RESPIRATO

RY •INTHUJA
•NATASHA

RADIOLOG
•ARHAM
•INANI

Y
CASE SUMMARY
• 71 years old Malay man, ex-smoker with underlying COPD. Currently, he is on MDI
Berodual 2 puff TDS and MDI Spiolto-respimat 2 puff OD.
• He was recently admitted for 13 days at HSNZ (23/6/2023 - 5/7/2023) due to
AECOPD secondary to HAP. Discharged well with medication.
• Admitted to Hospital Dungun on 12/7/23 with complaint of shortness of breath
associated with chest tightness and noisy breathing on the day of admission.
Diagnosed with AECOPD secondary to HAP
• Current admission (17/7/2023), referred from Hospital Dungun for worsening of
symptoms with suspicious finding on chest radiograph.
• He denied prolonged cough, night sweats or contact with any TB patient. (TRO TB)
• He also denied any loss of appetite, loss of weight (TRO malignancy)
TIMELINE

23/6/2023 - 5/7/2023 12-16/7/2023 17/7/2023

• Admitted to HSNZ • Admitted to Hospital • Referred to HSNZ

for AECOPD Dungun with same due to worsening of
secondary to HAP diagnosis symptoms.
• Treated with • Presented with SOB, • Also, TRO suspicious
antibiotics and chest tightness and findings on chest
discharged well wheezing on day of radiograph
admission
On examination:
• Able to talk in full sentences
• No respiratory distress present
• Present of generalised rhonchi bilaterally.
• SpO2 95% under venturi mask oxygen 24%
• 11/7/23, 10.03PM

AP view upright sitting

Collimation was good able to see 1st
rib and hemidiaphragm.
Normal penetration
Non- rotated
Good inspiration
There is consolidation at right
middle lobe may suggest
pneumonia.
The diaphragm was flattened for
both side. Ribs seen is 9, indicated
lung hyperinflation.
Previous admission on
June 2023
 CT thorax
Coronal view
CT thorax
Axial view