Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The patient was an 18 year old male with fever, cough, and halitosis. The patient's past medical history was remarkable for diabetes mellitus.
Clinical Physical Exam:
Clinical Differential Diagnosis:
Outside PA and lateral chest films from the first hospital day showed an air fluid level in the right lower lobe. This lesion was better demonstrated on a chest CT exam performed the next day.
Images 1 and 2
Imaging Differential Diagnosis:
On the second hospital day, after the chest CT exam, this pulmonary abscess was drained under ultrasound and fluoroscopic guidance and a sump catheter was left in place. An air leak was later noted between the bronchus and the lung abscess so the abscess catheter was placed to a water seal in a Pleurovac.
The cultures of the abscess grew out Strep milleri, an anaerobe.
Follow-up and Prognosis:
The patient had an uncomplicated post-drainage course.
Case 5, Case 52
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