Q fever pneumonia: CT findings

PURPOSE: To evaluate the computed tomographic (CT) features of Q fever pneu monia. MATERIALS AND METHODS: The authors retrospectively reviewed the chest radio graphs and CT scans obtained in 12 patients, who were selected on the basis of chest CT availability from a group of patients with a definite diagnosi s of acute Q fever infection during an 8.5-year period. RESULTS: In all cases, CT depicted lesions indicative of airspace involveme nt, which was expressed as lobar (n = 3), segmental (n = 3), patchy (n = 3) , or a combination of these patterns (n = 3). Involvement of more than one robe was observed in seven (58%) patients. In one patient with multiple pat chy areas of consolidation, nodular lesions with a vascular connection and a halo of ground-glass opacity, which were suggestive of an angioinvasive p rocess, were demonstrated. In addition, CT performed in a patient with acut e Coxiella burnetii infection who abused alcohol revealed necrotizing pneum onia. Pleural effusions were seen at both CT and radiography in three patie nts, and mild lymph node enlargement in isolated regions was seen at CT in four patients. Chest radiography was less accurate than CT in the detection of segmental and patchy areas of consolidation. CONCLUSION: The typical CT findings of Q fever pneumonia consisted mainly o f multilobar airspace consolidation. A nodular pattern accompanied by a hal o of ground-glass opacification and vessel connection, and necrotizing pneu monia in the setting of impaired immunity were less frequent.