Lobar

Pneumonia
• Konsolidasi homogen pada satu atau lebih
lobus paru, berbatas tegas pada fissure.
• Konsolidasi terjadi pada rongga alveoli dan
ada relative sparing terhadap bronkiolus  air
bronchogram
• Silhouette sign
• disebabkan oleh bakteri, terutama
streptococcus pneumoniae.
 Air bronchogram
Left upperlobe pneumonia.
- There are several black, branching structures in this
left upper lobe pneumonia (white arrows) that
represent typical air bronchograms seen in airspace
disease.
- This patient had pneumococcal pneumonia. The
disease is homogeneous in density, except for the
presence of the air bronchograms.
- Because this is airspace disease, its outer edges are
poorly marginated, indistinct, and fluffy (black arrow).
- Air bronchograms are much more likely to be visible
when the pneumonia involves the central portion of
the lung near the hilum. Near the periphery of the
lung, the bronchi are usually too small to be visible
Silhouette Sign
• Hilangnya batas dari struktur
intratorakal yang biasanya
terlihat akibat adanya
peningkatan densitas dari
struktur sekitarnya.
• Contoh gambar: Pneumonia
lobaris pada lobus medius
pulmo dextra yang menutupi
batas kanan dari jantung.
Broncho-pneumonia

Multiple small bilateral areas of

patchy confluent opacification,
lower zone predominant.
Findings are consistent with
bilateral bronchopneumonia.
The patient was admitted and
treated with IV antibiotics and
respiratory support.
Segmental Pneumonia
(Bronchopneumonia)

• The margins of segmental

pneumonia tend to be fluffy and
indistinct.
• air bronchograms are usually not
present and there is frequently
some volume loss (atelectasis)
associated with bronchopneumonia.
• Causal : Staphylococcus aureus,
Many gram-negative bacteria, such
as Pseudomonas aeruginosa
 Interstitial
pneumonia

Frequently, on chest x-ray, IPF

(idiopathic pulmonary fibrosis)
or UIP (usual interstitial
pneumonia) appears as
reticular and ground-glass
opacities in both lungs in
lower lobes with decreased
lung volumes.
 Interstitial
Pneumonia
• Adanya destruksi pada dinding
bronchioles dan septum interlobaris
menyebabkan terbentuknya
opasitas linear/reticular pada
daerah perihilar.
• Etiologi: viral pneumonia,
Mycoplasma pneumoniae, and
Pneumocystis pneumonia in
patients with acquired
immunodeficiency syndrome
(AIDS).
 Round
Pneumonia
• Spherical shape on chest radiographs.
• These round pneumonias are almost always
posterior in the lungs, usually in the lower lobes.
• Causative agents include Haemophilus
influenzae, Streptococcus, and Pneumococcus.
• A round pneumonia could be confused with a
tumor mass
Cavitary
Pneumonia
• Biasa terjadi pada Tuberkulosis
postprimer (reaktivasi), jarang pada
TB primer
 Meskipun terdapat beberapa pola
yang memberikan kecenderungan,
secara umum gambaran foto thoraks
tidak dapat membedakan secara
definitif antara pneumonia virus,
bakteri, mikoplasma, atau campuran
mikroorganisme tersebut
Tatalaksana umum
• Oksigen pada semua anak dengan saturasi <92%
• Antibiotik:

Kriteria rawat inap:

- SaO2 <92%, sianosis
- Nafas cepat
- Disstress pernafasan,
apnea intermiten, grunting
- Tidak mau menetek
• Supportive: antipiretik, suction mukus,
- Keluarga tidak bisa bronkodilator jika wheezing, kebutuhan cairan
merawat di rumah harian, nutrisi
• Terapi penyakit lain yang menyertai
Referensi
• Herring, W. 2016. Learning radiology: recognizing the basics. 3rd edition. Philadelphia.El
Sevier
• Bell, Dan J & Hacking, C. 2018. Pneumonia| Radiology Reference Article | Radiopaedia.org .
[online] Available at : https://radiopaedia.org/articles/pneumonia [Accessed 20 June
2018].
• Kasper et al. 2015. Harrison’s principles of internal medicine, ed.19, McGrawhill : New York
• Gamache, J. 2017. Bacterial Pneumonia [online] available at : https
://emedicine.medscape.com/article/300157-overview#a1 [Acessed 20 June 2018]
• Ikatan Dokter Indonesia. 2014. Panduan Praktik Klinis Bagi Dokter di Fasilitas Pelayanan
Kesehatan Primer.
• Perhimpunan Dokter Paru Indonesia. 2003. Pneumonia Komuniti Pedoman &
Penatalaksanaan di Indonesia.
Terima Kasih
Mohon Asupan