CXR Case 060
A 54 year old male presents with cough, high fevers and sweats
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There are air bronchograms and consolidation in the medial segment of the left lower lobe.
*The rest of the lung fields are clear
CLINICAL CORRELATION
This is pneumococcal pneumonia.
The left medial hemidiaphragm is obscured, confirming that this is involving the lower lobe.
CLINICAL PEARLS
Streptococcus pneumoniae is cultured in 20-25% of cases of community acquired pneumonia but is responsible for ~65% of cases with bacteraemia from pneumonia.
* Studies using PCR to isolate S pneumoniae suggest the incidence may be 35-40% of CAP cases (very variable on region and population studied)
*The use of PCR to detect S pneumoniae and other common pathogens may well become routine practice in years to come.
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