A 24 year old man presents with fever, pleuritic chest pain on the right and a dry cough.
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Describe and interpret this AP and lateral CXR
CHEST X-RAY INTERPRETATION
AP CXR Interpretation:
There is a cavitating lesion in the right mid zone laterally with an air fluid level and surrounding consolidation.
Allowing for slight rotation and a left nipple ring, the film is otherwise normal.
Lateral CXR Interpretation:
Lateral X-Ray confirms the presence of a cavitating lesion with air fluid level and surrounding consolidation.
The lesion is situated in the apical segment of the right lower lobe
This is most likely a lung abscess.
* Risk factors including immune suppression should be assessed.
Patients only have a productive cough if there is a draining bronchus.
*Classic organisms associated with acute lung abscesses include: Staphylococcus aureus, Klebsiella sp, Pseudomonas sp and Proteus sp.
*In the immune suppressed this can also include: TB, fungal, legionella sp and pneumocystis jirovecii infection.