Boucher Benoit, Virlan Doina, Buddharaju Venkata, Chaudhari Sanket
Pulmonary and Critical Care Medicine, Weiss Memorial Hospital, Chicago, USA.
Internal Medicine, Saint James School of Medicine, Chicago, USA.
Cureus. 2022 Nov 26;14(11):e31910. doi: 10.7759/cureus.31910. eCollection 2022 Nov.
A 72-year-old male presented to the ER with three days of productive cough, shortness of breath, and generalized weakness. Chest X-ray showed right lung opacity in the lower lobe. Chest CT scan showed consolidation in the superior segment of the right lower cavity with air-fluid level extending to the pleural and chest wall, suggestive of lung abscess with loculated empyema and thickened pleura. The patient received antibiotics and CT-guided aspiration of blood-tinged fluid followed by two weeks of drainage via a transthoracic catheter. There was a near-complete resolution of the opacity and closure of the lung abscess on follow-up chest imaging. The patient clinically improved with resolution of the cough and dyspnea. Workup was negative for bacteria and acid-fast bacilli (AFB). The purpose of this paper is to review short-term and long-term management, approach, and consideration to be taken while facing a pan-negative etiological workup of a complicated abscess.
一名72岁男性因咳嗽、咳痰、气短和全身乏力3天就诊于急诊室。胸部X线显示右肺下叶有不透明影。胸部CT扫描显示右下叶上段实变，气液平面延伸至胸膜和胸壁，提示肺脓肿伴局限性脓胸和胸膜增厚。患者接受了抗生素治疗，并在CT引导下抽取了带血的液体，随后通过经胸导管引流两周。随访胸部影像学检查显示不透明影几乎完全消退，肺脓肿闭合。患者的咳嗽和呼吸困难症状在临床上有所改善。细菌和抗酸杆菌（AFB）检查均为阴性。本文旨在回顾在面对复杂脓肿病因检查全阴性时的短期和长期管理、方法及注意事项。
