Visual Diagnosis in Emergency Medicine| Volume 45, ISSUE 4, P612-614, October 2013

Broncholithiasis with Post-obstructive Pneumonia and Empyema

  • Shane M. Summers
    Reprint Address: Shane M. Summers, md, Department of Emergency Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Dr., JBSA Fort Sam Houston, TX 78234
    Department of Emergency Medicine, San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas
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      A 53-year-old woman presented to an Emergency Department in Iraq complaining of severe right-sided pleuritic chest pain for 24 h. She also reported one episode of hemoptysis, shortness of breath, and subjective fevers. She was seen in the clinic earlier the same day and diagnosed with right middle lobe pneumonia on plain chest radiography (Figure 1). She denied any risk factors for pulmonary embolism. Her past medical and surgical history was unremarkable.
      Figure thumbnail gr1
      Figure 1Posteroanterior and lateral views of the chest, obtained earlier in the same day, reveal the presence of consolidation in the lateral segment of the right middle lobe (asterisk). There is also a suspected perihilar calcified lymph node, consistent with remote fungal infection or old granulomatous disease (arrow).
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