When is a lung abscess not a lung abscess? Recurrent pneumonia and empyema associated with intrapulmonary cystic teratoma

A 23-year-old woman presented with gradual-onset left chest and back pain. She had at medical history of asthma. She was a never smoker with no significant family history. Her observations and examination were normal. Blood tests performed revealed a raised C reactive protein of 119 mg/L and high white cell count of 12.81x109/L. A chest radiograph showed left hilar consolidation (figure 1A). She was treated with oral clarithromycin and follow-up radiograph showed resolution of the consolidation (figure 1B). One year later, she represented with a 10-day history of dry cough and pleuritic chest pain. A chest radiograph demonstrated a left-sided pleural effusion and blood tests were in keeping with infection. Pleural fluid examination showed an exudative effusion by Light’s criteria (pleural fluid protein 55.8g/L, Lactate dehydrogenase (LDH) 1798U/L, glucose 3.74 mmol/L, serum protein 77 g/L, serum LDH and pleural fluid pH not available) and mixed inflammatory cells on cytology...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Images in Thorax, Thorax Source Type: research