Left lower lobar pneumonia presenting as flank pain

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Patient presenting with left flank pain, fever, elevated CRP and white cell count, ? intra-abdominal sepsis

Patient Data

Age: 45
Gender: Male

Lobar consolidation in left lower lobe. In the context of sepsis these findings are consistent with pneumonia (completely unexpected by the clinicians)

Case Discussion

Lower lobar pneumonia can present as abdominal or flank pain and fever to the clinicians thus misinterpreted as cholecystitis or pyleonephritis. Always include a basal lung assessment using lung windows on all abdominal CT cases.

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