CXR Case 052

A 45 year old male is found collapsed in respiratory distress and is intubated on arrival in emergency

CXR CASE 052 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

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.


CLINICAL CORRELATION

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)


CLINICAL PEARLS

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.


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 |

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