A 27-year-old man with history of alcoholism and repeated bouts of aspiration pneumonia comes to the emergency room with a high fever and pleuritic chest pain. Physical examination reveals dullness on percussion and absence of breath sounds in the right lower lung field. A chest X-ray demonstrates pleural fluid on the right side. Thoracentesis returns a thick, foul-smelling fluid. Which of the following is the most likely diagnosis?
Pleuritis (inflammation of the pleura) may result from the extension of any pulmonary infection to the visceral pleura. Pyothorax refers to a turbid effusion containing many neutrophils. Empyema is a variant of pyothorax in which thick pus accumulates within the pleural cavity, often with loculation and fibrosis. Hydrothorax refers to transudation of edema fluid into the pleural cavity.
Chylothorax
Empyema
Hemothorax
Pneumothorax
Lung Tumor