The presentation provides information on lung abscesses, including their pathophysiology, clinical features, and radiological investigation. It notes that lung abscesses are caused by microbial infection which leads to liquefactive necrosis and cavity formation in the lung tissue. Common symptoms include fever, cough, and chest pain. Radiological exams like chest X-rays and CT scans are used to identify characteristics of lung abscesses such as thick-walled cavities containing air-fluid levels. CT scans provide additional details to differentiate abscesses from similar conditions like empyemas.

1. Welcome to my presentation
Presented by
RABEYA SULTANA MIM
Student ID :182408
Session: 2018-2019
Department of Physiotherapy & Rehabilitation
Jashore University of Science & Technology

2. RADIOLOGICAL INVESTIGATION ON LUNG ABSCESS

3. What is lung
abscess?
Pathophysiology
of pulmonary
abscess?
Radiological
Investigation of
it?
Clinical Features
of it?
Learning outcome

4. • 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.

5. Clinical features:
Early symptoms:
• Fever and chills
• Night sweats
• Persistent cough
• Later signs and symptoms :
• Pain with deep breathing
• Hemoptysis
• Shortness of breath
• Foul-smelling sputum
• Unintentional weight loss
• Fatigue
• Clubbing

6. Pathophysiology
Due to aspiration & Periodontal disease.
A bacterial inoculum from the gingival crevice reaches the lower
airways and infection is initiated
Aspiration pneumonitis
Progression to tissue necrosis 7-14 days later
Lung abscess.

7. Radiological Investigation by:
• Chest X-Ray(CXR)
• Chest CT Scan

8. • Chest X Ray: Parenchymal inflammation with a cavity containing an
air–fluid level
https://radiopaedia.org/cases/lung-abscess-17
Radiological findings on CXR

9. Radiological findings on CXR
• Usually single cavity
• Cavities typically have a
• Thick-wall
• Smooth inner margin
• Air-fluid level
• More frequent in superior segments of lower lobes or posterior
segments of lower lobes
• Unlike pleural collections, lung abscesses frequently have a fluid
level which is approximately the same length on both the frontal
and lateral projection
• About 1/3 may have an associated empyema

10. Lung abscess or empyema?
• A large peripheral lung abscess and an encysted empyema can be
confused on a chest X-ray .
• Thoracic CT is usually needed to make the distinction.

11. Differential diagnostic features between abscess and empyema in CT:
• Relationship to adjacent bronchi/vessels
• abscesses doesn’t interrupt the Broncho vascular structures
• empyema will usually distort and compress adjacent lung
• Shape
• Round/spherical in abscess
• Elliptical in empyema
• split pleura sign
• Wall
• abscesses have thick irregular walls
• empyema are usually smoother
• Angle with chest wall
• abscesses usually have an acute angle
• empyema tends to have obtuse angles

12. Chest CT scan of lung Abscess Chest CT scan of empyema

14. Reference:
• En.wikipedia.org. 2022. Lung abscess - Wikipedia. [online] Available at:
<https://en.wikipedia.org/wiki/Lung_abscess> [Accessed 15 March 2022].
• Verywell Health. 2022. What Is a Lung Abscess?. [online] Available at:
<https://www.verywellhealth.com/lung-abscess-overview-4768089> [Accessed 15 March
2022].
• Emedicine.medscape.com. 2022. Lung Abscess: Background, Pathophysiology, Etiology.
[online] Available at: <https://emedicine.medscape.com/article/299425-overview#a5>
[Accessed 17 March 2022].
• Learningradiology.com. 2022. Learning Radiology - Lung, Abscess, pulmonary. [online]
Available at: <http://www.learningradiology.com/archives2008/COW%20306-
Lung%20abscess/lungabscesscorrect.html> [Accessed 17 March 2022].
• Learningradiology.com. 2022. Learning Radiology - Lung, Abscess, pulmonary. [online]
Available at: <http://www.learningradiology.com/archives2008/COW%20306-
Lung%20abscess/lungabscesscorrect.html> [Accessed 17 March 2022].

15. THANK YOU