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Have pneumonia. X-ray showed lower lobe consolidation with increased coarsening peripherally. Infection or cancer?

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Internal Medicine Specialist
Practicing since : 1996
Answered : 961 Questions
my father has left lower lobe consolidation with increased coarsening peripherally does this mean he has an infection or cancer. He has had 3 chest infections since christmas, he uses inhalers for copd and has massive ankles, water retention, he takes 40mg of water tablets x 2 daily already and has done so for 6 months. has pneumonia at present and had xray which has revealed the above.
Posted Mon, 22 Apr 2013 in Lung and Chest disorders
Answered by Dr. Prasad Akole 1 hour later
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

Your father has underlying COPD and cor pulmonale (increased right heart overload secondary to COPD) and has 3rd pneumonia now.
COPD patients are prone to infections, more so at this age.

Recurrent pneumonia is common and a lowered immunity from whatever cause may enhance this chance.
His heart should be newly evaluated for the degree of dysfunction added by the pneumonia.

If all previous pneumonias were in the same left lower lobe, we must rule out any obstructive tumour (possibly cancer) there in the left LL bronchus.

Also resistant organisms may cause recurrent infections.

Does the Xray totally clear up with treatment each time?

If his oedema on the legs is increasing despite diuretics twice a day, we need to review his heart.

It would greatly help if you could uploadany reports / xrays here using the uploading service available on this site just below the text box. You can email the reports / scans to
with subject- (Attn: Dr. Prasad Akole)

I think a CT scan thorax (HRCT thorax) may be considered here (if not already) to look for causes like tumour/ complications.
A sputum culture is routinely done and antibiotics are tailored accordingly.

Please discuss with your treating team about these possibilities.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Please ask for any clarifications before closing and rating this answer.
Take care and please keep me informed of your progress at
Good Luck! Thank you!!
Above answer was peer-reviewed by
Follow-up: Have pneumonia. X-ray showed lower lobe consolidation with increased coarsening peripherally. Infection or cancer? 4 hours later
My dad has been referred for an echocardiogram and has got to have repeat x-ray in 7 days. My concern is shortness of breath at one point oxygen levels fell to 84 was admitted with levels 89 and how we can monitor his oxygen levels now back at home?
Answered by Dr. Prasad Akole 3 days later
You can not easily monitor oxygen levels at home, unless you have a portable finger pulse-oximeter.

You have to watch for breathlessness, distress and any bluish discoloration of fingertips. But it is a late sign.
If the oxygen saturation was at 84-89, did it improve with treatment to above 92%?
He should not be at home without O2 (oxygen) at lower saturations.

Good to know that an Echo has been planned.
We generally do all these investigations and treatments during hospital admission itself.
I do not have a good idea about how home care is delivered at your place.

Would be willing to read his reports soon.
If his breathlessness/ leg swelling is not settling, I would insist on an admission to the hospital (ICU).
Rest advice remains the same.
We also advise vaccination against pneumococci and influenza for such COPD patients, to reduce infection incidences.

Above answer was peer-reviewed by
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