Lung Abscess

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• Localised collection of pus within a cavitated necrotic lesion in the lung parenchyma

• CXR characteristically shows a cavitating lesion containing a fluid level

• Symptoms typically:

• cough with expectoration of large amounts of foul material

• haemoptysis

• fever

• weight loss

• malaise


Causes

• Oropharyngeal aspiration is the commonest cause

• Infection distal to bronchial obstruction

• Centre of an area of destructive pneumonia

TB

• Blood-borne infection (via IV in IVDUs)

PE may cause pulmonary infarction, with secondary infection -> abscess

• Penetrating chest trauma is an UNCOMMON cuase of lung abscess

• Transdiaphragmatic spread from subphrenic abscess (e.g. post-cholecystectomy) or a hepatic abscess (e.g. amoebic abscess)

Necrobacillosis


• Treatment:

• Pus drainage - can be achieved by postural drainage physiotherapy

• Prolonged antibiotic therapy

• Surgical excision is sometimes required