Presentation
Weight loss. Background of schizophrenia.
Patient Data
Large rounded density projected over the right upper/mid zone, correlates to the posterior mediastinal location on the lateral projection, poorly defined superior margin and broad pleural base. Small right pleural effusion.
Multi-lobulated cavitatory mass in the right upper lobe crossing the oblique fissure to involve the apical right lower lobe. Concerning for a lung malignancy given the lack of clinical history of sepsis, however an abscess would remain a differential consideration.
Bronchoscopy was performed. Impression from bronchoscopy more favorable for infective rather than malignant cause of lung lesion. Antimicrobial therapy was commenced.
Resolution of lung lesion post antimicrobial therapy.
Case Discussion
A case of a new lung abscess found in a patient presenting with poor oral intake and weight loss, with no infective symptoms. Bronchoscopy grew Streptococcus constellatus. No malignant cells seen. Resolution after oral antibiotics for two weeks.
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