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Page 5 / Case 10.03

ANSWER

1. There has been deterioration in the interval
2. Cavitating lesion in the right lower lobe demonstrates lucency keeping with an air crescent sign
3. Increased parenchyma opacity in right lower lobe
4. Abnormal consolidation in the left lower lobe and lingula
5. Small added density (nodule) in right upper lobe is worrisome of endobronchial spread infection

Anti fungal is changed to Ambisone (liposomal amphotericine )
Her temperature decreased, the WBC started increasing, and she started to show some clinical improvements.

However, on July 21st she had increasing cough, fever, vomiting, and abdominal pain.

A chest X-ray done then is seen below.

ENLARGE this chest Xray.

WHAT IS THE MAIN ABNORMALITY IN THE CHEST X-RAY RELATED TO INVASIVE PULMONARY ASPERGILLOSIS?



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