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ANSWER

Right sided consolidation with pleural effusion.
It is possible the effusion is actually already fibrosed and/or loculated. An ultrasound and/or lateral decubitus Xray is needed to confirm the efusion. Ultrasound confirmed the effusion.

SUMMARY

A12 year old previously healthy male who immigrated from Zimbabwe in January 2001 with history of illness of 1 month duration presenting with respiratory tract symptoms, cachexia, hepatosplenomegaly, and clubbing with a chest x-ray showing right sided consolidation with pleural effusion.

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