Left Basal Pneumonia Diagnosed by Clinicoradiological Correlation in a Presentation of Abdominal Pain: Case Report

Abstract

The case of a previously healthy 34-year-old Costa Rican man is described, who presented with acute abdominal pain in the left flank, accompanied by fever and diaphoresis, without evident respiratory manifestations, which initially led to a diagnostic orientation toward an abdominal etiology. However, comprehensive clinical evaluation identified decreased breath sounds in the left hemithorax, while laboratory studies revealed leukocytosis with neutrophilia and chest radiography showed a left pleural effusion, subsequently confirmed and characterized by computed tomography. Clinico-radiological correlation was key to establishing the diagnosis of left basal pneumonia. Broad-spectrum antibiotic therapy was initially administered; however, due to an unfavorable clinical course, pulmonary decortication was performed, after which the patient showed progressive improvement until medical discharge. In this case, the timely identification of the underlying pulmonary etiology highlights the importance of correlating clinical history with physical examination to recognize atypical presentations of pneumonia and prevent diagnostic delays.