Pyopneumothorax

Case contributed by Townsville radiology training

Presentation

L. upper lobe pneumonia + abcess - CXR post ICC

Patient Data

Age: 48
Gender: Male
Modality: X-ray

ICD in situ in left hemithorax.

Left upper zone opacity consistent with previous CXR 3/7 ago. New opacity in lower zone suggesting early lower lobe consolidation although left hemidiaghram is still visible (i.e. no silhoutting yet).

Case Discussion

Apical pyopneumothorax suggested by lack of lung markings with an air fluid level. This is distinguished from a lung abcess (rounded) by the characteristic lentiform shape. Since it doesn't unifromly cross the whole hemithorax this collection is probably loculated.

Given the history of this patient and presence of adjacent consolidation it is reasonable to say that this is a pyopneumothorax (versus hydro or haemopneumothorax) secondary to a lung abcess leaking into pleural space/bronchopleural fistula.  

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Case Information

rID: 19208
Case created: 16th Aug 2012
Last edited: 24th Sep 2015
System: Chest
Inclusion in quiz mode: Included

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