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Lung Abscess and Pyothorax in Critically Ill COVID-19 Patients: A Single-Center Retrospective Study.Critical Care Explorations May 2023The mortality rate of patients with COVID-19 pneumonia requiring mechanical ventilation remains high. This study determined the percentage and characteristics of...
The mortality rate of patients with COVID-19 pneumonia requiring mechanical ventilation remains high. This study determined the percentage and characteristics of patients who developed lung abscesses or pyothorax and their mortality rates among adult patients with COVID-19 admitted to the ICU who required mechanical ventilation. Of the 64 patients with COVID-19 assessed, 30 (47%) developed ventilator-associated pneumonia (VAP), of whom 6 (20%) developed pyothorax or lung abscess. There were no statistically significant differences in patient characteristics, treatment after ICU admission, or outcomes between those with and without these complications, except for age. VAP complicated by Lung abscess or pyothorax was caused by a single organism, with = 4) and species ( = 2) being the primary causative agents. Occur infrequently in patients with COVID-19 requiring mechanical ventilation. Large-scale studies are required to elucidate their effects on clinical outcomes.
PubMed: 37197587
DOI: 10.1097/CCE.0000000000000919 -
Respiratory Medicine Sep 2023Lung abscess (LA) is a serious respiratory infection often followed by several weeks of antibiotic treatment. This study described the clinical presentation of LA,...
INTRODUCTION
Lung abscess (LA) is a serious respiratory infection often followed by several weeks of antibiotic treatment. This study described the clinical presentation of LA, treatment duration and mortality in a contemporary Danish population.
METHODS
In a retrospective multicenter cohort study at four Danish hospitals, patients diagnosed with LA were identified using the International Classification of Diseases and Related Health Problems 10th revision (ICD-10) between 2016 and 2021. A predefined data collection tool was used to extract data on demographics, symptoms, clinical findings and treatment.
RESULTS
Of 302 patients, 222 with LA were included after review of patient records (76%). Mean age was 65 years (54-74), 62.9% was male and 74.9% were ever-smokers. Chronic obstructive pulmonary disease (COPD) (35.1%), use of sedatives (29.3%) and alcohol abuse (21.8%) were common risk factors. Dental status was reported in 51.4%, whereof 41.6% had poor dental status. Patients presented with cough (78.8%), malaise (61.3%) and fever (56.8%) Patients were hospitalized for a median of 14 days (interquartile ranges, IQR 7-21) and median duration of antibiotic treatment was 38 days (IQR 30-51). All-cause mortality after 1, 3 and 12 months was 2.7%, 7.7% and 15.8%, respectively.
CONCLUSION
Risk factors for LA include COPD and use of sedatives, alcohol abuse, and poor dental status. Despite long-term antibiotic treatment, long-term mortality is markedly high.
Topics: Humans; Male; Aged; Lung Abscess; Cohort Studies; Disease Progression; Alcoholism; Pulmonary Disease, Chronic Obstructive; Anti-Bacterial Agents; Denmark
PubMed: 37302422
DOI: 10.1016/j.rmed.2023.107305 -
Canadian Medical Association Journal Jun 1938
PubMed: 20320980
DOI: No ID Found -
Canadian Medical Association Journal Apr 1963Foregut cysts frequently cause symptoms in the first three decades of life. The symptoms consist of dyspnea, wheezing, cough and sputum, dysphagia, stridor, and those...
Foregut cysts frequently cause symptoms in the first three decades of life. The symptoms consist of dyspnea, wheezing, cough and sputum, dysphagia, stridor, and those associated with right heart strain. Symptoms and the radiological appearance of the uncomplicated cyst mimic mediastinal tumour and mediastinal obstruction. The symptoms and radiological appearance of the ruptured infected cyst simulate those of lung abscess, diaphragmatic hernia, ruptured hydatid cyst, cavitated peripheral carcinoma and pulmonary tuberculosis. In this series the differentiation from other cysts was made thus: with intralobar sequestration, a systemic arterial blood supply was demonstrated; with hydatid cyst, there was a positive intradermal skin test and (radiologically) following rupture, the appearance of a pericystic pneumatocele followed by the water-lily sign was diagnostic; with emphysematous cysts, the signs of associated bronchitis were present; in the presence of pseudocysts, there was a previous history of lung abscess, staphylococcal infection or tuberculosis. Cysts should be removed when first diagnosed.
Topics: Animals; Bronchitis; Cough; Cysts; Dyspnea; Echinococcosis; Echinococcus; Hernia, Hiatal; Humans; Lung Abscess; Mediastinum; Radiology; Respiratory Sounds; Rupture; Sputum; Tuberculosis, Pulmonary
PubMed: 13974421
DOI: No ID Found -
International Journal of Surgery Case... Aug 2022Early thoracic empyema is usually treated through video-assisted thoracoscopic (VATS) decortication. Patient selection is important for decortication if an effective...
INTRODUCTION
Early thoracic empyema is usually treated through video-assisted thoracoscopic (VATS) decortication. Patient selection is important for decortication if an effective surgical outcome is required. Lung isolation techniques are required to provide anesthesia for these patients to facilitate the surgeon while operating on the affected lung. The ultimate target is to protect the non-diseased contra-lateral lung from contamination.
PRESENTATION OF CASE
We are presenting a unique case of 20-year-old female, resident of Karachi, who was brought to the emergency room (ER) with signs of sepsis, hypotension, and multi-organ failure. She was brought to the operating room to undergo video-assisted thoracoscopy (VATS) for lung abscess decortication when her medical therapy had failed. On table decision of right upper lobe resection was made and ventilation strategy had to be modified accordingly.
DISCUSSION
The main anaesthetic aim was to protect the healthy parts of the lung from the abscess. Regular suctioning of secretions during surgery via the double lumen tube (DLT) lumen on the diseased side is recommended. While performing VATS, the lung abscess got ruptured and immediate measures to isolate the lung was taken to assist with surgical resection of the affected lobe. Lobectomy can only be done once the lung was completely isolated and maintaining perfusion and ventilation of the relatively healthy lung help in managing hypoxia.
CONCLUSION
Peri-operative management of ruptured lung abscesses required thorough pre-op evaluation, intraoperative lung isolation and ventilation, and postoperative analgesia with combined team effort both surgical and anaesthetic, are vital fundamentals to consider in guaranteeing the best outcome.
PubMed: 35868131
DOI: 10.1016/j.ijscr.2022.107381 -
International Journal of Environmental... Feb 2020: The management of lung abscess may be a challenge in elderly patients undergoing chemotherapy and/or radiotherapy for previous malignancy. Herein, we reported a case...
: The management of lung abscess may be a challenge in elderly patients undergoing chemotherapy and/or radiotherapy for previous malignancy. Herein, we reported a case series of elderly patients with previous lymphoma undergoing endoscopic treatment followed by pulmonary rehabilitation for lung abscess. : Our study population included a consecutive series of elderly patients with previous lymphoma and lung abscess. Suppurative infection was refractory with specific antibiotic therapy. In all cases, drainage was endoscopically inserted in lung abscess via video-bronchoscopy. This strategy allowed performing daily therapy with the installation of gentamicin directly into the abscess cavity. All patients underwent a respiratory rehabilitation program to speed up convalescence and allow early discharge. : After positioning the catheter through a bronchoscopic route and subsequent washing with gentamicin, all the patients in our study showed an improvement in clinical conditions with resolution of fever within a few days of starting the procedure with normalization of blood tests (mean hospital length 7 ± 0.73 days). A follow-up chest computed tomography scan showed a resolution of lung abscess within a mean of 27 ± 1.53 days. Endoscopic treatment with a rehabilitation program may be a valuable strategy for the management of lung abscess that is refractory to standard antibiotic therapy. Further and larger studiesshould be done to confirm our results.
Topics: Aged; Anti-Bacterial Agents; Bronchoscopy; Female; Humans; Lung Abscess; Lymphoma; Male; Middle Aged; Respiratory Therapy; Tomography, X-Ray Computed
PubMed: 32033391
DOI: 10.3390/ijerph17030997 -
BMC Infectious Diseases Jul 2021Granulicatella adiacens is facultative anaerobic Gram-positive bacteria, which mainly involve bacterial endocarditis and bacteremia, but there are few reports of local...
BACKGROUND
Granulicatella adiacens is facultative anaerobic Gram-positive bacteria, which mainly involve bacterial endocarditis and bacteremia, but there are few reports of local suppurative infection. A case of lung abscess with a coinfection of Granulicatella adiacens and other bacteria in a lung cancer patient will be reported in this paper. To our knowledge, this is the first case report describing lung abscess due to G.adiacens.
CASE PRESENTATION
A 52-year-old Chinese woman was admitted to the hospital, She complained of coughing and expectoration for 1 month, shortness of breath for half a month, and dyspnea for 1 day. After a series of examinations, she was diagnosed with lung abscess, pleural effusion, and bronchogenic carcinoma. Draining pus culture demonstrated Granulicatella adiacens. After more than 5 weeks of antibiotic therapies in total, she gradually recovered to fight against lung cancer.
CONCLUSION
This is the first reported lung abscess caused by G.adiacens. In immunosuppressed hosts, G.adiacens is a virulent pathogen associated with a spectrum of intrathoracic suppurative. Earlier diagnosis and proper drainage surgery with effective antibiotics treatment are very important, and antimicrobial treatment should be more than 5 weeks. When complex pulmonary infection interferes with the CT diagnosis, clinical suspicion of lung cancer should be increased if G.adiacens or Eikenella corrodens is detected from a pulmonary infection.
Topics: Anti-Bacterial Agents; Carnobacteriaceae; Coinfection; Eikenella corrodens; Female; Humans; Lung Abscess; Lung Neoplasms; Middle Aged; Treatment Outcome
PubMed: 34238251
DOI: 10.1186/s12879-021-06191-8 -
Internal Medicine (Tokyo, Japan) Jan 2019
PubMed: 29984749
DOI: 10.2169/internalmedicine.0968-18 -
Respiratory Medicine Case Reports 2016Myotonic dystrophy is a group of inherited disorders called muscular dystrophies. Clinical presentation of this disease is characterised by progressive muscle weakness...
Myotonic dystrophy is a group of inherited disorders called muscular dystrophies. Clinical presentation of this disease is characterised by progressive muscle weakness with myotonia, cataracts, infertility (in males) and cardiac conduction defects. We present a case of a 35 year old male with lung abscess, later diagnosed to be a case of myotonic dystrophy. Lung abscess is an uncommon presentation of this disease and has never been reported before.
PubMed: 27330957
DOI: 10.1016/j.rmcr.2016.04.010 -
Open Access Macedonian Journal of... Sep 2018The incidence of lung abscess acquired in the community is unknown, but this is a common clinical problem encountered in developing countries. The incidence of lung...
BACKGROUND
The incidence of lung abscess acquired in the community is unknown, but this is a common clinical problem encountered in developing countries. The incidence of lung abscess was high in the pre-antibiotic era but the advent of susceptible antibiotics it has reduced with an equal fall in mortality to 8.7%. With the emerging antibiotic resistance and change in the trends of bacteriological profile causing lung abscess, it is the need of time to reevaluate lung abscess.
AIM
The study aimed to determine the clinical, radiological and bacteriological profile of lung abscess.
MATERIAL AND METHOD
The study was a non-randomized prospective observational study conducted in the department of pulmonary medicine for 18 months. In the study, patients > 15 years of age with clinical features of lung abscess were recruited and were subjected to chest X-ray, routine blood test. Sputum gram stain and culture, as well as antibiotic sensitivity according to the organism, were evaluated. Reports of all investigations along with patient characteristics and risk factors were analysed statistically using SPSS 20.0.
RESULTS
Forty-six cases of lung abscess were included, and the majority of patients were found to be adults with a mean age of 42.9 years with a male to female ratio of 6.6:1. The most common predisposing factor was an unhygienic oral cavity in 28% of cases with alcohol ingestion being the most important risk factor in 22% of cases. The most common organism found in lung abscess cases was , and they were sensitive to ceftazidime.
CONCLUSION
Our study shows that should be considered an important pathogen in community-acquired lung abscesses.
PubMed: 30337980
DOI: 10.3889/oamjms.2018.374