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Lemierre's syndrome presenting as multiple lung abscesses.

Lemierre's syndrome is thrombophlebitis of the internal jugular vein (IJV), complicating an oropharingeal infection. The causative organism is Fusobacterium, an anaerobic bacillus, and the syndrome typically occurs in previously healthy teenagers and young adults. Thromboembolic metastases are a common sequela, and the lungs are most frequently affected. We present a case of a 25-year-old woman, who presented with multiple lung abscesses, in whom IJV thrombophlebitis was subsequently noted.

Adult↗

Allergic bronchopulmonary aspergillosis with cavitary lesion simulating a lung abscess.

A 48-year-old female patient was diagnosed as a case of allergic bronchopulmonary aspergillosis (ABPA) on the basis of clinical, immunological and radiological criteria. In addition to central bronchiectasis, computed tomography (CT) of the thorax revealed hilar lymphadenopathy and cavitary lesions simulating a lung abscess, a presentation not described earlier. The patient responded to treatment with corticosteroids and the CT repeated after 14 months of treatment showed complete resolution of the cavitary lesions.

Adrenal Cortex Hormones↗

Lung abscess caused by Eikenella corrodens: report of a case.

Eikenella corrodens is a slow-growing, facultatively anaerobic, gram-negative bacillus. It is part of the normal flora of the human upper respiratory tract. We report a 68-year-old man who developed lung abscesses caused by E. corrodens while on long-term corticosteroid therapy for polymyositis. It was isolated by percutaneous transthoracic aspiration of an abscess under real-time sonographic guidance. The organism has a very unusual antimicrobial susceptibility: sensitive to penicillin, ampicillin, cephapirin, chloramphenicol, minocycline and erythromycin but resistant to clindamycin, oxacillin and gentamicin. The patient was treated empirically with penicillin G and gentamicin. The latter was discontinued after the results of the bacterial culture and sensitivity test were available. He was discharged one month later with marked improvement. Our report clearly demonstrates that E. corrodens can be the sole pathogen of a respiratory tract infection.

Aged↗

Lung abscess: an unusual presentation of congenital tracheoesophageal fistula without atresia.

Tracheoesophageal fistula (TEF) without atresia is rare and usually presents with symptoms from birth. In this report, a 9-year-old boy presented with productive cough of 4 month's duration and was shown to have a right lung abscess seen on chest radiograph. His parents denied earlier respiratory symptoms or illnesses. Rigid bronchoscopy showed a fistulous opening of about 1 mm in diameter in the posterior wall of the trachea about 16 cm from the upper incisor teeth. Cannulation with a ureteral catheter demonstrated that the fistulous opening communicated with the esophageal lumen. The tracheoesophageal fistula was 1 cm long and was divided through a right supraclavicular incision. The postoperative period was uneventful, and the patient was discharged on the third postoperative day. This case demonstrated that TEF should be considered in any patient presenting with chronic respiratory problems even after a prolonged symptom-free period.

Bronchoscopy↗

[Cystic adenomatoid malformation of the lung revealed in a newborn infant by an image of a lung abscess].

BACKGROUND: Cystic adenomatoid malformation, a rare pulmonary malformation, usually appears as a cystic mass, radiologically. It may be infected and confusion has also arisen in distinguishing it from pneumonia with pneumatoceles. CASE REPORTS: A full-term boy suffered from severe neonatal respiratory distress. Pregnancy had been uneventful despite the fact that his mother had insulin-dependent diabetes. Prenatal ultrasonographies did not reveal any abnormality. On day 2, X-rays showed a right pulmonary mass that appeared solid. The patient was treated for E Coli sepsis. Subsequently, the pulmonary mass became lacent, cystic, fluid-filled, resembling an abscess; the CT scan confirmed these features. As the lesion increased in volume, a limited resection was performed. Histologic examination showed adenomatoid proliferation of bronchiolar elements with formation of cysts and necrosis. CONCLUSION: Infection of cystic adenomatoid malformation may supervene the first days of life resulting in a lung abscess appearance.

Cystic Adenomatoid Malformation of Lung, Congenita↗

Diagnosis of Legionella lung abscess by percutaneous needle aspiration.

Pneumonia is a life-threatening infection of immunocompromised patients, and accurate identification of the causative agent is essential for early initiation of appropriate antibiotic therapy. Percutaneous needle aspiration was used to identify Legionella pneumonia after sputum and bronchoscopy specimens had failed to provide a diagnosis in a 13-year-old leukemic patient with a lung abscess. We believe this is the first report of a child with this disease diagnosed in this way.

Adolescent↗

[A case of multiple lung abscesses successfully treated with computed tomography guided percutaneous thoracic drainage].

A 48-year-old woman who had abused alcohol admitted to our hospital because of fever and chest pain. Laboratory data presented inflammation and liver dysfunction. Chest X-ray films revealed multiple mass lesions with air fluid levels. We diagnosed multiple lung abscesses and started treatment with antibiotics. However, her fever did not improve and mass lesions increased. On day 6 of hospitalization, three drainage tubes were inserted percutaneously into the mass lesions under computed tomography (CT) guidance, and alpha-hemolytic streptococcus, peptostreptococcus sp. and neutrophils were isolated from the drainage fluid. Abcesses and inflammation were improved by administration of the antibiotics selected according to the result of fluid culture. Because all multiple abcesses were located near the pleura, we successfully treated them with simultaneous percutaneus thoracic drainage.

Drainage↗

Legionnaires' lung abscess.

A patient with a clinical course consistent with Legionnaires' disease rapidly developed acute respiratory failure. Sputa and bronchoscopic washings revealed many polymorphonuclear leukocytes but no organisms on gram stain and culture. The diagnosis of Legionnaires' disease was strengthened when the transthoracic aspirate revealed weakly staining gram-negative bacilli with no growth noted on culture. Serologic titers confirmed the diagnosis of Legionnaires' disease. This patient's course was complicated by cavitation which responded to medical therapy with erythromycin. This is the second reported case of Legionnaires' lung abscess.

Adult↗

Lung abscess.

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Humans↗

A case of nephrobronchial and colonobronchial fistula presenting as lung abscess.

A nephrobronchial fistula is an uncommon clinical entity and perinephric abscess in the most common etiological lesion. At times, pulmonary symptoms may dominate the clinical picture and the diagnosis of an associated renal lesion may be overlooked. An unusual case of a coexisting nephrobronchial and colonobronchial fistula is reported. The patient had been treated for chronic lung abscess for 4 years before the final diagnosis was made.

Bronchial Fistula↗