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Interactive Cardiovascular and Thoracic... Jun 2022This study aimed to elucidate the outcomes of emergency salvage surgery following life-threatening events (serious haemorrhage and/or infections) among patients with...
OBJECTIVES
This study aimed to elucidate the outcomes of emergency salvage surgery following life-threatening events (serious haemorrhage and/or infections) among patients with lung cancer who had undergone chemo- and/or radiotherapy.
MATERIALS AND METHODS
We analysed the data of patient from 2015 to 2020, retrospectively. The clinical characteristics, including preoperative treatment, perioperative outcomes and survival time, were analysed.
RESULTS
Of the 862 patients who underwent primary lung cancer surgeries, 10 (1.2%) underwent emergency surgeries. The preoperative clinical characteristics were: median age, 63.7 years [interquartile range (IQR) 55-70.5]; sex (male/female), 9/1; clinical staging before initial treatment (I/II/III/IV), 1/1/3/5; initial treatment (chemoradiotherapy/chemotherapy/proton beam therapy), 5/4/1; and indications for emergency surgery (lung abscess/lung abscess with haemoptysis/haemoptysis/empyema), 5/3/1/1. The selected procedures and results were as follows: lobectomy/bilobectomy/pneumonectomy, 8/1/1 (all open thoracotomies); median operation time, 191.0 min (IQR 151-279); median blood loss, 1071.5 ml (IQR 540-1691.5); postoperative severe complications, 3 (30%); hospital mortality, none; median postoperative hospital stay, 37 days (12-125); control of infection and/or haemoptysis, all the cases; final outcome (alive/dead), 3/7 (all the cancer deaths); median postoperative survival, 9.4 months (IQR 4.3-20.4); and median survival from initial treatment, 19.4 months (IQR 8.0-66.9).
CONCLUSIONS
Emergency salvage lung resection is a technically challenging procedure; however, the results were feasible and acceptable when the surgical indication, procedure and optimal timing were considered carefully by a multidisciplinary team. Although the aim was palliation, some patients who received additional chemotherapy afterwards and, thus, had additional survival time.
Topics: Carcinoma, Non-Small-Cell Lung; Female; Hemoptysis; Humans; Lung; Lung Abscess; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Pneumonectomy; Retrospective Studies; Salvage Therapy; Treatment Outcome
PubMed: 35253874
DOI: 10.1093/icvts/ivac043 -
Journal of Clinical Microbiology Jan 2017
Topics: Bronchoalveolar Lavage Fluid; Gentian Violet; Humans; Legionella pneumophila; Lung Abscess; Phenazines; Pneumonia
PubMed: 28031452
DOI: 10.1128/JCM.03512-14 -
BMJ Case Reports Sep 2020genus comprises of obligate anaerobic, gram-negative bacteria that are commensal organisms of oral cavity, gut and vaginal mucosa. Although many species have... (Review)
Review
genus comprises of obligate anaerobic, gram-negative bacteria that are commensal organisms of oral cavity, gut and vaginal mucosa. Although many species have well-established pathogenicity with respect to pulmonary infections, rarely has been isolated as a cause of lung abscess. We present a rare case of left lower lobe lung abscess due to identified using next-generation sequencing of microbial cell-free DNA testing. A brief review of the literature regarding species pulmonary infections, use of next-generation cell-free DNA testing early in the evaluation, antibiotic susceptibility and resistance is also a part of this report.
Topics: Adult; Bacteroidaceae Infections; Humans; Lung Abscess; Male; Prevotella
PubMed: 32900736
DOI: 10.1136/bcr-2020-235960 -
Journal of Investigative Medicine High... 2022Lung abscesses and empyemas are 2 forms of pulmonary infection that can present with similar clinical features. However, empyemas are associated with higher morbidity...
Lung abscesses and empyemas are 2 forms of pulmonary infection that can present with similar clinical features. However, empyemas are associated with higher morbidity and mortality, necessitating the need to distinguish one from the other. Plain radiographs can sometimes provide clues to help differentiate the 2 pathologies but more often than not, a computed tomography scan is required to confirm the diagnosis. Correct diagnosis is essential, as the goal standard therapeutic intervention for empyemas may be contraindicated in patients with lung abscesses. Empyemas require percutaneous or surgical drainage in combination with antibiotics, while lung abscesses are generally treated with antibiotics alone as drainage can be associated with various complications. We present a case of a 65-year-old man with parapneumonic empyema diagnosed with characteristic findings on chest computed tomography and treated with surgical drainage and antibiotics. We hope to improve patient outcomes by highlighting the classical radiographic findings that help distinguish empyema and abscess.
Topics: Male; Humans; Aged; Lung Abscess; Empyema; Drainage; Tomography, X-Ray Computed; Anti-Bacterial Agents
PubMed: 36398866
DOI: 10.1177/23247096221139268 -
JFMS Open Reports 2022An 8-year-old neutered female domestic shorthair cat was referred with complaints of lethargy, anorexia, fever, tachypnoea and a pulmonary mass on thoracic radiography....
CASE SUMMARY
An 8-year-old neutered female domestic shorthair cat was referred with complaints of lethargy, anorexia, fever, tachypnoea and a pulmonary mass on thoracic radiography. Whole-body CT revealed the presence of a nodular lesion in the right caudal lobe of the lung. Fine-needle aspiration of the lung mass yielded purulent fluid and cytology showed a large number of mildly to moderately degenerated neutrophils with numerous cocci and bacilli, leading to the diagnosis of a lung abscess. Empirical administration of doxycycline and orbifloxacin was initiated on the day of referral. Bacterial culture and antibiotic susceptibility tests using the collected fluid sample detected two types of bacteria, which were susceptible to both antibiotics. The clinical signs of the cat improved after the initiation of treatment, and the antibiotics were discontinued 28 days later, after the lung lesions disappeared. No recurrence of lung abscess was observed until 588 days after the discontinuation of treatment.
RELEVANCE AND NOVEL INFORMATION
Only one case of a lung abscess has been previously reported in cats. Furthermore, while surgical resection is the most common treatment for lung abscesses in the field of veterinary medicine, this is the first report of successful treatment with antibiotic administration alone.
PubMed: 35356306
DOI: 10.1177/20551169221086434 -
Infection and Drug Resistance 2019A lung abscess is an infectious pulmonary disease characterized by pus-filled cavity formation and often an air-fluid level. In this article, we described an indolent...
A lung abscess is an infectious pulmonary disease characterized by pus-filled cavity formation and often an air-fluid level. In this article, we described an indolent community-acquired lung abscess suspected as a tumor previously. A 56-year-old male presented with cough and expectoration for 2 months and hemoptysis for 2 weeks. His physical examinations, whole blood count and C-reactive protein level were normal. The chest computed tomography (CT) scan showed a 40×38×39 mm high-density mass in the right upper pulmonary lobe, with irregular borders. The pathology of a CT-guided percutaneous needle aspiration biopsy showed numerous inflammatory cells and bacteria infiltration without tumor lesions. Bacteriological detection of lung tissue revealed the cause was odontogenic flora. A next-generation sequencing demonstrated the etiologic correlation between lung abscess and periodontitis. After a 2-month pathogen-directed oral antibiotics therapy combined with chlorhexidine gargle oral care, this patient showed a remarkable improvement. Periodontitis can be a cause of a lung abscess, which would be taken into account in the treatment regimes preventing infectious recurrence.
PubMed: 31496760
DOI: 10.2147/IDR.S218921 -
The Western Journal of Medicine Nov 1974The bacteriology of the gastrointestinal tract is rapidly changing in laboratory techniques and clinical correlations. The flora is found to be very complex,... (Review)
Review
The bacteriology of the gastrointestinal tract is rapidly changing in laboratory techniques and clinical correlations. The flora is found to be very complex, predominantly anaerobic, and importantly dependent on diet. An etiologic role for colon bacteria in colon cancer is suggested by correlations between epidemiologic data and prevalent dietary patterns and stool culture findings. Cultures from aspiration pneumonia, subphrenic abscess, and other intra-abdominal sepsis all yield anaerobes, and for best results antibiotic therapy should combat them as well as aerobes.
Topics: Adolescent; Adult; Aged; Anaerobiosis; Anti-Bacterial Agents; Bacteria; Child; Clostridium; Colonic Neoplasms; Diet; Eubacterium; Feces; Female; Humans; Intestines; Japan; Jejunum; Lung Abscess; Male; Middle Aged; Pneumonia, Aspiration; Sepsis; Stomach Neoplasms; Streptococcus; Subphrenic Abscess; United States
PubMed: 4617971
DOI: No ID Found -
Italian Journal of Pediatrics Aug 2023Fusobacterium necrophorum is an anaerobic, gram-negative, non-motile, filamentous, non-spore forming bacillus found in the oral cavity, gastrointestinal tract, and... (Review)
Review
BACKGROUND
Fusobacterium necrophorum is an anaerobic, gram-negative, non-motile, filamentous, non-spore forming bacillus found in the oral cavity, gastrointestinal tract, and female genital tract, responsible of a rare disease named Lemierre Syndrome, characterized by septic thrombophlebitis of the internal jugular vein, which mainly affects previously healthy adolescents and young adults; some risk factors are reported, as smoking or primary viral or bacterial infection leading to the disruption of mucosa. The syndrome originates commonly from an upper respiratory infection such as pharyngotonsillitis, acute otitis media, cervical lymphadenitis, sinusitis, or odontogenic abscess, and may result in multiorgan metastasis, more frequently leading to pulmonary complications, especially lung abscesses.
CASE PRESENTATION
We describe two cases of adolescents with atypical Lemierre Syndrome evaluated in a tertiary care center, one with a confirmed infection by Fusobacterium necrophorum and one with a presumptive diagnosis based on clinical features, who developed lung abscesses needing a prolonged antibiotic course and hospitalization. Of interest, both were user of electronic cigarette, configuring a possible new risk factor. The proper diagnosis of Lemierre Syndrome is often difficult to establish, so a high degree of suspicion is needed, especially in the case of lung abscesses in otherwise healthy adolescents.
CONCLUSION
The current study will contribute to providing insight into Lemierre Syndrome clinical presentation and management in adolescents, promoting awareness for a rare but potentially fatal disease. Moreover, it suggests a possible relationship between Lemierre syndrome and the use of electronic cigarette, that should be investigated by future studies.
Topics: Young Adult; Humans; Female; Adolescent; Lemierre Syndrome; Lung Abscess; Electronic Nicotine Delivery Systems; Thrombophlebitis; Anti-Bacterial Agents
PubMed: 37563612
DOI: 10.1186/s13052-023-01499-4 -
Clinical Case Reports Dec 2022Granuloma polyangiitis (GPA) is a necrotizing granulomatous inflammation, which is a systemic autoimmune disease that mainly affects the upper respiratory tract, lungs,...
Granuloma polyangiitis (GPA) is a necrotizing granulomatous inflammation, which is a systemic autoimmune disease that mainly affects the upper respiratory tract, lungs, and kidneys. Clinically, the clinical manifestations of GPA vary greatly, and it is extremely easy to be misdiagnosed. We report a 60-year-old man with granulomatous polyangiitis with dysuria and parotid gland enlargement as the first symptom. As the condition worsened, he gradually developed symptoms in multiple systems such as persistent high fever, nosebleeds, hemoptysis, skin rash, and multiple cavities in the lungs. Due to high fever, hemoptysis, and the gradual expansion of lung cavities, the suspected hematogenous lung abscess was not well controlled and transferred to the respiratory department. The manifestation of involvement was finally confirmed by skin biopsy. Biopsy was performed on the skin of the lower extremities with a dark red rash with multiple microprojections. Pathology indicated neutrophilic infiltration and necrosis of small vessel walls, and granuloma formation. Blood anti-protease 3 antibody (PR3) was positive Monotherapy with prednisone. Body temperature gradually returned to normal; hemoptysis and nasal bleeding disappeared; parotid gland enlargement and dysuria relieved, and lung cavities gradually reduced. When anti-infective treatment is ineffective, we should consider the presence of some non-infectious diseases, especially when multiple systems are involved; biopsy should be performed as soon as possible. Granulomatous polyangiitis has various manifestations. Parotid glands and prostate may also be the first organs involved, not limited to common targets such as the respiratory tract and kidneys.
PubMed: 36518914
DOI: 10.1002/ccr3.6445 -
World Journal of Gastrointestinal... Apr 2023Colopleural fistula is a rare condition, and only a limited number of cases have been reported. Here, we report a case of idiopathic colopleural fistula in an adult...
BACKGROUND
Colopleural fistula is a rare condition, and only a limited number of cases have been reported. Here, we report a case of idiopathic colopleural fistula in an adult without any known predisposing factors. The patient presented with a lung abscess and refractory empyema and was successfully treated with surgical resection.
CASE SUMMARY
A 47-year-old man with a history of lung tuberculosis, which had been completely cured 4 years ago, presented to our emergency department with a productive cough and fever for 3 d. Tracing his history, he had undergone left lower lobe segmentectomy of the left lung due to lung abscess one year ago at another hospital. However, he developed refractory empyema postoperatively despite surgical intervention including decortication and flap reconstruction. After admission, we reviewed his previous medical images and noted a fistula tract between the left pleural cavity and splenic flexure. In addition, according to his medical records, bacterial culture of the thoracic drainage showed growth of and . Our lower gastrointestinal series and colonoscopy confirmed the diagnosis of colopleural fistula. The patient underwent a left hemicolectomy, splenectomy, and distal pancreatectomy, and the diaphragm was repaired under our care. No further empyema recurrence was noted during follow-up.
CONCLUSION
Indicative signs of colopleural fistula include refractory empyema accompanied by the growth of colonic flora in the pleural fluid.
PubMed: 37206068
DOI: 10.4240/wjgs.v15.i4.740