Cavitary Lung Abscess Mistaken for Pneumothorax after Drainage of Pus

A 64-year-old male was admitted due to abruptly developed, severe dyspnea via local clinic. He had been a heavy smoker and alcoholic for a long time. Chest PA showed huge haziness in right upper lung field. Sputum culture for bacteriology was positive for Klebsiella pneumoniae. Immediately, appropriate antibiotics were administered and artificial ventilation was started. On 40th hospital day, simple chest roentgenogram taken due to sudden aggravated dyspnea showed marked hyperlucency in right upper lung field, suggestive of rupture of abscess cavity and resultant pneumothorax. At that time, chest tube was inserted but air leakage from the chest tube persisted. Chest CT scan taken after chest tube insertion showed the tube inserted into a thin-walled cavity in the above lesion. on 84th hospital day, right upper lobectomy with decortication was performed. Pathologically, cavittary lung abscess was diagnosed on the findings of partial re-epithelialization of ciliated columnar epithelium with severe pulmonary vascular occlusion and extensive fibrous pleural adhesions.