Left lower lobe pneumonia

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Productive cough and fever

Patient Data

Age: 55
Gender: Male
x-ray

Region of consolidation with air bronchograms in the left lower lobe posterobasal segment identified.  No other abnormality seen.

Case Discussion

It is important to remember that left lower lobe pulmonary vessels should be able to be traced through the cardiac shadow on a PA chest x-ray. In this case the vessels cannot be traced and instead air bronchograms are seen consistent with consolidation (left lower lobe pneumonia). The medial portion of the left hemidiaphragm is also obscured. Consolidation in this area is easily missed on frontal projections by inexperienced readers and therefore it's an important check area to remember. 

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