Definition
- Bulging of the minor fissure below its normal, roughly horizontal position at the level of the 4th rib anteriorly) due to increased volume of the RUL
Etiology
- Post-Obstructive Pneumonia Associated with Bronchogenic Carcinoma (see Pneumonia):
- Bronchioloalveolar Cell Carcinoma (see Bronchioloalveolar Cell Carcinoma)
- Klebsiella pneumoniae (see Klebsiella Pneumoniae): 62% of cases
- Streptococcus pneumoniae (See Streptococcus Pneumoniae): 14% of cases
- Acinetobacter calcoaceticus var. anitratus (see Acinetobacter): occasional
- Haemophilus influenzae (see Haemophilus Influenzae): occasional
- Yersinia pestis (see Yersinia Pestis): occasional
- Tuberculosis (see Tuberculosis): occasional
Diagnosis
Prognosis
- Bulging fissures have no prognostic significance
References
- The diagnostic and prognostic significance of bulging fissures in acute lobar pneumonia. Aust NZ J Med 1988; 18:130-133
- Complications of Klebsiella pneumoniae: CT evaluation. J Comput Assist Tomogr 1995; 19:176-181
- Guidelines for the management of adults with community-acquired pneumonia: diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 2001; 163:1730-1754
- The pathophysiology and treatment of sepsis. N Engl J Med 2003; 348:138-150
- Treating patients with severe sepsis. N Engl J Med 1999; 340:207-214