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Dr. Andrew Rynne

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What does chest X-ray showing shadows post pneumonia treatment indicate?

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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14308 Questions

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Posted on Wed, 28 Oct 2015 in Lung and Chest disorders
Question: My father had pneumonia, for which he was hospitalised for 6 days at the end of August. Yesterday we visited the consultant, expecting he would get the all clear, instead he still had a shadow on his left lung. The Doctor spend a lot of time reviewing all his xrays and the results of other tests. He told us there was no sign of cancer or TB, although he was still waiting on the results of the culture for the fluid on my fathers lungs which takes about 6 weeks to come through. Although he said that if it had been sinister he would have received notice within 3 weeks. My father is 80 years of age, and has always been in good health, although he does have anglelitus spondilitus (I have spelled that incorrectly). When he was admitted to the hospital, they performed a CT scan, daily xrays and they send a camera to investigate his lung internally and they found nothing untoward. They inserted a chest drain and removed 1.5 litres of fluid from his left lung. Prior to the hospital admission, my father had been ill for about a month. He had visited his GP every week and was prescribed with antibiotics, but his condition deteriorated. In the 10 days before the hospital stay he had great difficulty breathing, and as a result was unable to walk very far. He was also unable to lie down to sleep. Yesterday, the doctor prescribed a 12 day course of antibiotics and has arranged our next appointment for 6 weeks hence. Except for the shadow on his lung, otherwise my father has made a good recovery. He is eating well, has no pain, can walk and sleep normally, although he still has a cough although the phlem is now white. We are concerned that we may not be doing enough to care for my father. We are left to worry for 6 weeks about whether there is a more sinister reason for the shadow on his lung. Yesterday the doctor seemed to be perplexed by the xray, he spend a lot of time checking all the results of the tests before talking to us. What else can we really do except wait for the next appointment and if the shadow is still there, he said he would have a scan and then more tests. We don't really know what is going on. We are relying on the Medical profession but we think that Dad should have been admitted to the Hospital at least a week before he actually was , and then the infection and its aftermaths would have been less severe. My mother and I don't want to make the same mistake again, and we would be grateful for your advice.
doctor
Answered by Dr. Kaushal Bhavsar 2 hours later
Brief Answer:
Better to get done CT thorax with Contrast.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your situation and problem.
Persistence of Shadows on chest x ray even after treatment of pneumonia is commonly seen in
1. Non resolving pneumonia
2. Slowly resolving pneumonia
3. Fibrosis and healing
4. Cancer.
Non resolving pneumonia and slowly resolving pneumonia are common with tuberculosis, anaerobic infection, parasitic infection, fungal infection etc.
So CT thorax with Contrast is needed.
This will also help in diagnosis of fibrosis and cancer.
So better to get done CT thorax with Contrast.
Please let me know
1. Was he smoker?
2. Is he gaining weight?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wishing good health to your father. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 2 hours later
He was a smoker from his teens to his early forties, when he gave up completely.
He doesn't seem to have lost or gained weight. He is 6 foot 2 inches tall, and weighs about 16- 17 stone.

Do you think we should be getting the CT thorax with contrast test done immediately rather then waiting for another 6 weeks.

Many Thanks

XXXX
doctor
Answered by Dr. Kaushal Bhavsar 3 hours later
Brief Answer:
You can wait for 6 weeks.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
Since he is improving with symptoms, you can definitely wait for 6 weeks.
Get done repeat chest x ray after 6 weeks, if it is still showing shadow than get done CT thorax with Contrast.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your father.
Thanks.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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