Aspiration pneumonia

Case contributed by Bálint Botz
Diagnosis almost certain

Presentation

Aspiration event a few hours before presentation

Patient Data

Age: 80 years
Gender: Female

Initial CXR (Supine, AP)

x-ray

Bilateral inhomogeneous patchy airspace opacities mainly in the lower zones. Effacement of the costophrenic recesses consistent with aspiration.

Day 3

x-ray

Compared to the previous radiograph, there is marked improvement seen in the right lung; however, there is no sign of regression in the left lower zone. There is also a nasogastric tube which appears to be appropriately positioned.

Day 10

x-ray

A confluent consolidation with air bronchograms has developed in the left lower zone, completely effacing the diaphragm on that side.

Findings are in line with left lower lobe aspiration pneumonia. The nasogastric tube remains in a satisfactory position.

Control CXR two weeks later

x-ray

After successful treatment, an almost complete regression of the the left lower lobe consolidation can be seen. 

Case Discussion

The case demonstrates a typical course of aspiration and subsequent lower lobe pneumonia in elderly patients. The causative microorganism in this case was determined to be E.Coli. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.