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Case of the Week 340

What's the most likely diagnosis?

  • 34 year old with cough, fever and chest pain

  1. Congestive heart failure
  2. Cystic adenomatoid malformation
  3. Empyema
  4. Lung abscess
  5. Diaphragmatic hernia

Additional Image - Axial contrast-enhanced CT of chest


Additional Image


Axial contrast-enhanced CT of chest




3. Empyema



More (Click Discussion Tab)


General Considerations

  • An inflammatory fluid collection in the pleural space
  • Occurs most frequently with bacterial pneumonia
    • 20-60% of which are associated with a parapneumonic effusion
  • Most parapneumonic effusions clear with pneumonia (90-95%)
  • Some lead to pleural adhesions and an infected effusion—empyema
  • Other causes of an empyema besides pneumonia
    • Trauma
    • Extension of an abdominal infection
    • Rupture of a lung abscess
    • Ruptured esophagus
    • Chest tubes
  • Frequently associated with anaerobic organisms introduced into lung by aspiration

More ...


This Week

34 year-old with cough, fever and chest pain
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is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.