Presentation
1 week of right upper back pain and fever
Patient Data
Consolidation located in the periphery of the posterior segment of the right upper lobe with surrounding ground-glass opacities. Consolidation is comprised of more ground-glass component centrally with peripheral dense consolidation. Multiple locules of gas centrally in keeping with cavitation. No fluid component demonstrated. No other sites of consolidation identified. Bibasal atelectasis noted. Trace right pleural effusion.
No mediastinal, hilar or axillary lymphadenopathy by size criteria.
Case Discussion
The finding of right upper lobe consolidation with central cavitation is most likely infectious in etiology. Differentials include typical and atypical organisms as well as septic embolism.
This patient was immunosuppressed due to a previous splenectomy. The organism was not identified. The patient was managed with with IV antibiotics with good effect.
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