Difference between revisions of "Lung abscess"

(Text replacement - "==Clinical Presentation==" to "==Clinical Features==")
(Text replacement - " w/ " to " with ")
Line 18: Line 18:
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
*Cavitary lesion w/ air-fluid level
+
*Cavitary lesion with air-fluid level
 
*Infected bullae
 
*Infected bullae
 
*Pleural fluid collection with bronchopleural fistula
 
*Pleural fluid collection with bronchopleural fistula
Line 25: Line 25:
 
==Diagnostic Evaluation==
 
==Diagnostic Evaluation==
 
*CXR or CT Chest
 
*CXR or CT Chest
*Dense consolidation w/ air-fluid level inside of a thick-walled cavitary lesion
+
*Dense consolidation with air-fluid level inside of a thick-walled cavitary lesion
 
**Air-fluid level indicates communication of abscess cavity with a bronchiole
 
**Air-fluid level indicates communication of abscess cavity with a bronchiole
  
 
==Management==
 
==Management==
 
*Medical management will successfully treat 70-90% of lung abscesses
 
*Medical management will successfully treat 70-90% of lung abscesses
**Drainage occurs spontaneously from communication of cavity w/ tracheobronchial tree
+
**Drainage occurs spontaneously from communication of cavity with tracheobronchial tree
 
**Bronchoscopic drainage may result in seeding other parts of the lung
 
**Bronchoscopic drainage may result in seeding other parts of the lung
 
*Antibiotics
 
*Antibiotics

Revision as of 01:53, 14 July 2016

Background

Causes

  • Aspiration PNA (7-14 days to become lung abscess)
  • Bacteremia from nonpulmonary infection
  • Pulmonary infarction
  • Infection as a result of penetrating chest trauma
  • Primary and metastatic neoplasms
  • Wegener's, sarcoidosis

Clinical Features

  • Cough, fever, pleuritic chest pain, wt loss, night sweats (generally over course of several weeks)
    • Tachycardia, tachypnea, or fever may be absent

Differential Diagnosis

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

Diagnostic Evaluation

  • 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

Complications

  • Empyema
  • Massive hemoptysis

Disposition

  • Admit

See Also

References