Pleural empyema with endobronchial mass due to Rhodococcus equi infection after renal transplantation: A case report and review of literature

Figure 1 Chest computed tomography scan. A: Right-sided fluid pneumothorax with multiple fluid within it; right lung with multiple exudates, right lower lobe abscesses; B: After drainage of right-sided fluid pneumothorax, the right-sided encapsulated effusion was significantly reduced compared with the previous one, and the pneumoperitoneum had been largely absorbed; the right intrapulmonary exudation and right lower lobe abscess were reduced compared with the previous one; the right middle lobe of the lung was atelectatic; C: Right pleural encapsulated effusion as before; right lower lobe abscess and multiple exudates in both lungs as before; right middle lobe atelectasis was slightly worse than before; D: Right pleural encapsulated effusion absorbed more than before; right lower lobe abscess and multiple right lung exudates reduced more than before; right middle lobe atelectasis as before; E: Right pleural encapsulated effusion was significantly greater than before; right lower lobe abscess and multiple right lung exudates were lesser than before; right middle lobe atelectasis was the same as before; F: Right pleural encapsulated effusion decreased compared to before; right lower lobe abscess and multiple right lung exudates as before; right middle lobe atelectasis as before.

Figure 2 Biopsy of endobronchial mass. A: Nascent mass at the mouth of the right middle and lower lobes with symptomatic hypertrophic luminal narrowing of the right pulmonary mucosa; B: Fibrinoscopic biopsy: The mucosa shows chronic inflammation. Fibrillar hyperplasia within the lamina propria was seen with a large number of histiocyte-like cells; C: Fiberscope brushing: A large number of erythrocytes and ciliated columnar cells and a few neutrophils and phagocytes are seen; no malignant cells are seen; D: Immunohistochemistry: Chronic inflammation of the mucosa. Fibrous granulation tissue proliferation.