46-year-old chronic smoker with bullous emphysema presents with fever and cough for the last 4 days. Diagnosis: 1. Hydropneumothorax 2. Infected bulla 3. Lung abscess
most likely it is infected bulla ,as pt is not dyspneic, hydropneumothoax is unlikely. second there is no cavity wall visible lung abcess unlikely.advice ,Sp afb,sp c/s pyogenic and CT thorax for diagnosis.
The shadow is less dense to call a fluid. Though it gives an impression of a fluid level but a possibility of collapse consolidation should be considered
looks more like collapse consolidation to me. auscultatory and percussion findings will help us more. one thing is for sure this is not how fluid appears on cxr,and the area above that straight line has vascular markings which goes against pneumotic component too.
infected bulla could be most probable diagnosis.as the cp angle is not obliterated may be hydropneumo thorax secondly.needs a CT chest
Hydropeumothorax, advised MRI chest and under water seal drainage.
hydropneumothorax
right middle lobe consolidation , could be an infected bulla. USG thorax most easily available, non invasive and a very useful modality.
Hydropneumothorax
Lung Abscess
effusion in horizontal fissure R ( ? infected ) + bulla R lower zone
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