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There is a large multiloculated right pleural collection encasing the right lung. It has a few higher density areas and multiple foci of gas. If there has been no intervention, this is highly suspicious for empyema. There is collapse of most of the right lower lobe with minor atelectasis elsewhere and minor ground glass opacity.
There is marked volume loss on the left with elevation of the left hemidiaphragm. The mediastinum is displaced to the left.
Patient proceeded to decortication and Streptococcus anginosus group (milleri group) was cultured.