Interventional radiology treatment of empyema and lung abscesses

This patient presented with a right upper lobe pneumonia (*) and a pleural effusion (arrow) seen in (a). The chest CT (b) shows the effusion (*) which appears to be free flowing as it is dependent. An ultrasound in (c) shows multiple septations in the pleural fluid (arrows). (d) shows the radiograph after image guided insertion of a small bore chest tube and fibrinolytic therapy. The empyema is nearly resolved, with persistent pneumonia (*) causing persistent fevers. After removal of the chest tube and completion of antibiotics, (e) shows minimal residual pleural thickening (arrow).

(a) Shows a cavitary lesion in the left lower lobe (*) with an air fluid level representing an abscess. After insertion of a chest drain with image guidance (b), a follow up CT shows a markedly smaller abscess (arrow) with the drain in the middle.