PMC6001145_01
The chest radiograph revealed a mass in the left upper lung, bilateral pleural effusions and cardiac enlargement
40248_2018_132_Fig1_HTML.jpg
PMC6001145_01_40248_2018_132_Fig1_HTML.jpg
Fig1
The chest radiograph (Fig. 1) revealed a mass in the left upper lung, bilateral pleural effusions and cardiac enlargement.
The chest CT scan showed a wedge-shaped and pleural-based mass in the left upper lobe (white arrow on (a), and black arrow on (b)), thick-walled cavitary lesion containing water density in the left lower lobe (white arrows on (c)), bilateral pleural effusions and pericardial effusion (* on (c))
40248_2018_132_Fig2_HTML.jpg
PMC6001145_01_40248_2018_132_Fig2_HTML.jpg
Fig2
The chest computed tomography (CT) scan showed a wedge-shaped and pleural-based mass in the left upper lobe (LUL), a thick-walled cavitary lesion containing only water density in the left lower lobe (LLL), bilateral pleural effusions and pericardial effusion (Fig. 2).
a The chest CT with enhancement on the 9th day showed a thick-walled cavitary lesion containing water density in the left lower lobe (white arrows) and a small amount of pericardial effusion; b Purulent fluid obtained by ultrasound-guided pneumocentesis of the cavitary lesion in the left lower lobe; c Gram stain of the fluid showed Gram-positive filamentous rods; d Cultures from the fluid grew Actinomyces species
40248_2018_132_Fig3_HTML.jpg
PMC6001145_01_40248_2018_132_Fig3_HTML.jpg
Fig3
After the cardiopulmonary state was stabilized, he underwent ultrasound-guided pneumocentesis of the cavitary lesion in the LLL and 35 ml of purulent fluid was obtained (Fig. 3). Gram stain of the fluid revealed Gram-positive filamentous rods, and cultures of the fluid grew Actinomyces species (Fig. 3).
The chest CT scan after the completion of six-month antibiotic therapy showed a significant improvement
40248_2018_132_Fig4_HTML.jpg
PMC6001145_01_40248_2018_132_Fig4_HTML.jpg
Fig4
At follow up, 6 months after discharge, the patient was gaining weight, felt well, and his CT images had continued to show improvement (Fig. 4).