MRSA infected emphysematous bullae in an asymptomatic COPD patient

Abstract

SUMMARYThis is a case of a 57-year-old gentleman with a history of chronic obstructive pulmonary disease (COPD) who presented with diarrhoea of more than 4 weeks in length. On chest x-ray, he was incidentally found to have a large cavitating lesion in his right lung. He denied having any respiratory distress at any stage and clinically he had been completely asymptomatic. The CT-guided biopsy confirmed a methicillin-resistant Staphylococcus aureus positive lung cavitation, most likely secondary to his poor dentition. A full dental clearance was performed, and he was treated with a course of intravenous vancomycin and oral clindamycin with good effect. BACKGROUND

Fluid-filled Cystic Lesions of the Lungs

“…Asymptomatic patients are not routinely treated with antibiotics. An infected bulla can also be secondary to Mycobacterial infection or mimic cavitation from Mycobacterial infection, as both infections tend to involve the upper lungs 25…”