Lung abscess

Case contributed by Dr Vijay Mistry

Presentation

Weight loss. Background of schizophrenia.

Patient Data

Age: 60 years
Gender: Female
X-ray

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.

CT

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 favourable for infective rather than malignant cause of lung lesion. Antimicrobial therapy was commenced.

X-ray

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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Case information

rID: 56959
Case created: 30th Nov 2017
Last edited: 2nd Dec 2017
System: Chest
Inclusion in quiz mode: Included
Institution: Princess Alexandra Hospital

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