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A scary chest X-ray
  1. Cameron K M W Schauer1,
  2. Caitlin M Prendergast2,
  3. Matlawene J Mpe1
  1. 1 Department of General Medicine, Whangarei Hospital, Whangarei, New Zealand
  2. 2 Whangarei Base Hospital, Whangarei, New Zealand
  1. Correspondence to Dr Caitlin M Prendergast, Whangarei Base Hospital, Private Bag 9742, Whangarei 0148, New Zealand; Caitlin.Prendergast{at}northlanddhb.org.nz

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Clinical introduction

A 50-year-old construction worker presented to our Emergency Department with a 24 h onset of respiratory distress. His medical history was most significant for a 15 pack-year tobacco smoking history and social marijuana use. The patient was only able to speak in short sentences and confirmed a 24 h history of productive cough, fevers and malaise. Examination showed saturations of 92% on a 15 L non-rebreathing Hudson mask. The trachea was midline and neck veins non-distended. He had hyper-resonance to percussion and corresponding decreased air entry over his entire right lung field and also the upper half of his left lung field.

Chest radiograph …

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