
Have Pneumonia. X-ray Showed Lower Lobe Consolidation With Increased Coarsening Peripherally. Infection Or Cancer?

I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) 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
YYYY@YYYY
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 http://bit.ly/Dr-Prasad-Akole
Good Luck! Thank you!!


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.

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