Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Clinical History:
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:
Febrile.
Clinical Labs:
Non-contributory
Clinical Differential Diagnosis:
Pneumonia
Imaging Findings:
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.
Imaging Differential Diagnosis:
Pulmonary abscess
Operative Findings:
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.
Pathological Findings:
The cultures of the abscess grew out Strep milleri, an anaerobe.
Final Diagnosis:
Lung Abscess
Follow-up and Prognosis:
The patient had an uncomplicated post-drainage course.
Similar Cases:
Case 5,
Case 52
References:
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
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