Late 2019 Chest X-ray

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Clinical information

  • 72-year-old female
  • Chronic lymphocytic leukaemia (CLL) in remission
  • Being investigated for per rectal bleeding and iron deficiency anaemia
  • Short of breath at rest

Late 2019 Chest X-ray

  • Prior chest X-ray shown for comparison
  • All areas of the lungs appear normal
  • Specifically the peripheries of the lung bases are clear

Admission chest X-ray (April 2020)

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Clinical information

  • Acute onset shortness of breath at rest
  • Known CLL and iron deficiency anaemia
  • O2 saturation 85% on 15 litres of O2
  • Bilateral basal crackles
  • Tested swab positive for COVID-19 earlier on the same day

Admission chestX-ray (April 2020)

  • AP chest
  • Nasogastric tube in situ
  • Bilateral patchy airspace shadowing
  • The pattern is asymmetric with peripheral shadowing on the left and more perihilar shadowing on the right
  • Although not very dense the shadowing is extensive - compare with the previous image above
  • Classification: Severe

CPAP commenced

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Clinical information

  • Worsening of respiratory failure
  • Continuous Positive Airway Pressure (CPAP) started
  • This patient died two days later

CPAP commenced

  • The lung shadowing is denser and more extensive
  • Classification: Severe

Page author: Salisbury NHS Foundation Trust UK (Read bio)

Last reviewed: May 2020