A 63 year old man presents with productive cough, fever and breathlessness. He presents to the emergency department following two episodes of haemoptysis
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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.
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