A 61-year-old male with poor dentition and alcohol use disorder presents with fever, copious foul-smelling sputum, and weight loss over 3 weeks. Vital signs show temperature 38.9°C, heart rate 102/min, respiratory rate 22/min, and oxygen saturation 94% on room air. Chest CT reveals a cavitary lesion with air-fluid level in the right upper lobe. Sputum culture grows anaerobic organisms. He denies recent aspiration events. Which of the following is the most likely diagnosis?
- A)Empyema
- B)Klebsiella pneumoniae
- C)Lung abscessGABARITO
- D)Tuberculosis
- E)Pulmonary embolism
Explicação
Lung abscess is correct. A foul smelling productive cough with a cavitary lesion containing an air fluid level strongly suggests a necrotic abscess, usually due to aspiration of anaerobes. Poor dentition and alcohol use are classic predisposing factors. Ver explicação completa e trilha adaptativa →