Presentation
Fever and cough.
Patient Data
Dense consolidation in the right upper lobe, with air bronchograms evident. The consolidation abruptly stops at the horizontal fissure.
Heart size normal. Left lung clear.
Case Discussion
Dense consolidation with a very defined appearance in keeping with the right upper lobe. This is very much lobar pneumonia.
In cases such as this, a follow chest x-ray is essential after antibiotics, to ensure it is not the result of a central mass causing post-obstructive change. This may be revealed on the later film or if unresolved merits further investigation.
The follow up film is typically 6 weeks after antibiotics, with an extra week added for each decade of life after the age of 60 years. For example, in this case, 8 weeks after treatment.
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