Question:

A 53-year-old male presents to the ED with several months of weight loss and cough. He states that he has become progressively dyspenic in the last week. He is a poor historian. He is noted to be febrile upon arrival to the ED. What does his radiograph show, and what is the treatment?

Answer:

This patient’s chest radiograph demonstrates a right upper lobe opacity with gas and an air fluid level, consistent with a pulmonary abscess. The patient was found to be septic in the ED. A sepsis protocol was initiated, and the patient was admitted. The patient required a thoracostomy tube. He was found to be HIV positive with a low CD4 count. After a protracted hospital course, the patient was eventually discharged with outpatient infectious disease management. ■