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Lung abscess — SCE Acute Medicine MCQ

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EasyAcute Respiratory PresentationsLung abscessSCE Acute Medicine

A 57-year-old man is assessed on the acute medical unit. He has fever, weight loss and foul sputum after alcohol-related aspiration. Chest radiograph shows a thick-walled cavity with an air-fluid level in the posterior upper lobe. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: D — Lung abscess

Lung abscess is the best answer because the subacute septic picture with foul sputum and a cavity after aspiration is typical of lung abscess. Acute pulmonary oedema is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Anaerobic cover and evaluation for obstruction are important in lung abscess.

Reference: BTS CAP guideline