Chest x-ray showed Left sided lower lung consolidation.

[revcathfrog]

After a review with practice nurse, after noticing my bronchiectasis hasn't been right for a year now, numerous chest infection. Anyway change and increase of meds and I was sent for chest x-ray which showed consolidation. So antibiotics taken, sputum sample taken but shows no infection. Is this just a consolidation without infection which should improve with increase carbosistene and mucus extractor?

[Hidden]

I could be wrong, but my understanding is that consolidation related to a respiratory condition is either active infection or demonstrative of underlying lung damage. If it were purely mucus plugging likely to respond to intensive physio without any infection behind it, that appears differently on x-ray, but if it is purely an infective indicator, some if not all of the consolidation can clear up with appropriate treatment, including airway clearance.

I think one of the biggest banes of dealing (even by association in my case) with respiratory conditions is that just because sputum results are negative - sometimes even those obtained by BAL during a bronch - that doesn’t mean there’s no bacteria down there causing problems. If you’ve been having recurrent issues, even if they’ve been responding to antibiotics, it could be you’ve got a pocket of infection that keeps flaring. The child had a lower left pneumonia that showed up as a slight but noticeable increase in cough and SOB, and consolidation on an x-ray luckily taken as standard for an annual review appointment: the tertiary team didn’t think there was anything wrong in spite of my concerns, so wouldn’t have agreed an x-ray otherwise. Fast forward 3 years, and although the films have improved a bit, she still has persistent and consistent consolidatory changes in the same area on x-ray, and I can guarantee you that if an infection doesn’t start there, it will absolutely always end up there, the area often palpably rattling if she’s got a full on exacerbation. A CT scan after moving teams last year showed that the worst of her small airway disease and bronchiectasis is in that area, and in her case, the x-ray reflects the lung damage she has, and why it tends to be a focal area for infections. Given an entirely negative bronch in spite of a spontaneous (green) sample the day before being positive for multiple things, we also think it’s probably where she’s harbouring some of the bacteria and fungus that have permanently taken up residence. Situations like these are one of the reasons why having baseline x-rays to compare to in superlative lung diseases is really important, so that medics know what’s normal for the patient, as opposed to what’s normal for someone without a disease.

[Cade1 in reply to Hidden]

Agree with you Charlie_G re lots of bacteria. They are colonising the mucus ie living quite happily but because there are so many of them they are fighting with each other & therefore no one bacteria is able to cause an infection.

[revcathfrog in reply to Hidden]

Thank you makes complete sense.