in some journals, I found that we need chest x-ray follow up in patients with pneumonia 6 weeks after we diagnosed them with pneumonia. Its function is to differentiate between pneumonia and lung cancer. For antibiotic effect after its administration in patient with pneumonia, should we follow up them with chest x-ray? and when does the right time to do that?
I am kind of agree with the 6 weeks follow up CXR if lung cancer is considered as your differential diagnosis. In general the pneumonic patched will not disappear in one week even antibiotics are effective so that follow up CXR in a few days is not recommended. The 6-week is kind of an arbitary number but practical to unnecessary work ups.
6-8 weeks chest radiographic follow-up is a good idea in anyone with risk for lung cancer. My personal rule, if they are 40 or older, I suggest it. Anyone younger, I don't formally suggest follow-up but don't discourage it either. Lung cancer from genetic mutations can present in people in their 20s and 30s.
if the patient improves with treatment ( improvement in cough , fever subsides & no dyspnea ) , there is no need for repeat x-ray . Complications such as parapneumonic effusion or progression of pneumonia should prompt repeat x-ray or CT-Chest . This approach is for Community acquired Pneumonia ( CAP ) .
Hello
You must check pneumonia will be cleaned in the chest x ray.
If pneumonia persiste you must look for another diagnosis as lung cancer, cop
As a general rule chest x-ray 6 weeks after treatment is wise in most adults with pneumonia, especially those 40 and over and certainly in people who are either current or past smokers.
It depends on the age , the risk factors and other comorbidities.
a 6 weeks a FU chest X ray is mandatory in a patient smoker, more than 40 years of age, still symptomatic....
4-6 weeks chest radiographic follow-up is mandatory in patient with pneumonia, However, anyone with risk for lung cancer should have chest x ray follow up earlier not more than 4 weeks.
AS FAR AS OUR PRACTICE WE REPEAT CXR AFTER 7 DAYS TO CHECK WORSENING OR NEW DEVELOPMENT, EVEN THOUGH PNEUMONIA TAKE 6 WEEKS TO RESOLVE COMPLETELY WE MAY GET SOME PARTIAL RESPONSE ON XRAY WITHIN ONE TO TWO WEKS
Thanks every one for your contribution. Actually, Chest x ray will improve in pneumonia if resolution process was complete. maybe we will find clinical improvement faster than chest x-ray resolution. How long does immune process take times to clear lesion in pneumonia after antibiotic gives good effect?
Dear Gina Amanda
What is your purpose of Chest X-Ray examination? Is it for evaluation or to differentiate it with Lung Cancer? If you want to evaluate patient with Pneumonia then you could evaluate it through clinical sign and symptoms and other modest laboratory findings such as blood routine within 3 days after antibiotic treatment. If you want to differentiate between lung cancer and pneumonia, then chest X Ray is not good choice since its specify and sensitivity are low. The CT Scan with contrast is the good cne while biopsy though Bronchoscopy is the gold standard. Careful clinical examination could determine whether it is pneumonia or lung cancer indeed.
follow up of radiological resolution is mandatory and preferred after 6 weeks as some cases has delayed resolution if you still have shadow you should do bronchoscopy or image guided biopsy to exclude lung cancer. now thoracic ultrasound is useful in suspecting lung cancer and in follow up of resolution of pneumonia. if there is static airbronchogram no need to wait 6 weeks, bronchoscopy is recommended as it is highly suggestive of post-obstructive pneumonia and if dynamic airbronchogram wait for resolution up to 6 weeks
definetly there are no clear guidelines for a control chest X ray in pneumonia after antibiotics administration.
It is related to the age , and absence or presence of comorbidities and risk factors in the patient. 3 weeks and above is a logilical interval to do it.
I typically do it at 8-12 weeks in adults. Definitely towards the 12-week side in COPD as it takes longer for pneumonias to resolve in emphysematous lung.
I agree with Mirna Waked that age ( > 40 years ) & risk factors ( smoking ) are important in determining the need for repeating chest x-ray in a patient with pneumonia . This is to exclude carcinoma lung .
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