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Papers of the Week


2019 Jul


Emerg Med J


36


7

Curious CXR.

Authors

Pluck G, Friedman M, McGrath H
Emerg Med J. 2019 Jul; 36(7):442-450.
PMID: 31320335.

Abstract

A 98-year-old man with 2 days of headache, nausea, malaise and unsteadiness was referred to the ED by his GP with a suspicion of an intracranial bleed. His medical history included atrial fibrillation (AF) (taking warfarin). Observations were SpO2 95% on air, RR24, HR88, BP210/104, GCS14, Temp 34.3. On examination he had bilateral creps and was sleepy but not confused. A septic screen was undertaken and intravenous ceftriaxone given. His CTH was essentially normal. His CXR is shown in figure 1 emermed;36/7/442/F1F1F1Figure 1Anteropsterior(AP) CXR at presentation. QUESTION: What is the diagnosis?Acute collapse and consolidation secondary to pneumonia.Spontaneous haemothorax.Acute consolidation with underlying old TB.Traumatic lung contusions.