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Unusual case of a giant lung abscess initially misdiagnosed and treated as an empyema
  1. Joana Sofia Carvalho1,
  2. Diogo Paixão Marques2,
  3. Inês Oliveira1 and
  4. Ana Cláudia Vieira1
  1. 1 Pulmonology, Hospital de Egas Moniz, Lisboa, Portugal
  2. 2 Medicine II, Hospital de Egas Moniz, Lisboa, Portugal
  1. Correspondence to Dr Joana Sofia Carvalho, joana.svc{at}


We report the case of a 66-year-old man with dental infection who presented to our emergency department complaining of a 3-month medical history of chest pain and productive cough, in association with malaise, fever, weight loss and anaemia. His chest radiograph showed a nearly total opacification of the right hemithorax and chest ultrasound findings were suggestive of empyema, subsequently confirmed by a chest CT. The patient started appropriate treatment. A follow-up chest CT performed to rule out bronchopleural fistula revealed a large lung abscess. The patient had the final diagnosis of a giant lung abscess, which was initially thought to be an empyema because of the clinical and radiologic similarities with this entity. The initial misdiagnosis led to prompt percutaneous drainage of the lung abscess in addition to antibiotherapy and respiratory physiotherapy with a good final outcome, which suggests the efficacy of this approach in similar cases.

  • empyema
  • pneumonia (respiratory medicine)
  • cardiothoracic surgery
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  • Contributors JSC, the corresponding author, was directly involved in the care of this patient and was responsible for drafting this article and obtaining patient’s consent. DPM was responsible for acquisition of data and providing critical revisions of the article. IO and ACV were responsible for reviewing medical literature and providing critical revisions of the article.

  • 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.

  • Patient consent for publication Obtained.

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