On the 4th day after recovering from a cold a patient was hospitalized with complaints of solitary spittings of mucoid sputum. On the 2nd day there was a single discharge of about 250 ml of purulent blood-streaked sputum. Objectively: the patient's condition is moderately severe. Respiratory rate - 28-30/min, Ps- 96 bpm, AP-110/70 mm Hg. Respiration above the left lung is vesicular, weak above the right lung. There are moist rales of different types above the lower lobe and amphoric breath near the angle of scapula. What is the most likely diagnosis?

Answer options

1. Acute focal pneumonia
2. Acute pulmonary abscess
3. Pleural empyema
4. Pyopneumothorax
5. Exudative pleuritis

Explanation

Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection. Cough, fever with shivering, and night sweats are often present. Cough can be productive of foul-smelling purulent mucus or less frequently with blood in one-third of cases. Affected individuals may also complain of chest pain, shortness of breath, lethargy, and other features of chronic illness. On examination of the chest, there will be features of consolidation such as localized dullness on percussion and bronchial breath sounds.