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BMJ Case Reports 2013; doi:10.1136/bcr-2012-008306
  • CASE REPORT

Unusual case of a lung abscess

  1. Russell Phillips1
  1. 1Department of Respiratory Medicine, Norfolk and Norwich University Hospital, Norwich, UK
  2. 2Department of Medical Microbiology and Virology, Whittington Hospital NHS Trust, London, UK
  3. 3Department of Clinical Parasitology, Hospital for Tropical Diseases, London, UK
  1. Correspondence to Dr Gauri Godbole, gaurigodbole{at}doctors.org.uk

Summary

A 56-year-old Caucasian lady presented with a short history of pleuritic chest pain on the background of a 2-month history of fever, chills, 10-kg weight loss and cough with brown sputum after a laparoscopic cholecystectomy. She had persistent eosinophilia and was diagnosed with a lung abscess as seen on chest x-ray. She did not respond to standard intravenous broad spectrum antibacterial medication and her chest CT scan showed a moderate pleural collection in continuity with the abscess. She also underwent bronchoscopy, the microscopy of the bronchial washings revealing eggs of the trematode Fasciola. The bacterial and fungal cultures of the washings were sterile. She had visited Turkey in the previous year but did not remember consuming any watercress or aquatic plants. She was successfully treated with two doses of the antiparasitic agent triclabendazole. Ectopic Fasciola can be a rare cause of a lung abscess.

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