Hemithorax white-out (pneumonia)

Case contributed by Ryan Schwertner


Three-day history of productive cough, chills, and nausea/vomiting

Patient Data

Age: 30 years
Gender: Female

Complete white-out of left lung with air bronchogram sign consistent with total consolidation. Patchy areas of ground glass opacities in right lung. There is silhouetting of the left heart border and left hemi-diaphragm. There is no rib crowding to suggest atelectasis. 

Case Discussion

Complete white-out of the hemithorax with air bronchograms and trachea in a central position is consistent with consolidation secondary to pneumonia. The patient is on linezolid, micafungin, and piperacillin-tazobactam pending culture and susceptibility studies. 

Differential diagnosis of hemithorax white-out with a midline trachea include:

  • consolidation
  • pulmonary edema/ARDS
  • pleural mass
  • chest wall mass

Case made with the help of Dr Jayanth Keshavamurthy, Medical College of Georgia, Augusta.

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