Pyopneumothorax

Case contributed by Dr Abdallah Khateeb

Presentation

Young adult with previous pneumonia which was treated with antibiotics, presenting with fever, chest pain and cough. No history of trauma.

Patient Data

Age: 35 years old
Gender: Male
Modality: X-ray

Distorted right lung field with a large air fluid level at the upper zone, few large mass-like opacities, indistinct right hemi diaphragm and right heart border. These findings are overlapping an area of consolidation at the middle zone and aerated lung at the apex and lower zone.

Minimal mediastinal shift to the left.

The left lung is unremarkable.

 

Modality: CT

A large multiloculated pyopneumothorax with thickening and enhancement of the pleural linings.

Middle lobe consolidation with air bronchograms.

Increased interstitial markings at the right lower lobe.

The left lung field is unremarkable.

Few reactive mediastinal lymph nodes.

Ill-defined hypodensity at the liver dome, abutting the collection; mostly reactive.

Case Discussion

A history of pneumonia with subsequent development of pyopneumothorax in the absence of trauma or intervention guides you to think of a bronchopleural fistula.

Chest drain was inserted and pus was drained.

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Case Information

rID: 44606
Case created: 28th Apr 2016
Last edited: 20th Mar 2017
System: Chest
Inclusion in quiz mode: Included

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