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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2007.128asm-2-128What's Your Diagnosis?A 19-year-old male with cough and right lower lobe opacity Al-Khouzaie Thamer H. *Bukhari Medhat †AL Jameel Ahmed J. ‡Abdelaliam Awani A. §
* Division of Internal Medicine Services, Dhahran Health Center, Aramco, Dhahran, Saudi Arabia
† Division of Surgical Services, Dhahran Health Center Aramco, Dhahran, Saudi Arabia
‡ Division of Internal Medicine Services, Dhahran Health Center, Aramco, Dhahran, Saudi Arabia
§ Division of Radiology Services, Dhahran Health Center, Aramco, Saudi ArabiaCorrespondence and reprint requests: Dr. T. Al-Khouzaie. Internal Medicine Services Division, Room A-420-42, Dhahran Health Center, Aramco, DH, Saudi Arabia, T: (03) 877-3524, F: (03) 877-3790, thnerr@hotmail.comMar-Apr 2007 27 2 128 128 01 6 2006 Copyright © 2007, Annals of Saudi Medicine2007This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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A 19-year-old male was referred for investigation of left lower lobe opacity. He was well until two months prior to his presentation when he developed a persistent productive cough of yellow phlegm, and a fever two weeks prior to his presentation. He denied chest pain, wheezing, dyspnea, or hemoptysis. He had no history of recent travel, contact with a person with active tuberculosis, or weight loss.

On physical examination, the blood pressure, pulse and respiratory rate were normal. His temperature was 37.2°C. There was no cyanoses or clubbing. Chest examination revealed decreased breath sounds over the right lung base. Heart sounds were of normal intensity, with physiologic splitting and without audible murmur. The remainder of the examination was normal.

What are the abnormal findings on the chest CT scan (Figure 1)

What is your diagnosis?

Answer on page 136

Figure 1 Contrast C.T. scan