Lung abscess

You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.

Lung abscess Classification and external resources
Gross lung section showing apical abscess
ICD-10	J85.
ICD-9	513.0
DiseasesDB	7607
eMedicine	med/1332
MeSH	D008169

WikiDoc Resources for Lung abscess
Articles
Most recent articles on Lung abscess Most cited articles on Lung abscess Review articles on Lung abscess Articles on Lung abscess in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Lung abscess Images of Lung abscess Photos of Lung abscess Podcasts & MP3s on Lung abscess Videos on Lung abscess
Evidence Based Medicine
Cochrane Collaboration on Lung abscess Bandolier on Lung abscess TRIP on Lung abscess
Clinical Trials
Ongoing Trials on Lung abscess at Clinical Trials.gov Trial results on Lung abscess Clinical Trials on Lung abscess at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Lung abscess NICE Guidance on Lung abscess NHS PRODIGY Guidance FDA on Lung abscess CDC on Lung abscess
Books
Books on Lung abscess
News
Lung abscess in the news Be alerted to news on Lung abscess News trends on Lung abscess
Commentary
Blogs on Lung abscess
Definitions
Definitions of Lung abscess
Patient Resources / Community
Patient resources on Lung abscess Discussion groups on Lung abscess Patient Handouts on Lung abscess Directions to Hospitals Treating Lung abscess Risk calculators and risk factors for Lung abscess
Healthcare Provider Resources
Symptoms of Lung abscess Causes & Risk Factors for Lung abscess Diagnostic studies for Lung abscess Treatment of Lung abscess
Continuing Medical Education (CME)
CME Programs on Lung abscess
International
Lung abscess en Espanol Lung abscess en Francais
Businness
Lung abscess in the Marketplace Patents on Lung abscess
Experimental / Informatics
List of terms related to Lung abscess

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Lung abscess is necrosis of the pulmonary tissue and formation of cavities (more than 2 cm)^[1] containing necrotic debris or fluid caused by microbial infection.

This pus-filled cavity is often caused by aspiration, which may occur during altered consciousness. Alcoholism is the most common condition predisposing to lung abscesses.

Lung Abscess is considered primary(60%^[1]) 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.

Causes

Conditions contributing to lung abscess

• Aspiration of oropharyngeal or gastric secretion
• Septic emboli
• Necrotizing pneumonia
• Vasculitis: Wegener's granulomatosis
• Necrotizing tumors: 8% to 18% are due to neoplasms across all age groups, higher in older people; primary squamous carcinoma of the lung is the commonest.

Organisms

In the post-antibiotic era pattern of frequency is changing. In older studies anerobes were found in upto 90% cases but they are much less frequent now^[1].

• Anaerobic bacteria: Peptostreptococcus, Bacteroides, Fusobacterium species,
• Microaerophilic streptococcus : Streptococcus milleri
• Aerobic bacteria: Staphylococcus, Klebsiella, Haemophilus, Pseudomonas,Nocardia, Escheria coli, Streptococcus, Mycobacteria^[1]
• Fungi: Candida, Aspergillus
• Parasites: Entamoeba histolytica,

Symptoms and signs

Onset of symptoms is often gradual, but in necrotizing staphylococcal or gram-negative bacillary pneumonias patients can be acutely ill. Cough, fever with shivering and night sweats are often present. Cough can be productive with foul smelling purulent sputum (≈70%) or less frequently with blood (i.e. hemoptysis in one third cases) ^[1]. Affected individuals may also complaint chest pain, shortness of breath, lethargy and other features of chronic illness.

Patients are generally cachectic at presentation. Finger clubbing is present in one third of patients^[1]. Dental decay is common especially in alcoholics and children. On examination of chest there will be features of consolidation such as localised dullness on percussion, bronchial breath sound etc.

Diagnosis

Chest Xray and other imaging studies

Abscess is often unilateral and single involving posterior segments of the upper lobes and the apical segments of the lower lobes as these areas are gravity dependent when lying down. Presence of air-fluid levels implies rupture into the bronchial tree or rarely growth of gas forming organism.

Laboratory studies

Raised inflammatory markers ( high ESR, CRP) are usual but not specific. Examination of sputum is important in any pulmonary infections and here often reveals mixed flora. Transtracheal of Transbronchial (via bronchoscopy) aspirates can also be cultured. Fibre optic bronchoscopy is often performed to exclude obstructive lesion; it also helps in bronchial drainage of pus.

Management

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.

Complications

Rare now a days but include spread of infection to other lung segments, bronchiectasis, empyema, and bacteraemia with metastatic infection such as brain abscess^[1].

Prognosis

Most cases respond to antibiotic and prognosis is usually excellent unless there is a debilitating underlying condition. Mortality from lung abscess alone is around 5% and is improving.

See also

• Other chronic lung infections
  • Empyema
  • Bronchiectasis
• Abscess
• Pleural effusion

External links

• Merck
• 02036 at CHORUS

Reference

v • d • e Pathology of respiratory system (J, 460-519), respiratory diseases
Upper RT (including URTIs, Common cold)	Head sinuses: Sinusitis nose: Rhinitis (Vasomotor rhinitis, Atrophic rhinitis, Hay fever) - Nasal polyp - Deviated septum tonsil: Tonsillitis - Adenoid hypertrophy - Peritonsillar abscess Neck pharynx: Pharyngitis (Strep throat) larynx: Laryngitis - Croup - Laryngospasm - vocal folds: Vocal fold nodule - epiglottis: Epiglottitis trachea: Tracheitis - Tracheal stenosis
Lower RT/lung disease (including LRTIs)	Pneumonia Viral - Bacterial/Atypical pneumonia (Mycoplasma) - Fungal pneumonia (Pneumocystis pneumonia) - Parasitic pneumonia - Bronchopneumonia - Chemical pneumonia (Mendelson's syndrome) Bronchial/ obstructive Acute: Bronchitis (Acute, Chronic) - Bronchiolitis Chronic: Emphysema - COPD - Asthma (Status asthmaticus) - Diffuse panbronchiolitis - Bronchiectasis Interstitial/ restrictive External agents/ occupational lung disease Pneumoconiosis (Asbestosis, Baritosis, Bauxite fibrosis, Berylliosis, Caplan's syndrome, Chalicosis, Coalworker's pneumoconiosis, Siderosis, Silicosis, Byssinosis) Hypersensitivity pneumonitis (Bagassosis, Bird fancier's lung, Farmer's lung) Other ARDS - Pulmonary edema - Löffler's syndrome/Eosinophilic pneumonia - Respiratory hypersensitivity (Allergic bronchopulmonary aspergillosis) Hamman-Rich syndrome - Idiopathic pulmonary fibrosis Obstructive or restrictive Atelectasis - Bronchiolitis obliterans
Pleural cavity/mediastinum	Suppuration Empyema - Lung abscess Pleural disease/pleural effusion Hemothorax - Pneumothorax (Tension pneumothorax) - Hemopneumothorax - Hydrothorax - Chylothorax - Pleurisy Mediastinal disease Mediastinal emphysema - Mediastinitis
Other/general	Respiratory failure - Influenza - SARS - Idiopathic pulmonary haemosiderosis
see also congenital, neoplasia

v • d • e WikiDoc Research Resources for Lung abscess
Articles on Lung abscess	Most recent articles on Lung abscess • Most cited articles on Lung abscess • Review articles on Lung abscess • Articles on Lung abscess in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Lung abscess	Powerpoint slides on Lung abscess • Images of Lung abscess • Photos of Lung abscess • Podcasts & MP3s on Lung abscess • Videos on Lung abscess
Evidence Based Medicine Regarding Lung abscess	Cochrane Collaboration on Lung abscess • Bandolier on Lung abscess • TRIP on Lung abscess
Cost Effectiveness of Lung abscess	Cost Effectiveness of Lung abscess
Clinical Trials Involving Lung abscess	Ongoing Trials on Lung abscess at Clinical Trials.gov • Trial results on Lung abscess • Clinical Trials on Lung abscess at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Lung abscess	US National Guidelines Clearinghouse on Lung abscess • NICE Guidance on Lung abscess • NHS PRODIGY Guidance • FDA on Lung abscess • CDC on Lung abscess
Textbook Information on Lung abscess	Books and Textbook Information on Lung abscess
Pharmacology Resources on Lung abscess	Dosing of Lung abscess • Drug interactions with Lung abscess • Side effects of Lung abscess • Allergic reactions to Lung abscess • Overdose information on Lung abscess • Carcinogenicity information on Lung abscess • Lung abscess in pregnancy • Pharmacokinetics of Lung abscess •
Genetics, Pharmacogenomics, and Proteinomics of Lung abscess	Genetics of Lung abscess • Pharmacogenomics of Lung abscess • Proteomics of Lung abscess
Newstories on Lung abscess	Lung abscess in the news • Be alerted to news on Lung abscess • News trends on Lung abscess
Commentary on Lung abscess	Blogs on Lung abscess
Patient Resources on Lung abscess	Patient resources on Lung abscess • Discussion groups on Lung abscess • Patient Handouts on Lung abscess • Directions to Hospitals Treating Lung abscess • Risk calculators and risk factors for Lung abscess
Healthcare Provider Resources on Lung abscess	Symptoms of Lung abscess • Causes & Risk Factors for Lung abscess • Diagnostic studies for Lung abscess • Treatment of Lung abscess
Continuing Medical Education (CME) Programs on Lung abscess	CME Programs on Lung abscess
International Resources on Lung abscess	Lung abscess en Espanol • Lung abscess en Francais
Business Resources on Lung abscess	Lung abscess in the Marketplace • Patents on Lung abscess
Informatics Resources on Lung abscess	List of terms related to Lung abscess

nl:Longabces

fi:Keuhkopaise

WikiDoc Help Menu Quick Start.. Get Started Here! How to Login How to Search Pages How to Start a New Page How to Edit a Page Cheat Sheet Editing basics Learning Basic Formatting How to make Links in WikiDoc & to External Sites How to Make Lists How to Ignoring Formatting Adding References or Footnotes to Articles Tracking Changes You Have Made How to Put an Article Into a Category When Multiple Topics Should Go To The Same Page (MI, Acute MI, AMI) Using Redirection Advanced editing How to Make Tables How to Insert Images and Other Media How to Add Video Help:How to Make Columns Web Colors How To Make Templates How to Move Pages Inserting Dynamic Dates and Times Inserting WikiDoc Statistics Editing the Table of Contents Communicating your edits Let others know what you changed: The importance of Edit Summaries Minor Edits Edit Conflicts Help Videos You Can Watch Getting Started Video

Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .