Rhinovirus is a common viral cause of community-acquired pneumonia (CAP) in adults and children, though it is more often associated with upper respiratory tract infections. On CT chest, the findings are nonspecific and overlap with other viral pneumonias. Reported patterns include:
Collage of chest radiograph and CT demonstrating lower lobe predominant viral pneumonia. The chest X-ray shows left lower lobe opacity. Corresponding coronal and axial CT images demonstrate crazy paving with thickened interlobular septa and superimposed ground-glass opacities. There is also peribronchial thickening consistent with small airway involvement. The differential includes rhinovirus pneumonia, other viral pneumonias (influenza, RSV, COVID-19), Pneumocystis jirovecii pneumonia, and less likely organizing pneumonia or alveolar hemorrhage in this clinical setting.
Ashley Davidoff MD, TheCommonVein.com (b12981c)
CT Appearance of Rhinovirus Pneumonia
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Ground-glass opacities (GGO):
Usually patchy and bilateral, sometimes confluent. Most often in a peribronchial or subpleural distribution. -
Consolidation:
Can be focal or multifocal, often mixed with GGOs (“GGO + consolidation” pattern). -
Bronchial wall thickening & tree-in-bud nodules:
Reflect small airway involvement, sometimes present. -
Interlobular septal thickening:
Can give a “crazy-paving” appearance when superimposed on GGO. -
Lower lobe predominance is described more often, but distribution may be variable.
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Absence of large pleural effusions or lymphadenopathy:
Helps distinguish viral from bacterial pneumonia in many cases.
Comparative Note
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Rhinovirus CT findings overlap heavily with influenza, RSV, adenovirus, and SARS-CoV-2 pneumonia.
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No pathognomonic CT sign exists. The diagnosis relies on clinical setting and PCR confirmation from respiratory specimens.
👉 In summary: Rhinovirus pneumonia on CT most often appears as bilateral, patchy GGOs with areas of consolidation, sometimes with bronchial wall thickening and tree-in-bud nodules, but lacks specific distinguishing features.
Comparative CT Patterns: Rhinovirus vs Other Viral Pneumonias
| Virus | CT Findings |
|---|---|
| Rhinovirus | • Bilateral patchy GGOs • Patchy consolidations • Peribronchial and subpleural distribution • Bronchial wall thickening • Occasional tree-in-bud nodularity • Lower lobe predominance |
| Influenza | • Diffuse bilateral GGOs • Consolidations more confluent than rhinovirus • Peribronchovascular distribution • Frequent crazy-paving (GGO + septal thickening) • May progress rapidly with ARDS |
| RSV (Respiratory Syncytial Virus) | • Peribronchial thickening prominent • Centrilobular nodules • Tree-in-bud opacities common • Patchy GGOs and consolidation • Atelectas |