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.
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 | ICIS Course ANZ