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Pulmonary puzzle
Wandering consolidation
  1. Tatsuyuki Kawahara1,
  2. Nobuaki Ochi1,
  3. Katsuya Kato2,
  4. Kentaro Shibamoto2,
  5. Yasunari Nagasaki1,
  6. Nozomu Nakagawa1,
  7. Hidekazu Nakanishi1,
  8. Hiromichi Yamane1,
  9. Yasumasa Monobe3,
  10. Nagio Takigawa1
  1. 1 General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
  2. 2 Diagnostic and Therapeutic Radiology, Kawasaki Medical School, Okayama, Japan
  3. 3 Pathology, Kawasaki Medical School, Okayama, Japan
  1. Correspondence to Dr Nobuaki Ochi, General Internal Medicine 4, Kawasaki Medical School, Okayama 700-8505, Japan; placidus.aura{at}gmail.com

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Case presentation

A 47-year-old man developed chest pain and low-grade fever. He was diagnosed with pneumonia with parapneumonic pleural effusion using a chest X-ray image (figure 1A) and CT without contrast (figure 2A). Although he received azithromycin, followed by garenoxacin, imaging indicated worsening of the condition (figures 1B and 2B). As haemoptysis was observed, he was referred to our hospital.

Figure 1

Chest X-rays taken at the time of the first onset of illness (A), on the day of bronchoscopic examination (B), on the first day of prednisolone (0.5 mg/kg/day) treatment (C) and after prednisolone administration (0.5 mg/kg/day for 7 days and 1 mg/kg/day for 7 days) (D).

Figure 2

Chest CT scans obtained at the time of first onset of illness (A), at the time of the first visit to our hospital (B), on the day of bronchoscopic examination (C) and after prednisolone administration for 14 days (D). Arrowheads indicate the site for transbronchial lung biopsy.

He had never smoked and had been previously healthy except for atrial fibrillation that had been successfully treated via catheter ablation, without …

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