This article is to discuss the definition , aetiology , pathogenesis , and treatment of lung abscess .
The centre of the infected area first becomes necrotic and purulent .
(The causative organisms are Staphylococcus. aureus or S. pyogenes organism)
1- Primary (aspiration or inhalation) usually it is right and basal, the causes are :
- Loss of Consciousness
- G. anesthesia
- Gastro-esophageal reflux
- Alcohol abuse
- During vomiting
2- Secondary to :
- Lung disease : Pneumonia , Infected cyst , Bronchial carcinoma .
- Subdiaphragmatic : Amoebic abscess or subphrenic abscess .
- Mediastinal & thoracic wall diseases .
Area of consolidation + overlying acute pleurisy
II. Stage of acute abscess .
Suppuration & pus discharge into near-by bronchus leaving cavity with irregular wall + inflamed pleura
III. Chronic abscess .
Cavity with regular & smooth border i.e the wall of abscess become intensely lined with fibrous and granulation tissue.
The pleura becomes thick.
Lung abscess is usually is surrounded by pneumonic consolidation .
Diagnosis of Lung abscess | symptoms, signs and investigations : Here
1- Postural drainage
2- The antibiotic of choice is clindamycin (Dalacin-C) 600 mg/8hours I.V, then after clinical improvement and when fever subsides we give oral C1indamycin
300-450 mg every 6 hours. Clindamycin must be combined with ampicillin or amoxicillin 2gm I.V/6hours then 500mg/6hours oral .
3- Metronidazole infusion then oral 500 mg/6hours can be used instead of clindamycin.
4- Ampicillin/sulbactam (unasyn) or amoxicilline/clavulanate (augmentin) are better to be used instead of ampicillin or amoxicilline.
5- Expectorants
6- Surgery for resistant cases e.g lobectomy or segmentectomy
What is meant by Lung abscess ?
A lung abscess is a localized area within the lung parenchyma that develops from an initial pneumonic stage.The centre of the infected area first becomes necrotic and purulent .
What are the causes of lung abscess ?
Aetiology :(The causative organisms are Staphylococcus. aureus or S. pyogenes organism)
1- Primary (aspiration or inhalation) usually it is right and basal, the causes are :
- Loss of Consciousness
- G. anesthesia
- Gastro-esophageal reflux
- Alcohol abuse
- During vomiting
2- Secondary to :
- Lung disease : Pneumonia , Infected cyst , Bronchial carcinoma .
- Subdiaphragmatic : Amoebic abscess or subphrenic abscess .
- Mediastinal & thoracic wall diseases .
Pathology of primary abscess
I. Pneumonic stage.Area of consolidation + overlying acute pleurisy
II. Stage of acute abscess .
Suppuration & pus discharge into near-by bronchus leaving cavity with irregular wall + inflamed pleura
III. Chronic abscess .
Cavity with regular & smooth border i.e the wall of abscess become intensely lined with fibrous and granulation tissue.
The pleura becomes thick.
Lung abscess is usually is surrounded by pneumonic consolidation .
Diagnosis of Lung abscess | symptoms, signs and investigations : Here
Treatment of lung abscess :
(The duration of antibiotic therapy is about 4-8 weeks).1- Postural drainage
2- The antibiotic of choice is clindamycin (Dalacin-C) 600 mg/8hours I.V, then after clinical improvement and when fever subsides we give oral C1indamycin
300-450 mg every 6 hours. Clindamycin must be combined with ampicillin or amoxicillin 2gm I.V/6hours then 500mg/6hours oral .
3- Metronidazole infusion then oral 500 mg/6hours can be used instead of clindamycin.
4- Ampicillin/sulbactam (unasyn) or amoxicilline/clavulanate (augmentin) are better to be used instead of ampicillin or amoxicilline.
5- Expectorants
6- Surgery for resistant cases e.g lobectomy or segmentectomy
Suppurative pneumonia
is a term used to describe a form of pneumonic consolidation in which there is destruction of the lung parenchyma by the inflammatory process.
Although micro abscess formation is a characteristic histological feature, it is used to restrict the term pulmonary abscess to lesions in which there is large localized collection of pus .
Although micro abscess formation is a characteristic histological feature, it is used to restrict the term pulmonary abscess to lesions in which there is large localized collection of pus .