Abstract
We report a case of pulmonary abscess accompanied by rib destruction. The patient was a 40-year-old male with relapsed leukemia. He received chemotherapy and cord blood stem cell transplantation, and achieved complete remission again. One month after, CT images showed an infiltrative shadow in the right upper lobe of the lung, and it was suspected to be caused by fungal infection. Despite the administration of anti-fungal drugs, the lesion was uncontrollable and a pulmonary abscess developed. Thereafter, the abscess infiltrated the chest wall with rib destruction, and then he complained of severe right chest pain. At the initial operation, when the scapula was peeled off from his chest wall, a large amount of pus was expelled from the abscess. Because adhesion between the chest wall and right upper lobe was marked, it was considered difficult to perform a right upper lobectomy, and an open window thoracostomy combined with resection of the chest wall was performed. After the cavity had been cleaned, several bronchial fistulas were occluded with EWSs, and the window was closed with a pedicled pectoralis major musclo-cutaneous flap. He recovered from the series of infection and pain.
