How to determine pneumonia and bronchitis by chest X-ray

Most chest X-rays of bronchitis are normal, and a few may show enhanced lung texture. Chest radiographs of pneumonia are different depending on the causative organism. Commonly, as in the case of Streptococcus pneumoniae infection, X-rays show large infiltrating shadows or solid shadows, and in some cases there may be bronchial insufflation signs. In Klebsiella pneumonia, the inflammatory exudate is viscous and heavy, making the interlobular spaces prone to arcuate downward, and honeycomb changes can be seen. In viral pneumonia, the X-ray shows increased lung texture, fuzzy shadows, small patchy infiltrates, or extensive solid shadows, and in severe cases, even diffuse changes in both lungs can be seen. Chest radiographs have some limitations in visualizing pneumonia because some of the posterior cardiac margins and paraspinal areas are really hard to see, and it is necessary to check the chest front and side views, and in some cases, it may be necessary to check the CT in order to make a definitive diagnosis.