PMC4298925_01
Previous X-ray
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F1
Chest X-ray was suggestive of left side encysted pleural effusion [Figure 1] and initial pleural fluid analysis showed lymphocyte predominant exudative type pleural effusion with low adenosine deaminase (ADA).
Previous computed tomography
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F2
Patient's computed tomography (CT) thorax at that time confirmed encysted pleural effusion left side and small necrotic posterior mediastinal node and splenic cyst [Figure 2].
Chest X-ray at time of presentation
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F3
Chest X-ray showed features of volume loss and blunting of left costophrenic angle with fracture of left eighth rib [Figure 3].
Computed tomography new
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F4
Patient was subjected to CT thorax which shows multiple areas of subsegmental atelectasis noted in basal segments of left lower lobe, minimum displacement fracture lateral aspect of left eighth rib with adjacent collection (osteomyelitis), multiple enhancing lesions in spleen, and splenic cysts [Figure 4].
Culture plate
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F5
Pus culture and sensitivity report came as B. pseudomallei with corn flower colonies [Figure 5] and bipolar staining safety pin appearance on microscopy [Figure 6].
Microscopy
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F6
Pus culture and sensitivity report came as B. pseudomallei with corn flower colonies [Figure 5] and bipolar staining safety pin appearance on microscopy [Figure 6].
Current chest X-ray
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F7
Repeat chest X-ray showed clearance of lung shadow [Figure 7].