Imaging discussion
A lung abscess is defined as a circumscribed area of pus or necrotic deposits in the lung tissue with the formation of cavities containing necrotic deposits or fluid caused by a microbial infection, and if suspected, chest computed tomography (CT) should be done because CT provides a more accurate anatomical definition than a chest x-ray and can identify other abscesses and chest lesions that are not clearly delineated on a chest x-ray 21. On CT, an acute lung abscess is usually surrounded by a less well-defined area of ​​lung parenchyma filled with thick necrotic debris, often involving the apical segment of the inferior lobe of the right lung, which corresponds to the location in our case 21. Furthermore, in some cases, CT can distinguish between lung carcinomas and abscesses because malignant lesions have a thicker wall and are more irregular than abscesses 21. In our case, this differential diagnosis was considered due to the presence of irregular borders on CT, absence of fever, purulent sputum, and leukocytosis, as well as persistence of the lesion. However, histological studies ruled out malignancy and confirmed a bacterial lung abscess due to S. intermedius.