CXR Case 005

An 18 yo male presents with fevers, productive cough with fresh haemoptysis, and wheeze. He has a background history of frequent chest infections as a child and teenager.

CXR CASE 005 LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is upper lobe predominant bronchial wall thickening and ring shadows suggestive of bronchiectais and possibly cystic fibrosis.

In the left mid zone there is a cavity with a fluid level and surrounding consolidation suggesting a lung abscess*


CLINICAL IMPLICATIONS

The haemoptysis could be from the bronchiectais or the lung abscess.

*In the immunocompetent, the microbiology of lung abscess is commonly mixed anaerobes*


CLINICAL PEARLS

Pulmonary haemorrhage (from abscess extension into the lung parenchyma and erosion of blood vessels) is an unusual complication of pulmonary abscess and may require bronchial artery embolization and rarely surgical lobectomy.


TOP 150 CXR SERIES



Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar |

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