Lung abscess, its drainage, and resolution

Case contributed by Dr Ian Bickle

Presentation

Under the weather. No chest specific symptoms.

Patient Data

Age: 60 years
Gender: Female

10 cm thick-walled cavitating mass in the right lower lobe with an air-fluid level.

Left lung normal.

Large hiatus hernia.

11 x 8 x 10 cm well-defined cavitating lesion seen in the right lower lobe extending up to the apical segment with thick enhancing irregular walls. Intracavity gas fluid level within. Adjacent basal segments of the right lower lobe consolidation. Small right basal pleural effusion.

Multifocal patchy ground-glass and dense airspace opacities some of which are peripherally based in both upper lobes, lingula, and right middle lobe. Focal atelectasis in the left lower lobe adjacent to the hiatus hernia. Minor tree in bud nodularity in the left lower lobe basal segments.

Small-volume mediastinal and hilar lymph nodes.

A percutaneous drain was inserted under CT guidance into the abscess.

Large hiatus hernia.

The right lung abscess has resolved.

Minor linear scarring at the site of the prior abscess.

Left lung clear.

Large hiatus hernia.

Case Discussion

The successful diagnosis, treatment, and follow-up of a large lung abscess.

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