CXR Case 052

There are bilateral air bronchograms and consolidation in both upper lobes including the lingula.
The left hemidiaphragm is a little indistinct, possibly reflecting early lower lobe consolidation, or small pleural effusion
* There is an ETT, an NGT in situ, with a left subclavian line.

This is severe multilobar pneumonia.

*We know the lingula is involved because the left heart border has been lost (as distinct to the right heart border)

Sputum cultures and urinary antigens for pneumococcus and Legionella are routinely recommended in all cases of pneumonia.

*The urinary antigen is useful as you generally get an answer back quicker than traditional sputum cultures.