14 yo male c cough since 3 days n loose stool 2 days brought to emergency in shock...wid severe metabolic acidosis...on ionotrops.

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Rt mid zone consolidation. With prominent horizontal fissure. Hospitalise the patient Iv antibiotics, stabilise the patient Watch for vitals Investigate in detail PNEUMONIC CONSOLIDATION

Thickened minor fissure. Lobulated and enlarged right hilar shadow. Enlarged lymhnodes. Consolidation right mid zone. Pneumonitis/Tubercular.

Rt Middle Lobe Pneumonia ( Round Pneumonia ) Any Immunodeficiency state sir ?

Pneumonic Consolidation with Prominent Horizontal Fissure

Right middle zone consolidation with lymphadenopathy.

Right mid zone pneumonitis with fissural edema

Rt.middle zone pneumonia..

14 year old presenting with shock/cough /?loose stools X only 3 days...does not say fever..radiologically no doubt about radiological homogenous round shadow With clear borders..no cavitation...definitely upper lobe Possibly anterior segment..?volume loss in the upper lobe..? Compensatory emphysema in the lower lobe.. Synpneumonic effusion (horizontal fissure). Here what worries is shock to be on ionotropes.. Metabolic acidosis( wise anion gap? that is what you want to say?.No ABG?.Coin shadow in Pediatrics ..it is more than coin ..(Staph)..FB in 14 year unlikely.. Any Tumor /collapse consolidation.. What ever lung pathology is ..I don’t think it is explaining shock with very limited history and no labs Other than cxr...certainly ABCD approach to stabilise the patient...Antibiotics yes..but overall diagnosis? Presenter has conclusive answer?

Since the consolidation is also seen above the horizontal fissure I suppose the upper lobe is also involved and it has a well drfined rounded margin a hilar mass should be excludes, so a lateral film and CT should be done after stabilising the patient and management of shock hypoxia and acidosis are definitely the priority

Right mid zone consolidation.. Thicked minor fissure... Dx- Pnumonitis, TB start O2, treat met acidosis, start antibiotics

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