CHEST 2023 On Demand Pass-Pulmonary Infections Clinical Case Puzzlers

Video Transcription

Video Summary

The first case presented a 72-year-old male with a known history of COPD and bronchiectasis who had recently recovered from COVID-19 pneumonia. He presented to the emergency department with fever, dyspnea, and cough. On chest X-ray, there was an opacity in the left upper lobe and a new opacity in the right base on subsequent X-ray. CT imaging showed consolidation with air bronchograms in the right lower lobe, consistent with a low-bar pneumonia. The patient underwent bronchoscopy, and the bronchial alveolar lavage (BAL) fluid was sent for pathogen testing. Legionella pneumophila was detected, and the patient was treated with antibiotics. The patient gradually recovered over a two-week hospital stay. In the second case, an 18-year-old female swimmer presented with worsening symptoms following a dental procedure. Chest X-ray showed a large cavity in the right upper lobe, surrounded by consolidation. CT imaging confirmed these findings, and the patient underwent bronchoscopy, which revealed inflamed tissue and purulent material in the right upper lobe. The patient was treated with antibiotics and gradually improved. The imaging findings were consistent with a bacterial lung abscess. In both cases, bronchoscopy was performed to obtain samples for further testing and to guide appropriate treatment.

Meta Tag

Category Chest Infections

Session ID 5002

Speaker Jordan Finizio

Speaker Lauren Groner

Speaker Kirk Jones

Speaker Stephen Machnicki

Speaker Anthony Saleh

Speaker Rakesh Shah

Speaker Kasem Sirithanakul

Speaker Henry Tazelaar

Track Chest Infections

Keywords

COPD

bronchiectasis

COVID-19 pneumonia

fever

dyspnea

chest X-ray

CT imaging

Legionella pneumophila

antibiotics

bronchoscopy

bacterial lung abscess

Chronic Obstructive Pulmonary Disease