Presentation
Left upper lobe pneumonia + abcess - CXR post ICC
Patient Data
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 hemidiaphragm is still visible (i.e. no silhouetting yet).
Case Discussion
Apical pyopneumothorax is suggested by lack of lung markings with an air-fluid level. This is distinguished from a lung abscess (rounded) by the characteristic lentiform shape. Since it doesn't uniformly 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 hemopneumothorax) secondary to a lung abscess leaking into pleural space/bronchopleural fistula.
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