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Lung abscess.

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Anti-Bacterial Agents↗

Isolation of Legionella pneumophila by centrifugation of shell vial cell cultures from multiple liver and lung abscesses.

A 7-year-old girl was admitted to the hospital with acute lymphoblastic leukemia and was treated with allogenic cord blood transplantation. At day 30 after graft, she developed a fever and multiple nodular lesions disseminated in the liver and lungs. All bacterial cultures attempted on liver and lung biopsy specimens and blood remained sterile on standard axenic media. However, inoculation of liver and lung biopsy specimens on eukaryotic cell monolayers by the centrifugation-shell vial technique (M. Marrero and D. Raoult, Am. J. Trop. Med. Hyg. 40:197-199, 1989) led to the recovery of a strain of Legionella pneumophila serogroup 1, identified by 16S rRNA gene amplification and sequencing and serotyping. Our findings demonstrate that the centrifugation-cell culture method, which has previously been useful for the isolation of other strictly or facultatively intracellular bacteria, can also serve as a method for the recovery of L. pneumophila from clinical material.

Biopsy↗

Lung abscesses mimicking multiple pulmonary metastases.

Five patients receiving chemotherapy for cancer through Hickman central venous catheters had lung lesions detected by plain chest radiography or computed tomography. In each case these were initially misdiagnosed as metastases, although they ultimately proved to be staphylococcal abscesses. Because of the grave implications of an erroneous diagnosis of metastatic malignant disease, clinicians are urged to consider abscesses in the differential diagnosis of radiological chest abnormalities in such patients.

Adolescent↗

Lung abscess and osteomyelitis of rib due to Yersinia enterocolitica.

The first reported case of infection of the lung and bone with Yersinia enterocolitica is described. This organism has only recently been known to infect humans. Although a wide spectrum of diseases has been described, all have appeared to be relatively benign; however, in our case a rapid necrotizing process occurred. Therefore, the aggressive nature of this organism outside its usual surroundings, eg, the gastrointestinal tract, is worth noting.

Aged↗