Difference between revisions of "Lung abscess"

(Evaluation)
 
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===Causes===
 
===Causes===
 
*Aspiration [[pneumonia]] (7-14 days to become lung abscess)
 
*Aspiration [[pneumonia]] (7-14 days to become lung abscess)
*Bacteremia from nonpulmonary infection
+
*[[Bacteremia]] from nonpulmonary infection
*Influenza leading to Bacterial superinfection (e.g. ''S. Aureus'')
+
*[[Influenza]] leading to Bacterial superinfection (e.g. ''S. Aureus'')
 
*Pulmonary infarction
 
*Pulmonary infarction
*Infection as a result of penetrating chest trauma
+
*Infection as a result of penetrating [[chest trauma]]
 
*Primary and metastatic neoplasms
 
*Primary and metastatic neoplasms
*Granulomatosis with polyangiitis (Wegener's), sarcoidosis
+
*[[Granulomatosis with polyangiitis]] (Wegener's), [[sarcoidosis]]
  
 
==Clinical Features==
 
==Clinical Features==
*Cough, fever, pleuritic chest pain, wt loss, night sweats (generally over course of several weeks)
+
*[[Cough]], [[fever]], pleuritic [[chest pain]], weight loss, night sweats (generally over course of several weeks)
**Tachycardia, tachypnea, or fever may be absent
+
**[[Tachycardia]], [[tachypnea]], or [[fever]] may be absent
 +
 
 +
===Complications===
 +
*[[Empyema]]
 +
*Massive [[hemoptysis]]
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
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**[[Clindamycin]] + 2nd or 3rd gen [[cephalosporin]] '''OR'''
 
**[[Clindamycin]] + 2nd or 3rd gen [[cephalosporin]] '''OR'''
 
**[[Clindamycin]] + [[ampicillin/sulbactam]]
 
**[[Clindamycin]] + [[ampicillin/sulbactam]]
 
==Complications==
 
*Empyema
 
*Massive hemoptysis
 
  
 
==Disposition==
 
==Disposition==

Latest revision as of 15:41, 9 October 2019

Background

  • Localized, suppurative necrotizing process occurring within the pulmonary parenchyma
  • Microbiology

Causes

Clinical Features

Complications

Differential Diagnosis

  • Cavitary lesion with air-fluid level
  • Infected bullae
  • Pleural fluid collection with bronchopleural fistula
  • Loop of bowel extending through diaphragmatic hernia

Evaluation

Pulmonary abscess on CXR
Pulmonary abscess on CT scan
  • CXR or CT Chest
  • Dense consolidation with air-fluid level inside of a thick-walled cavitary lesion
    • Air-fluid level indicates communication of abscess cavity with a bronchiole

Management

  • Medical management will successfully treat 70-90% of lung abscesses
    • Drainage occurs spontaneously from communication of cavity with tracheobronchial tree
    • Bronchoscopic drainage may result in seeding other parts of the lung
  • Antibiotics

Disposition

  • Admit

See Also

References