Demographics:
73 years old, Female
Indication:
Atrial fibrillation, chest pain
Findings
Chest radiograph
- Patchy bibasilar opacities
- Endotracheal tube tip projects 6 cm above the carina
- Left subclavian approach central venous catheter with tip overlying the SVC
- NG/OG tube tip and side-port overlie the gastric fundus
- CABG changes
CT
Chest
- Irregular wall thickening of the lower trachea and proximal mainstem bronchi with surrounding mediastinal fat stranding but no pneumomediastinum or mediastinal fluid collection
- Debris layering in the central airways
- Dependent consolidation and groundglass opacification in the right greater than left lower lobes and left upper lobe
- Widespread bronchial wall thickening and interlobular septal thickening
- Trace right pleural effusion
- Endotracheal tube terminates above the carina
- Left subclavian approach central venous catheter terminates in the SVC
- Post-CABG changes with postsurgical stranding/scarring in the anterior mediastinum
- Thoracic aortic atherosclerosis without aneurysm
- Moderate coronary artery calcification
Upper abdomen
- NG/OG tube terminates in the gastric fundus
MSK
- No acute findings
- Small subcutaneous nodule in the mid back soft tissues, likely a sebaceous cyst
Diagnosis
Tracheitis
Sample Report
Irregular thickening of the lower trachea and proximal mainstem bronchi with surrounding fat stranding suggestive of tracheitis/proximal bronchitis with surrounding mediastinitis. No pneumomediastinum or drainable fluid collection.
Multifocal pneumonia, which may relate to aspiration.
Trace right pleural effusion.
Discussion