Lung abscess

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Background

  • Localized, suppurative necrotizing process occurring within the pulmonary parenchyma
  • Microbiology

Causes

Clinical Features

Complications

Differential Diagnosis

  • Cavitary lesion with air-fluid level
  • Infected bullae
  • Pleural fluid collection with bronchopleural fistula
  • Loop of bowel extending through diaphragmatic hernia

Evaluation

Pulmonary abscess on CXR
Pulmonary abscess on CT scan
  • CXR or CT Chest
  • Dense consolidation with air-fluid level inside of a thick-walled cavitary lesion
    • Air-fluid level indicates communication of abscess cavity with a bronchiole

Management

  • Medical management will successfully treat 70-90% of lung abscesses
    • Drainage occurs spontaneously from communication of cavity with tracheobronchial tree
    • Bronchoscopic drainage may result in seeding other parts of the lung
  • Antibiotics

Disposition

  • Admit

See Also

References

Authors:

Ross Donaldson