We report the case of a 45-year-old male patient, a smoker, with a known condition of situs inversus totalis (SIT), who was diagnosed with an alveolar consolidation process during a chest imaging examination. Thorough medical investigations, including a surgical lung biopsy, resulted in the diagnosis of pulmonary infarction. The patient's clinical picture began suddenly, with chest pain of a stabbing character on the left side, inspiratory dyspnea, one episode of hemoptysis, fever (40°C), chills, and profuse sweating.  Pulmonary infarction can have many different causes and determining the underlying etiology is frequently a considerable challenge, particularly given the urgency imposed by the severity of the condition. The association of pulmonary infarction in a patient with SIT is particularly noteworthy, as each of these conditions represents distinct pathological entities, with their overlap addressed in only a few cases in the literature. A rare genetic predisposition, possibly a fairly ordinary pairing, or even incidental coexistence, are some of the speculations discussed in this case presentation. We emphasize that pulmonary consolidation requires a comprehensive diagnostic approach due to its broad differential diagnosis. This highlights the critical importance of surgical lung biopsy and histopathological analysis in securing a precise and accurate diagnosis.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470973PMC
http://dx.doi.org/10.7759/cureus.71334DOI Listing

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