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

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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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Diseases Related to Discussion

Pneumothorax
Lung Abscess