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Lung abscess
Cavitating area of localized,suppurative infection within the lung
Causes
• Inadequately treated pneumonia
• Aspiration (alcoholism,oesophageal obstruction,bulbar palsy)
• Bronchial obstruction (tumor,foreign body)
• Pulmonary infarction
• Septic emboli (septicemia,right heart endocarditis,IV drug use)
• Subphrenic or hepatic abscess
Clinical features
• Swinging fever
• Cough
• Purulent,foul smelling sputum
• Pleuritic chest pain
• Haemoptysis
• Malaise
• Weight loss
• Finger clubbing
• Anaemia
• Crepitations
• Empyema (20-30%)
Tests
• Blood
• FBC (anaemia,neutrophilia0
• ESR
• CRP
• Blood cultures
• Sputum
• Microscopy
• Culture
• Cytology
• CXR
• CT scan
• Bronchoscopy
CXR
• Walled cavity
• Fluid level
Treatment
• Antibiotics indicated by sensitivities
• Continue until healed (4-6 weeks)
• Antibiotic instillation may be needed
• Postural drainage
• Repeated aspiration
• Surgical excision

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Lung abscess

  • 1. Lung abscess Cavitating area of localized,suppurative infection within the lung
  • 2. Causes • Inadequately treated pneumonia • Aspiration (alcoholism,oesophageal obstruction,bulbar palsy) • Bronchial obstruction (tumor,foreign body) • Pulmonary infarction • Septic emboli (septicemia,right heart endocarditis,IV drug use) • Subphrenic or hepatic abscess
  • 3. Clinical features • Swinging fever • Cough • Purulent,foul smelling sputum • Pleuritic chest pain • Haemoptysis • Malaise • Weight loss • Finger clubbing • Anaemia • Crepitations • Empyema (20-30%)
  • 4. Tests • Blood • FBC (anaemia,neutrophilia0 • ESR • CRP • Blood cultures • Sputum • Microscopy • Culture • Cytology • CXR • CT scan • Bronchoscopy
  • 6. Treatment • Antibiotics indicated by sensitivities • Continue until healed (4-6 weeks) • Antibiotic instillation may be needed • Postural drainage • Repeated aspiration • Surgical excision