Multiple lung abscess closely simulating congenital cystic disease of the lung.
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Abscess↗
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Differentiating lung abscess and empyema: radiography and computed tomography.
Conventional chest radiographs and computed tomographic (CT) scans of 70 inflammatory thoracic lesions in 63 patients were reviewed and scored for diagnostic features. Pathologic confirmation of the final diagnosis was available in 42% (5/12) of lung abscesses and 31% (18/58) of empyemas. CT alone was sufficient to correctly diagnose 100% (70/70) of cases. Diagnostic information not available from conventional chest radiographs was obtained in 47% (33/70) of cases; in an additional 34% of patients, CT more accurately defined the extent of disease. The most reliable CT features for the differential diagnosis of lung abscess and empyema were wall characteristics, pleural separation, and lung compression. Conventional radiographic features such as size, shape, and the angle of the lesion with the chest wall were less helpful, though also best assessed by CT.
Diagnosis, Differential↗
Lung abscess with group A beta-hemolytic Streptococcus. Case report and review.
Invasive infections with group A beta-hemolytic streptococci became less common in the early 20th century prior to the widespread use of antibiotics. From the early 1960s until the mid-1980s, reports of invasive infections continued to decline. In the past 5 years, there has been a resurgence of invasive infections and, possibly, also of postinfectious sequelae from this organism. We describe a patient with lung abscess from group A beta-hemolytic Streptococcus. Lung abscess from hemolytic streptococci was not uncommon in Osler's day, but it was not reported in the English-language literature for 20 years until recently. Clinicians should be aware of the broad and growing spectrum of infections with this pathogen.
Adult↗
Chronic lung abscess with Pasteurella multocida infection.
We report a patient with chronic lung abscess due to Pasteurella multocida infection that may be caused by the contact with cows in his workplace. Despite its apparent rarity, chronic abscess due to P. multocida should be considered in the differential diagnosis of solitary pulmonary masses. This case report suggests that P. multocida infection can be potentially caused from saliva of cows as well as dogs or cats.
Bronchoscopy↗
Multiple lung abscesses due to Ochroconis gallopavum, a dematiaceous fungus, in a nonimmunocompromised wood pulp worker.
An occurrence of multiple chronic lung abscesses managed by lobectomy is described. These abscesses were present for 13 years in the patient, a nonimmunocompromised wood pulp worker. The patient had hemoptysis at presentation. The organism isolated was Ochroconis gallopavum, a dematiaceous fungus known to cause disease in immunocompromised patients and epidemic encephalitis in poultry. The fungus is typically found in warm environments and in decaying compost; for this reason, we postulate that his illness was occupationally acquired.
Adult↗
[Amebic lung abscess: an unexpected diagnosis].
Pleuropulmonary amebiasis is a very rare complication of amebiasis infection and direct pulmonary involvement is exceptional. The clinical diagnosis is difficult without any intestinal or extraintestinal manifestations. A percutaneous drainage is necessary to aspirate pus. We report herein the case of a 56-year-old man presenting with an amebic lung abscess in his right lower lung and pleural effusion. The diagnosis was suspected by our laboratory from a serological assay (antiamebic antibodies reaching 320 by IHA) and established from a direct examination of the pus in which rare trophozoites of Entamoeba were detected. We pointed out the importance of the communication between the clinician and the biologist. Protozoan infection should be suspected in pleuropulmonary infection when antibiotics failed even in France. This patient left endemic area a long time ago and the way of his amebiasis contamination is unknown: recurrence of amebic infection is rare and prevalence in industrialized countries reaches only 1%. Several hypothesis are exposed.
Animals↗
[LUNG CANCER AND LUNG ABSCESS UNDER ASPECTS OF THEIR RELATIONS].
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Humans↗
[Lung abscess in a patient with Good's syndrome and pure red cell aplasia].
A 56-year-old man with pure red cell aplasia (PRCA), hypogammaglobulinemia and mediastinal tumor was admitted to our hospital with of dyspnea, high fever and general fatigue. Chest X-ray showed a large cavity with a niveau in the left lung. Biopsy of the mediastinal tumor revealed an epithelial cell-type thymoma. Lung abscess with Good's syndrome and PRCA was diagnosed. Antibiotics was administered, and percutaneous catheter drainage of the lung abscess was performed. He recovered and was discharged. Hypogammaglobulinemia in the case may have resulted from reduced production of gammaglobulin associated with a quantitative B-cell defect.
Agammaglobulinemia↗
Klebsiella pneumonia with lung abscess in a male child.
An unusual presentation of Klebsiella pneumonia with lung abscess in a male child with no apparent predisposing factor is described.
Child↗
Neonatal lung abscess. A report of six cases.
Six infants 8 weeks of age or younger had lung abscesses treated in our medical center during the 20-year period of from 1957 to 1977. The duration of symptoms prior to diagnosis, the etiologic organisms, and the therapeutic approach differ from those in older children and adults. The pathogenic organisms were Escherichia coli, group B streptococcus, and Klebsiella pneumoniae, initial therapy with a penicillin and an aminoglycoside are indicated until identification and susceptibility results are available on the organism isolated from the abscess cavity. Previously undiagnosed cystic malformations of the lung were seen in two of the six patients. Surgical intervention is usually required in this age group.
Escherichia coli Infections↗
Fatal lung abscesses: review of 11 years' experience.
A review of the outcome of 440 patients hospitalized between 1967 and 1977 because of lung abscess showed that 41 died (case fatality rate = 9.3%). Major predisposing factors were present in many of the fatal and nonfatal cases. Advanced age and concomitant diseases were associated with a higher risk of death. Aspiration of contents of large cavities may have played a major role in the death of seven patients.
Adult↗
Early echo-guided percutaneous aspiration of peripheral lung abscesses in children: report of two cases.
A 9 year-old boy and a 7 year-old girl suffered from fever and chest pains before they were brought to Chang Gung Children's Hospital. Chest radiographs and computed tomography scans showed lung abscesses with pleural attachment, and using echo-guidance, percutaneous aspirations were done which confirmed the growth of Fusobacterium sp, and Veillonella parvula respectively, both of which are susceptible to penicillin G. The fever and chest pains subsided within 24 hours after the procedure. We suggest using early percutaneous aspiration of peripheral located lung abscesses soon after admission, rather than after a 10-14 day trial of antibiotic therapy: it can be a safe and cost-effective procedure to shorten the duration of the parenteral antibiotic treatment and hospitalization.
Child↗
AN UNUSUAL CASE OF HODGKIN'S DISEASE PRESENTING THE X-RAY APPEARANCE OF LUNG ABSCESS.
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Diagnosis, Differential↗
[Surgical treatment of lung abscesses in children].
The authors report their clinical observations of 44 patients, aged from 2 months to 14 years, with acute pulmonary abscesses. As evidenced by the authors a roentgenological examination in dynamics is of great value in establishing the diagnosis of pulmonary abscess, since it makes possible to follow the destruction of lung tissues and the formation of cavities. For treatment of lung abscesses different methods were employed: toilet bronchoscopy with antibiotics perfusion, puncture and drainage of the abscess, in case of pulmonary hemorrhage a resection of the lung portion involved, the complex conservative therapy.
Acute Disease↗
[Patient with a lung abscess, primarily treated with drainage followed by antibiotics].
A 45-year-old woman presented herself with coughing, nocturnal sweating, weight loss, and chest pain, left laterally. In the previous 5 months she had been treated twice with antibiotics due to a suspected pneumonia. With the help of a CT scan, 2 subpleural lung abscesses were diagnosed. The primary treatment was CT-guided drainage, as a result of which the largest abscess was emptied and a microbiological diagnosis could be established. Subsequently, the patient made a quick recovery with the help of specific antibiotics. It might be better to drain lung abscesses, especially subpleural ones, at an early stage rather than wait for the results of a trial treatment with antibiotics.
Amoxicillin↗
Lung abscess caused by Paecilomyces lilacinus.
We report the case of a 57-year-old man who was referred to our department for further investigation of an abnormal chest shadow. Radiography on admission demonstrated a coin lesion in the right hilum. To make a final diagnosis, right middle lobectomy was performed and the mass was revealed to be a fungal abscess. Further examination confirmed that the fungus was Paecilomyces lilacinus. This is the first reported case of lung abscess caused by P. lilacinus in an otherwise healthy person.
Humans↗
[Peroneal paralysis following penicillin therapy of lung abscess].
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Lung↗
Resolution of lung abscess due to Pseudomonas aeruginosa with oral ciprofloxacin: case report.
A case of lung abscess due to Pseudomonas aeruginosa is presented that did not resolve with the use of conventional antipseudomonal antibiotics, including tobramycin with ticarcillin-clavulanate and ceftazidime with gentamicin and ticarcillin-clavulanate. Oral ciprofloxacin was administered for 12 weeks, and the infection was resolved. No resistance occurred, and there was no recurrence of abscess within 18 months following therapy.
Administration, Oral↗