Q: I got my Chest X-ray PA done and the report shows: non-specific infective changes in both lungs. What does this mean?

A:Infection of the lungs may be caused by typical or atypical bacteria, tuberculosis, atypical mycobacteria, viruses, fungi or other parasites. Each of these is accompanied by suggestive clinical (fever, cough, chest pain etc) and laboratory features (microbiological & haematological) which, when taken together with the X-ray findings, help define the underlying disease. Bacterial pneumonia on an X-ray is suggested on the basis of focal or diffuse opacities seen in the lungs often accompanied by air bronchograms, parapneumonic effusions and features of complications like lung abscesses and atelectasis. The findings in primary tuberculosis are nonspecific and include segmental or lobar airspace consolidation, ipsilateral hilar and mediastinal lymphadenopathy, and/or pleural effusion. There may be atelectasis and parenchymal consolidation. As it heals, the lung opacity tends to become rounded and shrinks into a small nodule, which may later calcify or ossify. Postprimary or reactivation tuberculosis may appear as patchy or confluent airspace opacities. There may be cavity formation or a tuberculoma or there may be endobronchial spread. Viral pneumonia involves the epithelium and adjacent interstitial tissue and appears as poorly defined nodules and patchy areas of peribronchial ground-glass opacity and airspace consolidation, with variable hyperinflation of the lung. You need to ask your doctor what the X-ray report means and its clinical implication.