Aspiration pneumonia

Case contributed by Dr Balint Botz

Presentation

Aspiration event a few hours before presentation

Patient Data

Age: 80 years
Gender: Female
X-ray

Initial CXR (Supine, AP)

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

X-ray

Day 3

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.

X-ray

Day 10

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.

X-ray

Control CXR two weeks later

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. 

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Case information

rID: 64251
Published: 12th Nov 2018
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included
Institution: University of Pécs

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