CXR Case 037
A 24 year old man presents with fever, pleuritic chest pain on the right and a dry cough.
AP CXR 
Lateral CXR
click images to enlarge
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
CLINICAL CORRELATION
This is most likely a lung abscess.
* Risk factors including immune suppression should be assessed.
CLINICAL PEARLS
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.
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