case_images: PMC10932497_01
case_images: Non-contrast CT scan of the chest revealing a large, loculated, left-sided pleural effusion concerning for empyema with gas-forming infection and consequent complete left lung collapse (A-C), as well as diffuse gallbladder wall thickening (D).
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case_images: PMC10932497_01_jchim-14-01-030f1.jpg
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case_images: Computed tomography (CT) of the chest without contrast demonstrated a large, loculated, left-sided pleural effusion concerning for empyema with gasforming infection and consequent complete left lung collapse (Fig. 1).
case_images: Pleural fluid gram stain growing Gram positive rods, subsequently identified as pan-sensitive C. perfringens.
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case_images: PMC10932497_01_jchim-14-01-030f2.jpg
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case_images: Pleural fluid gram stain (Fig. 2) grew Gram positive rods, subsequently identified as pan-sensitive C. perfringens consistent with an empyema.
case_images: Contrast-enhanced CT scan of the abdomen and pelvis revealing thickening and enhancement of the gallbladder wall, as well as a 1.6 cm x 4 cm x 2 cm fluid collection adjacent to the gallbladder fundus.
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case_images: PMC10932497_01_jchim-14-01-030f3.jpg
case_images: f3-jchim-14-01-030
case_images: C. perfringens, a contrast-enhanced CT scan of abdomen and pelvis was obtained to rule out occult abdominal infection. CT revealed cholelithiasis, thickening and enhancement of the gallbladder wall concerning for acute cholecystitis, as well as a fluid collection adjacent to the gallbladder fundus concerning for contained perforation (Fig. 3).