Bulging fissure sign (lobar consolidation)
The bulging fissure sign refers to lobar consolidation where the affected portion of the lung is expanded causing displacement of the adjacent fissure. Any type of pneumonia or space-occupying process can lead to bulging (sagging) fissure sign. Classically, it has been described in right upper lobe (RUL) consolidation secondary to Klebsiella pneumonia. It is now rarely seen due to prompt antibiotic therapy for suspected pneumonia.
The most common infective causative agents are :
- Streptococcus pneumoniae: pneumococcal pneumonia
- Klebsiella pneumoniae: Klebsiella pneumonia
- Pseudomonas aeruginosa: pseudomonas pulmonary infection
- Staphylococcus aureus
Other uncommon agents are:
- Legionella pneumophila
- Mycobacterium tuberculosis
It may also be seen with:
