Problems since infection now chest X-ray
October 4, 2015 | 50,00 EUR | answered by Dr. med. Christoph Schmülling
I had/have an acute bronchitis with mild fever of 38.5 to 39 about 2 weeks ago (since 20.09). This was treated with antibiotics. The sputum is white again, but in the last 5 days there have been occasional traces of blood in the mucus. (That's why the chest X-ray was done).
I received the following findings (chest X-ray) and have a few questions. The findings: Regular depth of inspiration with symmetrical, open and smooth diaphragm domes. The lungs are properly expanded and transparent. Accentuation of the bronchovascular structures, especially near the hila and in the lower fields, as well as significantly prominent lung hila. The bronchi hit orthogradically are slightly thickened in the walls, with no clear changes in caliber. No opacity of the peribronchial lung tissue, no alveolar or interstitial shadows. Assessment: Severe exacerbation of chronic bronchitis with peribronchial indurations without evidence of inflammatory lung infiltrates or focal lung ventilation disorders.
My questions are: - What does accentuation of the bronchovascular structures mean? - Are thickening of the bronchial walls curable again? What does "no clear caliber fluctuations" mean? - What exactly does "chronic bronchitis with peribronchial indurations" mean? What is meant by peribronchial indurations? Is this a lung inflammation or scarring? Is this COPD? Can the exacerbation of chronic bronchitis still heal?
Thank you for your response.
Dear inquirer,
You write that you have recently had an acute bronchitis or that it is still in the process of healing. Therefore, all radiological findings should be considered as likely related to this. The X-ray of the lungs is a snapshot of a condition and must always be evaluated in the context of a comprehensive assessment with knowledge of the patient's medical history and course of the illness. For example, "the orthograde taken (i.e. shown as undistorted as possible in cross-section) bronchi are slightly thickened" is a finding that is quite "soft" and could fit into the picture of an acute bronchitis, but also into the picture of an emerging chronic bronchitis. If you are a smoker, then the likelihood of developing chronic bronchitis increases, and quitting smoking would be strongly advised (for other reasons as well). If you are a non-smoker, then acute bronchitis is much more likely as the cause, and the changes will fully regress.
There are no fluctuations in caliber in your bronchi (which could indicate chronic bronchial diseases) and there are no signs of pneumonia (no infiltrates). In summary:
- An X-ray is always (!) just a tool that must be interpreted individually in the context of knowledge of the patient's medical history and condition.
- There is nothing in your findings that contradicts the possibility that the image is completely explained by the state of acute bronchitis.
- Your treating physician will, together with you, based on your personal medical history and course of the illness, decide whether a follow-up X-ray should be performed in 4-6 weeks, for example. The decision will be different for a previously healthy young patient with no lung disease and a normal course than for a 60-year-old smoker.
I hope I have satisfactorily answered your question and wish you a speedy recovery and a pleasant Sunday.
Best regards,
Dr. med. Christoph Schmülling
Specialist in Internal Medicine
