مريض مدمن على الكحول يسعل بلغماً كريه الرائحة منذ أسابيع، مع حمى ونقص وزن، والأشعة تظهر تجويفاً فيه سائل في الرئة. ما التشخيص الأرجح؟

A client with alcohol dependence has coughed foul-smelling sputum for weeks with fever and weight loss; X-ray shows a cavity with a fluid level. What is the likely diagnosis?

1. Lung abscess after aspiration
2. A simple transudative pleural effusion
3. Acute viral bronchitis
4. Post-operative atelectasis

Answer: A) Lung abscess after aspiration. Lung abscess usually follows aspiration of oral secretions when consciousness is impaired (alcohol, seizures, anaesthesia), with foul sputum and a cavity with an air-fluid level. Treatment is prolonged antibiotics, postural drainage and dental care.