Medical mishap as a cause of non-resolving pneumonia.
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A 15-year old boy was referred for evaluation of fever, productive cough, and recurrent/persistent right lower lobe (RLL) pneumonia of 1-month duration. Chest computed tomography scan showed RLL consolidation, with minimal pleural effusion and a liver abscess with sharp borders, containing a solid calcification in the lower portion. History revealed acute appendicitis with laparoscopic appendectomy 6 months prior to presentation, during which a fecalith dropped to the peritoneal cavity. Following laparoscopically guided drainage of the abscess the patient improved. Herein we describe a rare case of non-resolving RLL pneumonia secondary to pyogenic liver abscess caused by dropped appendicolith.