Admission Chest X-ray. Initial chest X-ray demonstrating left perihilar, right mid and lower lung patchy opacities, which may represent pneumonia or aspiration (white arrows). There is blunting of the right costophrenic angle may represent a small pleural effusion or pleural thickening (blue arrow). There is a left paratracheal opacity, superior to the aortic arch, which may represent lymphadenopathy (green arrow). 