CXR Case 088
This 43 year old man was discharged from hospital 1 week ago having been treated for pneumonia
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 | ICIS Course ANZ