Kewei Zhang, MD; Joshua Broder, MD
0196-0644/$-see front matter
Copyright © 2017 by the American College of Emergency Physicians.
http://dx.doi.org/10.1016/j.annemergmed.2017.04.003
[Ann Emerg Med. 2017;70:e33-e34.]
An 8-year-old boy presented to the emergency department with 6 days of fever, productive cough, and chest pain. The
patient had recently arrived in the United States from Iraq and was not immunized. Chest radiograph showed a cavitary
lesion with an air-fluid level in the left lung (Figures 1 and 2).
For the diagnosis and teaching points, see page e34.
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Figure 1. Upright posterior-anterior view chest radiograph
demonstrating a thick-walled cavitary lesion with an air-fluid
level in the left lung.
Figure 2. Lateral-view chest radiograph confirming a cavitary
lung lesion, consistent with abscess.
Figure 3. CT with intravenous contrast (axial view, soft tissue
window setting) demonstrating a large cavitary lesion with an
air-fluid level in the left lung. The abscess is enhanced around
its perimeter with intravenous contrast.
Figure 4. Postoperative posterior-anterior view chest
radiograph revealing resolution of the abscess after
marsupialization.
Figure 5. Lateral view chest radiograph after marsupialization.
A cavitary lesion is no longer observable.
Volume 70, no. 3 : September 2017 Annals of Emergency Medicine e33
IMAGES IN EMERGENCY MEDICINE