Search tips
Search criteria 


Logo of thoraxThoraxVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Thorax. 1984 January; 39(1): 28–33.
PMCID: PMC459717

Comparative radiographic features of community acquired Legionnaires' disease, pneumococcal pneumonia, mycoplasma pneumonia, and psittacosis.


The features of the chest radiographs of 49 adults with legionnaires' disease were compared with those of 91 adults with pneumococcal pneumonia (31 of whom had bacteraemia or antigenaemia), 46 with mycoplasma pneumonia, and 10 with psittacosis pneumonia. No distinctive pattern was seen for any group. Homogeneous shadowing was more frequent in legionnaires' disease (40/49 cases) (p less than 0.005), bacteraemic pneumococcal pneumonia (25/31) (p less than 0.01) and non-bacteraemic pneumococcal pneumonia (42/60) (p less than 0.05) than in mycoplasma pneumonia (23/46). Multilobe disease at presentation was commoner in bacteraemic pneumococcal pneumonia (20/31) than in non-bacteraemic pneumococcal pneumonia (15/60) (p less than 0.001) or legionnaires' disease (19/49) (p less than 0.025). In bacteraemic pneumococcal pneumonia multilobe disease at presentation was associated with increased mortality. Pleural effusions and some degree of lung collapse were seen in all groups, although effusions were commoner in bacteraemic pneumococcal pneumonia. Cavitation was unusual. Lymphadenopathy occurred only in mycoplasma pneumonia (10/46). Radiographic deterioration was particularly a feature of legionnaires' disease (30/46) and bacteraemic pneumococcal pneumonia (14/27), and these groups also showed slow radiographic resolution in survivors. Radiographic resolution was fastest with mycoplasma pneumonia; psittacosis and non-bacteraemic pneumococcal pneumonia cleared at an intermediate rate. Residual intrapulmonary streaky opacities remained in over a quarter of survivors from legionnaires' disease (12/42) and bacteraemic pneumococcal pneumonia (5/19).

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (797K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Macfarlane JT, Finch RG, Ward MJ, Macrae AD. Hospital study of adult community-acquired pneumonia. Lancet. 1982 Jul 31;2(8292):255–258. [PubMed]
  • White RJ, Blainey AD, Harrison KJ, Clarke SK. Causes of pneumonia presenting to a district general hospital. Thorax. 1981 Aug;36(8):566–570. [PMC free article] [PubMed]
  • Kirby BD, Peck H, Meyer RD. Radiographic features of Legionnaires' disease. Chest. 1979 Nov;76(5):562–565. [PubMed]
  • Dietrich PA, Johnson RD, Fairbank JT, Walke JS. The chest radiograph in legionnaires' disease. Radiology. 1978 Jun;127(3):577–582. [PubMed]
  • Fairbank JT, Mamourian AC, Dietrich PA, Girod JC. The chest radiograph in Legionnaires' disease. Further observations. Radiology. 1983 Apr;147(1):33–34. [PubMed]
  • Jay SJ, Johanson WG, Jr, Pierce AK. The radiographic resolution of Streptococcus pneumoniae pneumonia. N Engl J Med. 1975 Oct 16;293(16):798–801. [PubMed]
  • STENSTROM R, JANSSON E, WAGER O. Ornithosis pneumonia with special reference to roentgenological lung findings. Acta Med Scand. 1962 Mar;171:349–356. [PubMed]
  • Borthwick RC, Cameron DC, Philp T. Radiographic patterns of pulmonary involvement in acute mycoplasmal infections. Scand J Respir Dis. 1978 Aug;59(4):190–193. [PubMed]
  • Finnegan OC, Fowles SJ, White RJ. Radiographic appearances of mycoplasma pneumonia. Thorax. 1981 Jun;36(6):469–472. [PMC free article] [PubMed]
  • Miller AC. Early clinical differentiation between Legionnaires' disease and other sporadic pneumonias. Ann Intern Med. 1979 Apr;90(4):526–528. [PubMed]
  • Kennedy DH, Borland W. How common is Legionnaires' disease? Lancet. 1983 Feb 12;1(8320):360–361. [PubMed]
  • Tew J, Calenoff L, Berlin BS. Bacterial or nonbacterial pneumonia: accuracy of radiographic diagnosis. Radiology. 1977 Sep;124(3):607–612. [PubMed]
  • Taryle DA, Potts DE, Sahn SA. The incidence and clinical correlates of parapneumonic effusions in pneumococcal pneumonia. Chest. 1978 Aug;74(2):170–173. [PubMed]
  • Scanlon GT, Unger JD. The radiology of bacterial and viral pneumonias. Radiol Clin North Am. 1973 Aug;11(2):317–338. [PubMed]
  • Helms CM, Viner JP, Sturm RH, Renner ED, Johnson W. Comparative features of pneumococcal, mycoplasmal, and Legionnaires' disease pneumonias. Ann Intern Med. 1979 Apr;90(4):543–547. [PubMed]
  • Macfarlane JT, Macrae AD. Psittacosis. Br Med Bull. 1983 Apr;39(2):163–167. [PubMed]

Articles from Thorax are provided here courtesy of BMJ Publishing Group