Cough, fevers, interesting Chest Xray…

May 27, 2013

Chest XR, Non-Trauma, Respiratory, XR


This patient came in with cough, chills, fevers.  The patient’s initial pulse oximetry was 46% on room air, came up into the 90s on a non-rebreather mask.  He has had several months of weight loss and night sweats.  His chest xray:

PJP PNA

What are the concerning features of this Chest Xray and what would be on your differential diagnosis?

Answer to follow.

Author:  Russell Jones, MD

Image Contributor:  James Chenoweth, MD

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3 Comments on “Cough, fevers, interesting Chest Xray…”

  1. docskalski Says:

    Diffuse interstitial fibrosis with some air bronchogram signs… quite a wide differenital

    Relative sparing of the lung apices and notable absence of significant lymphadenopahty mitigate against infectious causes but do not rule them out. No silhouetting as well.

    Would include: adult ARDS, inhalation related, cystic fibrosis, autoimmune conditions, chronic eosinophilic pneumonia, granulomatous disease, medication induced.

    Reply

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