Imaging of Bacterial Pulmonary Infection in the Immunocompetent Patient

Pulmonary infection is a common reason for imaging of the lung and a common incidental finding in immunocompetent patients. Findings on chest radiography are nonspecific in defining acute infection; however, the radiologist should be aware of classically described patterns of infection, including air space, bronchopneumonia, and interstitial patterns. The radiologist must also be aware of potential limitations of the sensitivity of chest radiography. Imaging findings at computed tomography in acute infection have been poorly studied but may be more specific. Aspiration and septic emboli are additional potential radiographic patterns of infection that may be very characteristic in appearance. In the setting of nonresolving pneumonia, the differential diagnosis includes noninfectious causes as well as a variety of atypical infectious agents, specifically, mycobacterial and fungal agents, which have overlapping but distinctive clinical and radiographic presentations.