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The fluid was an exudate with 670 VVBCs (60 percent PMNs and 33 percent lymphocytes). A pleural biopsy was then performed which showed mild chronic inflammation. Acid-fast organisms or granulomas were not observed. A bronchoscopy performed six days after admission showed compression and distortion of the bronchus intermedins with bl<x>d and copious thick cottage cheese-like material coming from the right middle and lower lobes. Because the patient developed hypoxemia, bronchial biopsy specimens were not obtained. Bronchial lavage and brushing specimens showed no malignant cells, acid-fast bacilli or fungi. Eleven days after admission a CT of the chest showed multiple abscesses in the right lower lung fields and a right pleural effusion. The diaphragm was not well visualized (Fig 2). The patient still had a fever and hemoptysis. Sixteen days after admission, an ultrasound test was done on the right upper quadrant, which showed a 6.5-cm heterogenous lesion in the posterior right lobe with extension through the right diaphragm to the right pleural space (Fig 3 and 4). Serum amebic titers were 1:8,192 (normal:less than 1:8). Me was given metronidazole, 750 mg by mouth three times a day for ten days, and iodoquinal, 650 mg daily for 20 days. After two weeks, the patient remained asymptomatic. Figure 2. A CT scan in the area of the right lower thorax. The arrow identifies an abscess. Figure 3. An ultrasound scan of the right upper quadrant. The arrow points to a liver abscess adjacent to the diaphragm. Figure 4. This ultrasound scan shows the abscess penetrating through the diaphragm, which is identified by the arrows.