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A 56-Year-Old Woman With Nonresolving Pneumonia

      A 56-year-old woman, who is a current smoker, presented to the hospital complaining of productive cough, shortness of breath, and malaise. Chest radiography followed by a CT chest scan showed a large cavitary lung mass that involved the upper and middle lobes of the right lung. Sputum Gram stain and culture, urine streptococcus antigen, and blood cultures were negative during that hospitalization. She was treated with a 4-week course of antibiotics (piperacillin/tazobactam followed by amoxicillin/clavulanic acid). Repeat CT scan results after 1 month from initial presentation were unchanged (Fig 1), and her symptoms persisted. The lesion was also visible on point-of-care ultrasound scan (Fig 2; Video 1).
      Figure thumbnail gr1
      Figure 1CT scan shows consolidation of the right upper and middle lobe.
      Figure thumbnail gr2
      Figure 2Ultrasound image shows right upper lobe lesion.
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