A 63 year old man presents with productive cough, fever and breathlessness. He presents to the emergency department following two episodes of haemoptysis
click images to enlarge
Describe and interpret this CXR
CHEST X-RAY 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.