CXR Case 053
A 79 year old man is placed on non invasive ventilation for progressive type II respiratory failure with a history of worsening cough and fevers.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is volume loss and fibrosis in the left upper lobe (hilum pulled up).
There is airspace opacification in the right lower lobe on a background of possible fibrosis throughout both lung fields.
CLINICAL CORRELATION
This man has acute right sided pneumonia, exacerbating his already weak ventilatory reserve.
* The left upper lobe fibrosis is highly likely to be caused by TB
CLINICAL PEARLS
*Sending sputum cultures for AFB is mandatory in this situation – this guy had reactivation of his TB – nothing like some positive pressure to help generate aerosolized mycobacterium!
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