A cavitary lung lesion.

A 52-year-old male smoker presented with a 1-week history of fever, left-sided pleuritic chest pain, and body aches. Four days later, cough with hemoptysis developed. He visited the local hospital and was suspected to have left-sided parapneumonic pleural effusion. Repeated attempts at needle aspiration yielded a small amount of pleural fluid, which was exudative with a total leukocyte count of 23,300/ L and 98% polymorphs. The procedure resulted in worsening chest pain and dyspnea. The patient was transferred to our hospital, and chest radiography demonstrated a large left-sided pneumothorax. An intercostal chest tube was inserted and relieved the pneumothorax. A chest radiograph was obtained after placement of the chest tube (Fig 1).