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

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Images in Thorax
When is a lung abscess not a lung abscess? Recurrent pneumonia and empyema associated with intrapulmonary cystic teratoma
  1. Catherine Penman1,
  2. Giles Dixon1,
  3. Richard Daly2,
  4. Andrew Low1
  1. 1 Department of Respiratory Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  2. 2 Department of Histopathology, North Bristol NHS Trust, Bristol, UK
  1. Correspondence to Dr Giles Dixon, Department of Respiratory Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, Bristol, UK; gilesdixon{at}nhs.net

https://doi.org/10.1136/thorax-2022-219617

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    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 12.81×109/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).

    Figure 1

    (A) Chest radiograph at presentation showing left hilar consolidation. (B) Chest radiograph showing resolution of left hilar consolidation. (C) CT thorax showing left-sided complex pleural effusion with large bore chest drain in situ and 2.6 cm fluid collection in left hemithorax with surrounding consolidation. (D) Persistent fluid filled density in the left anterior hemithorax with resolution of the surrounding pleural effusion. (E) Postoperative follow-up chest radiograph showing elevated left hemidiaphragm.

    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 …

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    Footnotes

    • Contributors CP, GD and AL contributed to the manuscript planning. CP, GD and AL contributed to the conduct. CP, GD, AL and RD contributed to reporting the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.