Introduction Suppurative inflammation of lung tissue within normal parenchyma result of autodigestion of tissue by inflammatory cells Etiology most often a result of aspiration of oropharyngeal material bronchial obstruction e.g. cancer sequela of bacterial pneumonia common pathogens include Bacteroides, Peptostreptococcus, Fusobacterium more often seen in the right lung than the left result of wider and straighter right mainstem bronchus if multiple foci present the cause is most likely hematogenous spreading Risk factors poor oral hygiene impaired swallowing immunosuppression altered consciousness includes seizures, dementia and alcoholism Presentation Symptoms fever, malaise cough with sputum production putrid or foul-smelling sputum weight loss, night sweats (subacute) Evaluation CXR infiltrates often with cavity in dependent portion of lung (depends on position) air-fluid level in cavity Labs leukocytosis Sputum may be helpful to identify etiologic organism though contamination is common
QUESTIONS 1 of 2 1 2 Previous Next (M1.PL.13.78) An 86-year-old male with a past medical history significant for an MCA stroke presents with recurrent fevers. He is currently living in a nursing home facility. A chest radiograph was obtained and is shown in Figure A. Which of the following is the most likely causative organism for this lesion? QID: 100881 FIGURES: A Type & Select Correct Answer 1 Mycobacterium tuberculosis 17% (9/54) 2 Bacteroides spp. 33% (18/54) 3 Pseudomonas aeurginosa 20% (11/54) 4 Streptococcus pyogenes 0% (0/54) 5 Klebsiella pneumoniae 30% (16/54) M 2 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK