title: An 80-year-old man with a right upper lobe opacity.
abstract: OBJECTIVE
  The differential diagnosis of a right upper lobe pulmonary opacity in an elderly afebrile patient includes infectious and malignant etiology. However, unilateral lung edema should also be included in the differential diagnosis.
  
  
  METHODS
  Case report of an 80-year-old afebrile patient who presented with cough, dyspnea and blood-tinged sputum and had an isolated right upper lobe infiltrate on chest X-ray on whom a diagnostic work-up including computed tomography scan of the chest and echocardiography was performed.
  
  
  RESULTS
  Bilateral alveolar opacities and pleural effusions, not apparent on the chest X-ray, and a flail posterior leaflet with severe mitral valve regurgitation were revealed. His symptoms and findings responded to diuretic treatment.
  
  
  CONCLUSIONS
  Pulmonary edema should be considered in a patient with mitral valve regurgitation presenting with a unilateral lung infiltrate. Chest computed tomography scan findings consistent with heart failure and echocardiography demonstrating mitral valve regurgitation are the main clues to the diagnosis. Diuretic therapy should cause a rapid improvement of the radiologic and clinical findings.
authors.affiliation: Tuberculosis Clinic and Pulmonary Division, Nazareth Hospital, Faculty of Medicine, Galilee Bar-Ilan University, Nazareth, Israel.
authors.forename: Hashem
authors.initials: H
authors.lastname: Bishara
authors.affiliation: Internal Medicine Department, Nazareth Hospital, Faculty of Medicine, Galilee Bar-Ilan University, Nazareth, Israel.
authors.forename: Amer
authors.initials: A
authors.lastname: Saffuri
authors.affiliation: Tuberculosis Clinic and Pulmonary Division, Nazareth Hospital, Faculty of Medicine, Galilee Bar-Ilan University, Nazareth, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weiler-Ravell
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D019468:Disease Management; D004452:Echocardiography; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging*; D011654:Pulmonary Edema / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
keywords: mitral insufficiency; mitral regurgitation; pulmonary edema; unilateral