Updated: 4/19/2014

Lung Abscess

Topic

Review Topic

N/A

Questions

Evidence

Topic

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

Please rate topic.

Average 4.3 of 6 Ratings

Questions (2)

(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:

Type & Select Correct Answer

Type in at least one full word to see suggestions list

Mycobacterium tuberculosis

14%

(10/74)

Bacteroides spp.

34%

(25/74)

Pseudomonas aeurginosa

20%