An Immunocompromised Man With a Chest Wall Mass

A 57-year-old male with a history of Crohn’s disease on infliximab presented to the emergency department with 1 month of dyspnea and a progressively expanding chest wall “mass.” Examination showed an erythematous, fluctuant area over the patient’s right lateral chest wall. His vitals were normal, other than tachycardia at 107 bpm. Subcutaneous incision and drainage yielded 400 mL of brisk, purulent drainage. Point-of-care ultrasound (POCUS) of the right posterolateral lung zone demonstrated a large echogenic punctiform collection in the pleural space, communicating with the skin.