definition, etiology, clinicalfeatures,diagnostic evaluation,management

3. LUNG ABSCESS:
Lung Abscess is a localized necrotic
lesion of the lung parenchyma containing
purulent material that collapses and forms a
cavity.
It is generally caused by aspiration of
anaerobic bacteria.

4. The areas of the lungs most commonly
affected are :
• The superior segment of the lower
lobes.
• The posterior segment of the upper
lobes.

5. Causes of lung abscess:
1) Aspiration of oropharyngeal or gastric secretion.
2) Septic emboli.
3) Necrotizing pneumonia
4) Vasculities: granulomatosis
5) Necrotizing tumors
6) Gram negative organisms. (klebsiella)

6. 7) Anaerobic bacilli (Bacterorides)
8) Carcinoma of the lung
9) TB
10) Parasitic and fungal diseases of the lung.

7. Predisposing factors
for aspiration
Alcohol abuse
Seizure disorders
unconsciousness

8. PATHOPHYSIOLOGY
Due to etiological factors
Entry of micro-organisms in to the lungs
Infection and inflammatory changes in lungs
Necrosis of the lung tissue
Tissue hypoxia
Breathing impairment
dyspnea

9. CLINICAL MANIFESTATIONS:
1) Cough with foul smelling purulent sputum
(Halitosis).
2) Fever with shivering
3) Night sweats
4) hemoptysis
5) Chest pain
6) Shortness of breath

10. 7) Lethargy
8) Finger clubbing
9) Fever
10) Leukocytosis
11) Dyspnea
12) Weakness
13) Anorexia
14) Weight loss

11. DIAGNOSTIC EVALUATION
 Laboratory studies
 Raised inflammatory markers (high ESR,
CRP)

12. Con----------
 Transtracheal or transbronchial (via
bronchoscopy) aspirates can also be
cultured.
 Fiber optic bronchoscopy is often
performed to exclude obstructive lesion
 it also helps in bronchial drainage of
pus.

13. Radiologic Findings
CHEST RADIOGRAPH
Increased density
Cavity formation
Cavity with air-fluid levels
Fibrosis
Pleural effusion

14. MANAGEMENT
 Treatment: antibiotics (often with
surgical drainage). Clindamycin is a
good choice . Penicillin G might be
effective.

15. Con----------------
 Broadspectrum 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.