Which radiographic finding is most associated with pneumonia in a postoperative patient?

• A. Bibasilar infiltrates
• B. Pleural effusion
• C. Atelectasis
• D. Hyperinflation

Answer: (A)

Postoperative pneumonia typically presents as new air-space consolidation in the dependent parts of the lungs. Gravity and reduced chest movement after surgery make the bases the most common site for infectious consolidation, so bibasilar infiltrates best reflect pneumonia in this setting. Atelectasis, a frequent postoperative companion, usually appears as linear, plate-like densities with signs of volume loss rather than the more dense, confluent air-space opacity seen with infection. Pleural effusion can accompany pneumonia but is not as specific, and hyperinflation would indicate overdistension rather than infection.