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X-ray showed small patchy opacities in the bilateral mid and lower zones. How serious is it?

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I am admitted for severe cough and being treated in a hospital ICU for neumonia, which the x-ray showed. The x-ray report say few ill-defined small patchy opacities seen in the bilateral mid & lower zones, more on lfet side -s/o small patchy consolidation. Other parts are normal. They say it is atypical neumonia and changed the anti-biotics twice. They now suspect it is viral neumonia. How serious is it? What tests would confirm it?
Posted Wed, 23 Jan 2013 in Lung and Chest disorders
Answered by Dr. Shashi Dangwal 1 hour later

Thanx for posting your query on XXXXXXX

There are various causes of pneumonia. Commonest is bacterial pneumonia. Atypical pneumonia is caused by certain organisms like M pneumonae, chlamydia or legionella. Then there is viral pneumonia caused by certain viruses. Atypical and viral pneumonia are usually milder than bacterial pneumonia in normal and healthy young adults where as they can be more serious in children, elderly and immunocompromised individuals.

For the treatment, follow your treating doctor`s advice. Antibiotics are given to treat any superadded bacterial infection. Take rest, consume plenty of fluids and healthy diet. You may require nebulization and oxygen and some times even steroids for breathing difficulty. Your doctor will look into all these aspects.

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Follow-up: X-ray showed small patchy opacities in the bilateral mid and lower zones. How serious is it? 1 hour later
The HRCT reads "diffuse reticular opacities with interstitial thickening in bilateral lung field basal segment of left lung." What does it indicate?
Answered by Dr. Shashi Dangwal 52 minutes later

Reticular opacities with thickening of interstitial septa is a finding commonly seen in ILD or interstitial lung disease. This kind of picture may also be seen in viral pneumonia but it should resolve as you recover whereas in ILD these are generally permanent.

You could be suffering from ILD which has manifested now.Your doctors should rule out ILD in your case. Various tests are bronchoscopy to obtain some fluid and tissue from the lung, PFT, Diffusion studies and some more.

Take care.
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