PMC6560332_01
Chest X-ray showing left-sided consolidation and an effusion.
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fig1
Chest radiograph showed left lower zone effusion with consolidation (see Figure 1). Considering the history and the high inflammatory markers with X-ray changes, a possible diagnosis of left lower lobe pneumonia with parapneumonic effusion was considered.
CECT chest showing left side empyema necessitans with rib destruction (arrow).
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fig2
While awaiting TB culture, subsequent CECT revealed empyema necessitans with destruction of the left side anterior upper rib associated with left pleural and mediastinal lymphadenopathy with the most probable infection of tuberculosis (see Figures 2 and 3).
CECT chest exudative fluid in pleural cavity tracks down making fistula.
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fig3
While awaiting TB culture, subsequent CECT revealed empyema necessitans with destruction of the left side anterior upper rib associated with left pleural and mediastinal lymphadenopathy with the most probable infection of tuberculosis (see Figures 2 and 3).