4. 1 and 3

There is volume loss as indicated by the tracheal and mediastinal shift to the right. There appear to be cavities with the consolidation. Although there could be a small pleural effusion, a large effusion would cause volume expansion and not volume loss. Furthermore, there is no meniscus sign as seen in a pleural effusion. The silhouetting of the right diaphragm is probably mostly due to consolidation.

Which of the following should be done at this time? (Click on the correct answer to proceed to the third of six pages)

  1. Serum ß-D-glucan assay
  2. Sputum culture for fungi
  3. Sputum culture for tuberculosis
  4. 1 and 3
  5. All of the above