Diagnosis of lung abscess is often based on radiologic results showing a cavitary lesion with air fluid level, though blood cultures are normally required to identify the specific pathogen
Chest X Ray
An irregularly shaped thick walled cavity with an air-fluid level is typically seen in lung abscess on chest xray. Lung abscess[1]
Abscess is often unilateral and single involving posterior segments of the upper lobes and the apical segments of the lower lobes as these areas are gravity dependent when lying down.[2][3]
The presence of air-fluid levels implies rupture into the bronchial tree or rarely growth of gas forming organism.The extent of the air-fluid level within a lung abscess is often the same in posteroanterior or lateral views.
Anaerobic infection may be suggested by cavitation within a dense segmental consolidation in the dependent lung zones.
Lung infection with a virulent organism results in more widespread tissue necrosis
Up to one-third of lung abscesses may be accompanied by an empyema.[4]
Repeat chest radiographs must be obtained to determine the response of antimicrobial therapy.