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Lung diseases

Causes of Lower Right Lung Infiltration

05/12/2010

Question:

Was diagnosed with pneumonia in the E.R. I was treated with IV antibiotics and after ample dosing was to be sent home and continue antibiotics at home. Then I was told that I was in Acute Renal Failure and was being admited.White count was over 18,000 and I also had an U.T.I. Later I was told I did not have pneumonia. So what could this lower right lobe infiltration be,and what questions should I ask my doctor

Answer:

Quite a few pieces of information are not clear from your initial question. However, I will try to answer general questions about the diagnosis of pneumonia and its relationship to chest x-rays.

Pneumonia is a clinical diagnosis. That means that a doctor asks you questions, may perform some tests, examines you and then comes to a conclusion based on the information that you may have a problem. (Pneumonia in this case)

Your question is phrased “causes of lower right lung infiltration”. This implies that a chest x-ray was completed and that someone looked at it and thought that there were abnormal changes on that study located in the bottom part of the right lung. (Although those words did not appear in your question) These findings were then taken along with other information to give the clinical diagnosis of pneumonia. It then seems that subsequent review of available data suggested other problems. This may (although I cannot tell without information) be due to re-evaluation of the chest x-ray or review of subsequent studies.

Reading of chest x-rays may not always be easy or perfect. Subtle changes may sometimes be interpreted as normal and normal appearances can sometimes be perceived as being marginally abnormal. Very dramatic abnormalities usually are not easily overlooked or interpreted in different ways. Sometimes many things may have similar appearances even though they are very different.

It seems one important question to ask your physician is whether there is a real abnormality on your chest x-ray.

If there is no abnormality, then this is a moot point.

If there is an abnormality, then discuss what they believe it is and how they intend to follow or treat what is seen.

If there is uncertainty, then discuss ways to settle this uncertainty to insure that adequate testing, follow-up or treatment is in place.

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Response by:

Robert  Schilz, DO, PhD Robert Schilz, DO, PhD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University