Lung abscess

Case contributed by Mohammad Osama Hussein Yonso
Diagnosis probable

Presentation

The patient is complaining of fever, cough for 2 weeks with productive sputum, no other significant complaints, no history of any recent travel, no history of contact with a suspected or confirmed complaining of Covid-19 in the last 2 weeks. Clinical examination: febrile, chest shows crept in the right middle lung zone.

Patient Data

Age: 25 years
Gender: Male

Chest

x-ray

Right lower lung lobe at the apical segment, thickened walled cavitary lung lesion measuring 60X60mm is seen ? lung abscess
Prominent right hilum.
Bilateral prominent broncho-vascular markings. 
Normal heart size.
Minimal blunting of both costophrenic angles. 

Case Discussion

The differential diagnosis of the lung cavitary lesions inclouds :

  • infections: such as Streptococcus p, Staphylococcus aureus, Klebsiella p., mycobacterium
  • pulmonary abscess: as complicated pneumonia
  • mycobacterium tuberculosis infection
  • septic Emboli
  • aspergillosis: is caused by a fungus, Aspergillus fumigatus
  • malignancies
  • granulomatosis with polyangiitis, sarcoidosis and rheumatic nodules

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