CXR Case 088

This 43 year old man was discharged from hospital 1 week ago having been treated for pneumonia

CXR CASE 088 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is left sided consolidation and loculated air within a complex pleural effusion which surrounds the hemithorax.

There is a left hydropneumothorax.

Right lung field is clear.


CLINICAL CORRELATION

This is a complex empyema with pneumothorax.

Given the advanced pleural involvement this man should be considered for VATS early.


CLINICAL PEARLS

Despite IV antibiotics, chest drains and surgery, empyema still has a 15-20% mortality.

Despite being fit for surgery, some refuse: Dupuytren, Napoleon’s Surgeon declined surgery for his empyema, stating, “I would rather die at the hands of God than of surgeons”.


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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