Pneumococcal abscess manifesting as an anterior mediastinal mass and fatal hemoptysis.

摘要

An elderly man had several weeks of night sweats, weight loss, and an anterior mediastinal mass on chest radiography. Computed tomographic-guided needle aspiration was nondiagnostic. Shortly after the patient's admission, three sets of blood cultures yielded Streptococcus pneumoniae. Despite systemic antimicrobials, the patient had an episode of acute hemoptysis and died. Autopsy showed an anterior mediastinal abscess with pneumonic involvement of the left lung. There was histologic evidence of necrotizing pneumonia and parenchymal hemorrhage, which likely resulted in fatal hemoptysis.