A 45 year old man presents with 2 weeks of worsening fever, pleuritic chest pain and malaise.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is a multiloculated pleural effusion on the right side.
Left side is normal.
CLINICAL CORRELATION
This is likely to be pleural empyema.
IV antibiotics, further imaging and a chest drain are required.
CLINICAL PEARLS
Pleural drainage is definitely required with a chest tube.
It is not certain that a large bore drain is required – smaller e.g. 14-16F drains may be adequate with regular saline flushes to keep them patent.
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 |