CXR Case 116

CXR Interpretation:
There is patchy airspace shadowing over the medial aspect right mid zone.
The hila structures are still visualized.
The remaining parenchyma and pleura are clear.

Lateral CXR Interpretation:
There is lobar consolidation of the right apical segment, lower lobe.

This is lobar pneumonia.

Considering the description of ?haemoptysis – pneumococcal pneumonia is possible as this classically produces a ‘rusty brown‘ sputum which, in turn, classically is miss-labelled as haemoptysis.

Pneumococcal urinary antigen is strongly recommended in many community acquired pneumonia guidelines.
It is a simple, cheap investigation with good sensitivity with rapid processing time.

A positive pneumococcal urinary antigen in the appropriate clinical setting would support narrowing antibiotics to treat for Streptococcus pneumoniae.