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Infectious cavitary abcess

Eberly RSE - MedPix (2008)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Infectious cavitary abcess

History: Patient seen for shortness of breath at rest at the begining of December. In the work up a right lower lobe mass was discovered. Patient has a history of breast cancer and colon cancer 3 and 5 years ago respectively. Bronchoscopy was performed and the BAL showed cells suspicious for malignancy but a biopsy was negative. Patient was discharged on antibiotic therapy that was soon modified to include multiple antibiotic medications none of which provided improvement. She was referred for repeat bronchoscopy and lung biopsy to exclude carcinoma. Multiple anaerobes were cultured from the cavity fluid. The biopsy was negative for malignant cells. An endobronchial drain was placed to facilitate healing.

Findings: Opacity in RLL field. Well circumscribed, thick walled with a with an air fluid level that has organized in comparison with previous frontal CXR one month prior. On CT the opacity appears to have an air passageway that extends into the abnormality. On fluroscopy a guide wire can be seen in the abnormality and in another fluro image a pigtail catheter can be seen in the lesion.

Ddx: DDx for cavitary mass in lung fields includes: -Malignancy- either primary, secondary, -Granulomatous dz- infx or non-infx and can be active or inactive, this includes vasculitis such as Wegener's granulomatosis -Infection(non-granulomatous) such as PNA and abcess, including septic emboli, especially if multiple -Congenital abnormality

Dxhow: With the insertion of the pigtail catheter during the bronchoscopy fluid was drained that grew enterococcus faecalis, Klebsiella, and enterobacter cloacae.

No MeSH data available.


RLL cavity with endobronchial pigtail catheter
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MPX2062_synpic34419: RLL cavity with endobronchial pigtail catheter


Infectious cavitary abcess

Eberly RSE - MedPix (2008)

RLL cavity with endobronchial pigtail catheter
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2062&req=5

MPX2062_synpic34419: RLL cavity with endobronchial pigtail catheter

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Infectious cavitary abcess

History: Patient seen for shortness of breath at rest at the begining of December. In the work up a right lower lobe mass was discovered. Patient has a history of breast cancer and colon cancer 3 and 5 years ago respectively. Bronchoscopy was performed and the BAL showed cells suspicious for malignancy but a biopsy was negative. Patient was discharged on antibiotic therapy that was soon modified to include multiple antibiotic medications none of which provided improvement. She was referred for repeat bronchoscopy and lung biopsy to exclude carcinoma. Multiple anaerobes were cultured from the cavity fluid. The biopsy was negative for malignant cells. An endobronchial drain was placed to facilitate healing.

Findings: Opacity in RLL field. Well circumscribed, thick walled with a with an air fluid level that has organized in comparison with previous frontal CXR one month prior. On CT the opacity appears to have an air passageway that extends into the abnormality. On fluroscopy a guide wire can be seen in the abnormality and in another fluro image a pigtail catheter can be seen in the lesion.

Ddx: DDx for cavitary mass in lung fields includes: -Malignancy- either primary, secondary, -Granulomatous dz- infx or non-infx and can be active or inactive, this includes vasculitis such as Wegener's granulomatosis -Infection(non-granulomatous) such as PNA and abcess, including septic emboli, especially if multiple -Congenital abnormality

Dxhow: With the insertion of the pigtail catheter during the bronchoscopy fluid was drained that grew enterococcus faecalis, Klebsiella, and enterobacter cloacae.

No MeSH data available.