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Annals of Translational Medicine Aug 2015Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial... (Review)
Review
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection. It can be caused by aspiration, which may occur during altered consciousness and it usually causes a pus-filled cavity. Moreover, alcoholism is the most common condition predisposing to lung abscesses. Lung abscess is considered primary (60%) when it results from existing lung parenchymal process and is termed secondary when it complicates another process, e.g., vascular emboli or follows rupture of extrapulmonary abscess into lung. There are several imaging techniques which can identify the material inside the thorax such as computerized tomography (CT) scan of the thorax and ultrasound of the thorax. Broad spectrum antibiotic to cover mixed flora is the mainstay of treatment. Pulmonary physiotherapy and postural drainage are also important. Surgical procedures are required in selective patients for drainage or pulmonary resection. In the current review we will present all current information from diagnosis to treatment.
PubMed: 26366400
DOI: 10.3978/j.issn.2305-5839.2015.07.08 -
Ugeskrift For Laeger May 2021A lung abscess is a necrotising infection leading to loss of healthy lung tissue. It develops over several weeks, and the typical presentation includes cough, fever, and... (Review)
Review
A lung abscess is a necrotising infection leading to loss of healthy lung tissue. It develops over several weeks, and the typical presentation includes cough, fever, and general deterioration. The clinical work-up includes contrast-enhanced CT-scans, and frequently flexible bronchoscopy with broncho-alveolar lavage as described in this review. The infection commonly represents aspiration of oral bacterial flora, including anaerobic microbes. Penicillin resistance is common. A lung abscess generally requires long-term, tailored antibiotic treatment. The patient should consult a dentist to identify possible dental foci.
Topics: Anti-Bacterial Agents; Bacteria; Bronchoscopy; Humans; Lung; Lung Abscess
PubMed: 34060466
DOI: No ID Found -
Archives of Iranian Medicine Jun 2022
Topics: Actinomyces; Empyema, Pleural; Humans; Lung Abscess
PubMed: 35943021
DOI: 10.34172/aim.2022.65 -
Children (Basel, Switzerland) Jul 2022(1) Background: Lung abscess is a lung infection that leads to the destruction of the lung parenchyma, resulting in a cavity formation and central necrosis filled with...
(1) Background: Lung abscess is a lung infection that leads to the destruction of the lung parenchyma, resulting in a cavity formation and central necrosis filled with purulent fluids. It is an uncommon pediatric problem, and there is a paucity of literature reviews on this subject, especially for the pediatric age group. Lung abscess is commonly divided into those considered primary in previously well children or secondary in those with predisposing co-morbidities. The predominant pathogens isolated from primary lung abscesses are the aerobic organisms, including streptococcal species, Staphylococcus aureus, and Klebsiella pneumoniae, while anaerobic bacteria such as Bacteroides species are predominant in secondary groups. Children usually present with fever, cough, shortness of breath, chest pain, and sputum. While physical examination may reveal diffuse crackles on auscultation, the diagnosis is usually confirmed by chest X-ray. (2) Methods: We report four different cases with lung abscesses from both primary and secondary group with similar presentations and radiological findings, but the approach was different in each according to the underlining cause. (3) Conclusions: Conservative therapies with a prolonged course of antibiotics remain the cornerstone of therapy for both primary and secondary lung abscesses. The underlying cause should be considered when there is a suboptimal response. However, invasive intervention is becoming more popular with better yield, shorter duration of antibiotics and admission, and excellent prognosis.
PubMed: 35884031
DOI: 10.3390/children9071047 -
Bacteriological Reviews Sep 1961
Topics: Humans; Lung Abscess; Plague
PubMed: 14473142
DOI: 10.1128/br.25.3.249-261.1961 -
Cureus Nov 2022A 72-year-old male presented to the ER with three days of productive cough, shortness of breath, and generalized weakness. Chest X-ray showed right lung opacity in the...
A 72-year-old male presented to the ER with three days of productive cough, shortness of breath, and generalized weakness. Chest X-ray showed right lung opacity in the lower lobe. Chest CT scan showed consolidation in the superior segment of the right lower cavity with air-fluid level extending to the pleural and chest wall, suggestive of lung abscess with loculated empyema and thickened pleura. The patient received antibiotics and CT-guided aspiration of blood-tinged fluid followed by two weeks of drainage via a transthoracic catheter. There was a near-complete resolution of the opacity and closure of the lung abscess on follow-up chest imaging. The patient clinically improved with resolution of the cough and dyspnea. Workup was negative for bacteria and acid-fast bacilli (AFB). The purpose of this paper is to review short-term and long-term management, approach, and consideration to be taken while facing a pan-negative etiological workup of a complicated abscess.
PubMed: 36579261
DOI: 10.7759/cureus.31910 -
Critical Care (London, England) Oct 2023Patients undergoing mechanical ventilation (MV) for COVID-19 exhibit an increased risk of ventilator-associated pneumonia (VAP). The occurrence of lung abscesses... (Observational Study)
Observational Study
BACKGROUND
Patients undergoing mechanical ventilation (MV) for COVID-19 exhibit an increased risk of ventilator-associated pneumonia (VAP). The occurrence of lung abscesses following VAP in these patients has been poorly studied. We aimed to describe the incidence, characteristics, risk factors and prognosis of lung abscesses complicating VAP after COVID-19.
METHODS
We conducted an observational, retrospective study in three French intensive care units. Patients admitted for acute respiratory failure with a confirmed SARS-CoV-2 PCR and requiring MV for more than 48 h were included.
RESULTS
Among the 507 patients included, 326 (64%) had a documented VAP. Of these, 23 (7%) developed a lung abscess. Enterobacterales (15/23, 65%) were the main documentation, followed by non-fermenting Gram-negative bacilli (10/23, 43%) and Gram-positive cocci (8/23, 35%). Lung abscesses were mainly plurimicrobial (15/23, 65%). In multivariate analysis, a plurimicrobial 1st VAP episode (OR (95% CI) 2.93 (1.16-7.51); p = 0.02) and the use of hydrocortisone (OR (95% CI) 4.86 (1.95-12.1); p = 0.001) were associated with lung abscess development. Intensive care unit (ICU) mortality of patients with lung abscesses reached 52%, but was not significantly higher than for patients with VAP but no lung abscess. Patients with lung abscesses had reduced ventilator-free days at day 60, a longer duration of MV and ICU stay than patients with VAP but no lung abscess (respectively, 0 (0-3) vs. 16 (0-42) days; p < 0.001, 49 (32-73) vs. 25 (11-41) days; p < 0.001, 52 (36-77) vs. 28 (16-47) days; p < 0.001).
CONCLUSIONS
Lung abscessing pneumonia is not uncommon among COVID-19 patients developing VAP. A plurimicrobial first VAP episode and the use of hydrocortisone are independently associated with this complication. In COVID-19 patients with persistent VAP, a chest CT scan investigating the evolution toward lung abscess should be considered.
Topics: Humans; Pneumonia, Ventilator-Associated; Lung Abscess; Retrospective Studies; Cohort Studies; Hydrocortisone; COVID-19; SARS-CoV-2; Respiration, Artificial; Intensive Care Units
PubMed: 37794402
DOI: 10.1186/s13054-023-04660-x -
Cureus Aug 2022A 68-year-old male with a known history of von Hippel-Lindau disease with brain hemangioblastoma status post radiation therapy and recurrent hemangioblastoma in the...
A 68-year-old male with a known history of von Hippel-Lindau disease with brain hemangioblastoma status post radiation therapy and recurrent hemangioblastoma in the spine and multiple spinal surgeries presented initially to the emergency department due to hemoptysis and worsening shortness of breath. A CT chest demonstrated a left lung mass and left pleural effusion, which was initially suspected to be lung malignancy given his symptoms and history. However, it was determined to be a lung abscess following workup and consultations. This case highlights the similarities in the presentation of both pathologies and the critical features in lung abscesses.
PubMed: 36106291
DOI: 10.7759/cureus.27725 -
BMJ Case Reports Feb 2018
Topics: Anti-Bacterial Agents; Cefepime; Cephalosporins; Cerebral Palsy; Epilepsies, Myoclonic; Humans; Lung Abscess; Male; Middle Aged
PubMed: 29467125
DOI: 10.1136/bcr-2017-223954