Published: 2017-07-20

A study of respiratory distress in patients with bilateral lung opacities admitted in a tertiary care hospital

Mahendra Nagar, Anil Saxena, Suman Khangarot, Babulal Bansiwal, Anees K. V., Jitendra Phulwari


Background: Patients presented with respiratory distress along with bilateral lung opacities, like infections, Neoplasia, primary abnormality of the airways, pulmonary edema, pulmonary haemorrhage, acute respiratory distress syndrome, and interstitial lung diseases is a common scenario in our hospitals. The chest radiograph remains the basic radiological tool in many rural hospitals in our country. Thus, we aimed to study the patients presenting with respiratory distress having bilateral opacities in chest radiograph admitted in a tertiary care centre.

Methods: This study was cross sectional study conducted in the department of respiratory medicine, New Medical College and Hospital, Kota for a period of one year on indoor patients. Fifty patients were studied by detailed clinical history, thorough physical examination, chest x-ray, routine haematological, sputum, electrocardiogram and relevant investigations.

Results: Amongst 50 patients we found tuberculosis in 32% cases, pneumonia in 28%, pulmonary edema in 16%, silicosis (ILD) in 8 %, fungal pneumonia in 8 %, malignancy in 4% and aspiration pneumonia in 4% cases.

Conclusions: Patients presenting with respiratory distress and bilateral lung opacities can have different diagnosis, most of them can be diagnosed by thorough history, clinical examinations and basic investigations. Proper diagnosis is essential in these patients for their management.


Bilateral lung diseases, Bilateral lung opacities

Full Text:



Woodring JH, Vandiviere HM, Fried AM, Dillon ML, Williams TD, Melvin IG. Update: The radiographic features of pulmonary tuberculosis. AJR Am J Roentgenol. 1986;146:497-506.

Leung AN, Müller NL, Pineda PR, FitzGerald JM. Primary tuberculosis in childhood: Radiographic manifestations. Radiology. 1992;182:87-91.

Choyke PL, Sostman HD, Curtis AM, Ravin CE, Chen JT, Godwin JD, et al. Adult-onset pulmonary tuberculosis. Radiology. 1983;148:357-62.

Mukund A, Khurana R, Bhalla AS, Gupta AK, Kabra SK. CT patterns of nodal disease in pediatric chest tuberculosis. World J Radiol. 2011;3:17-23.

Haque AK. The pathology and pathophysiology of mycobacterial infections. J Thorac Imaging. 1990;5:8-16.

Leung AN. Pulmonary tuberculosis: The essentials. Radiol. 1999;210:307-22.

Raniga S, Parikh N, Arora A. Is HRCT reliable in determining disease activity in pulmonary tuberculosis. Ind J RadiolImag. 2006;16:221-8.

Palmer PE. Pulmonary tuberculosis: usual and unusual radiographic presentations. Semin Roentgenol. 1979;14:204-43.

Hadlock FP, Park SK, Awe RJ, Rivera M. Unusual radiographic findings in adult pulmonary tuberculosis. AJR Am J Roentgenol. 1980;134:1015-8.

Müller NL, Franquet T, Lee KS. In: McAllister L, editor. Imaging of pulmonary infections. Philadelphia, Pa: Wolters Kluwer/Lipponcott Williams and Wilkins; 2007.

Fraser RS, Pare JAP, Fraser RG, Pare PD. Infectious disease of the lungs. Synopsis of diseases of the chest. 2nd ed. W.B. Saunders company. 1994:287-391.

Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses. Occupational Safety and Health series No 22. Geneva International Labour Office. 2011 (Rev).

Heitzman ER, Ziter FM. Acute interstitial pulmonary edema. Am J Roentgenol Radium Ther Nucl Med. 1966;98:291-299.

Milne EN, Pistolesi M, Miniati M, Giuntini C. The radiologic distinction of cardiogenic and noncardiogenic edema. AJR Am J Roentgenol. 1985;144:879-94.

Friis B, Eiken M, Hornsleth A, Jensen A. Chest X-ray appearances in pneumonia and bronchiolitis. Correlation to virological diagnosis and secretory bacterial findings. ActaPaediatr Scand. 1990;79(2):219-25.