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Home | Top 100 | TOP 150 CXR | CXR Case 036

CXR Case 036

by Dr Fraser Brims, last update September 10, 2018

A 19 year old man is found collapsed at a friends house and brought to ED. His mates say he has been drinking alcohol heavily but deny other drug use.

BP 92/53, warm and dilated peripherally, Temp 37.7C, responds to voice.

  • CXR CASE 036 CXR LITFL
    CXR
  • CXR CASE 036 CT LITFL
    CT chest

click images to enlarge


Describe and interpret this CXR and CT chest


IMAGE INTERPRETATION

CXR Interpretation:
There is diffuse air space shadowing in the right mid zone with an area of central lucency and air fluid level.
*A left nipple ring is noted
The rest of lung parenchyma and pleura are normal

CT Interpretation:
CT demonstrates a thick walled cavity in the apical segment of the right lower lobe.
*There is an air fluid level with some surrounding consolidation


CLINICAL CORRELATION

The most likely diagnosis is aspiration from reduced conscious level causing a lung abscess and systemic sepsis.


CLINICAL PEARLS

The anatomical location of an abscess caused by aspiration relates to the position an individual was lying / sitting in when aspiration occurs – with the apical segment of the lower lobe often being the first stop for aspirated material when lying supine.


TOP 150 CXR SERIES



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About Dr Fraser Brims

A/Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic

+ Fraser Brims | Google Scholar

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