Pleural empyema

Case contributed by Ahmad Thuaimer
Diagnosis probable

Presentation

Cough and fever for 1 month not responding to 2 cycles of antibiotics.

Patient Data

Age: 71
Gender: Male
x-ray

Right lower long zone opacity silhouetting  the right hemidiaphragm and oblitrating the right costophrenic angle.

ct

Mediastinal window shows right pleural collection with air fluid level with minimal stranding of pleural fat. Diffuse aortic calcifications noted. Lung window shows air-fluid level indicating infection with gas-forming organism or bronchopleural fistula. Adjacent lung parenchymal consolidation 

Post contrast study show mild enhancement of the pleural and plural thickening especially at the base.

Case Discussion

Right lower lung zone opacity and obliteration of the ipsilateral CP angle on chest radiograph. CT chest suggests the diagnosis of empyema.

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