Friday, January 14, 2011

Lung Abscess.



Focal suppuration with necrosis of lung tissue
Strep, Staph, Gram negative & anaerobes
anaerobes are commensals of oral cavity: Prevotella, Fusobacterium, Bacteroides, Peptostreptococcus, and microaerophilic streptococci.

Mechanism:

Aspiration: bacteria from carious teeth or infected sinuses or tonsils, during oral surgery, anesthesia, coma, or alcoholic intoxication
Post pneumonic
Septic embolism, from septic thrombophlebitis or from infective endocarditis
Neoplasms: obstructing a bronchus
staphylococcal bacteremia


more common on the right side (more vertical airways)- single

Abscess that have developed in the course of pneumonia or bronchiectasis are commonly multiple, basal, and diffusely scattered

ruptures into airways forming air-fluid level on radiographic examination, and bronchopleural fistulas

C/F copious amounts of foul-smelling, purulent sputum; occasionally, hemoptysis, clubbing, weight loss, anemia and secondary amyloidosis

Complications: Systemic spread, septicemia
Lung Fungal Abscess: Candida.

Abscess formation.

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