Scan the lung: Point-of-care ultrasound of a pulmonary consolidation with loculated pleural effusion.

Thoracic ultrasound has become an increasingly valuable tool in the evaluation of critically ill patients in the emergency department (ED). The utility of point-of-care ultrasound (POCUS) to identify suspected pneumothorax, pulmonary edema, pleural effusion and pneumonia has been well established (Pagano et al.; Brogi et al.; Cortellaro et al.; Irwin and Cook [1-4]). The 2014 American College of Emergency Physicians (ACEP) Ultrasound Imaging Compendium included lung and pleural ultrasound with the primary indication of identifying pneumothorax and pleural effusion as part of the core POCUS indications for all emergency physicians [5]. We present a unique case in which a patient presented to the ED in respiratory distress. Portable chest X-ray demonstrated near complete opacification of his right hemithorax. POCUS demonstrated a large right sided loculated pleural effusion with associated septations and surrounding consolidation suggestive of a parapneumonic effusion.