Abscesses are walled cavities filled with purulent material, occurring in any area of the body including the lung, as a complication of other conditions such as aspiration, tuberculosis and pneumonia. Risk factors include impaired cough reflexes in such states as when under anesthesia, while intoxicated, or during seizures. Dental caries, bronchiectatisis and bronchial cancers are conditions which can lead to abscesses. Organisms commonly involved are Klebsiella, E. Coli, Staph Aureus.
Symptoms
Weight loss, malaise, night sweats, fever, and cough with productive, foul smelling sputum.
Diagnosis
1) Auscultation may not lead many positive signs.
2) X-rays may show a walled cavity, with possibly a fluid level present.
3) CT scans usually reveals the exact extent of the cavity.
4) Lung biopsy is necessary for specific microbiologic diagnosis
5) Sputum examination may not yield much because the cavity may be isolated from the bronchi.
Treatment
Antibiotics are needed according to the sensitivity. This may have to be continued for prolonged periods of time until the cavity is resolved on chest x-ray. When medical management fails, surgical intervention with video assisted thoractomy or even possibly lobectomy may be required. |
