          18. Wahlgren H et al: Radiographic patterns and viral studies in childhood pneumonia at various ages. Pediatr Radiol. 25(8):627-30, 1995
                                                          19. Korppi M et al: Comparison of radiological findings and microbial aetiology of childhood pneumonia. Acta Paediatr. 82(4):360-3, 1993
                                                          20. Kirkpatrick JA: Pneumonia in children as it differs from adult pneumonia. Semin Roentgenol. 15(1):96-103, 1980