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Aspiration lung abscess — SCE Respiratory MCQ

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ModerateRespiratory InfectionsAspiration lung abscessSCE Respiratory

A 52-year-old man with poorly controlled diabetes presents with fever, foul sputum and weight loss after a witnessed aspiration during alcohol intoxication. CT shows a right lower-lobe cavity with an air-fluid level and surrounding consolidation. What is the most likely diagnosis?

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Correct answer: B — Anaerobic lung abscess

Aspiration risk, foul sputum and a dependent cavitating lesion with air-fluid level are typical of anaerobic lung abscess. Chronic aspergillosis tends to complicate pre-existing cavities and is more indolent, while infarction usually has wedge-shaped peripheral opacity. LAM and sarcoidosis do not fit the infectious cavitary presentation.

Reference: BTS CAP Guideline; NICE pneumonia guidance