PMC6349301_01
Erect chest radiograph on day of admission showing left tension hydropneumothorax with significant mediastinal displacement.
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Imaging of her chest on admission revealed a left tension hydropneumothorax with significant mediastinal displacement and mixed density fluid containing air within the fluid component of the hydropneumothorax (Fig. 1, Fig. 2).
Erect chest radiograph on day 7 showing left-sided chest drain in situ, extensive loss of volume and consolidation in left hemithorax.
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A repeat chest radiograph on day 7 showed extensive loss of volume and consolidation in left hemithorax (Fig. 3) thus an additional third antimicrobial, clindamycin 800mg IV TDS, was commenced.
Erect chest radiograph on day 16 showing persistent left sided atelectasis and hydropneumothorax despite intervention with chest drain and 16 days of intravenous antibiotics.
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Erect chest radiograph at 6-month follow up showing resolution of hydropneumothorax and minimal residual pleural change on right side.
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At her 6-month interval follow up she was clinically well, a bronchoscopy was unremarkable and the hydropneumothorax had resolved with some residual volume loss on left side (Fig. 6).