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At least 127 records · Page 7Linked to original sources
PubMed1979

Lung abscess: a review of three-years' experience at the University College Hospital, Ibadan.

The experience with 45 patients with lung abscess over a three-year period at the University College Hospital (UCH), Ibadan, is presented. This study confirms the rarity of this disease among Nigerian children and its prevalence in young adults in the third and fourth decades of life. The most common presenting symptoms were purulent cough, chest pain, fever, and life-threatening hemoptysis which was the sole indication for emergency operation in 14 out of 16 patients who were treated surgically. The predominance of these abscesses in the right lung, especially in the superior segment of the lower lobe, supports the fact that aspiration of infected material, following depressed level of consciousness, esophageal obstruction, foreign bodies, and oral sepsis form the major causative factors in patients with lung abscess. The frequent association of sickle cell disease, bronchiectasis, hypertension, and pulmonary aspergilloma contribute significantly to the morbidity and mortality attendant to this disease in our environment. Twenty-nine patients were treated medically with five deaths and 16 patients were treated surgically with six deaths. The high operative mortality (37.5 percent) in this series was due to the extreme emergency conditions under which these patients were operated.

Adolescent↗
PubMed1989

Amoebic lung abscesses. A case report.

A case of multiple amoebic lung abscesses without indication of direct extension from a subclinical liver abscess, which delayed correct diagnosis, is reported. Severe constitutional symptoms, life-threatening haemoptysis and large pulmonary lesions were the prominent clinical manifestations. The response to metronidazole was dramatic. It is postulated that haematogenous spread was responsible. The rarity of this form of amoebiasis is evident on published reports.

Adult↗
PubMed1982

Primary lung abscess in childhood: the long-term outcome of conservative management.

Fourteen cases of primary lung abscess in childhood were treated with antibiotics alone. The only organism discovered was Staphylococcus aureus. All the children recovered. Roentgenographic abnormalities took from six weeks to more than five years to resolve. Recently, follow-up of 11 of the 14 children was performed an average of nine years after treatment of the abscess. In all children, the clinical status, lung volumes, and expiratory flow rates were normal, except in two with asthma. A conservative approach to the management of primary lung abscess in children is recommended.

Adolescent↗
PubMed1996

[Usefulness of transthoracic pulmonary aspiration biopsy in lung abscess secondary to neoplasm].

OBJECTIVE: To evaluate the usefulness of transthoracic needle biopsy (TNB) for the diagnosis of bronchial carcinoma underlying lung abscess (LA), and to determine the bacteriology of lung abscess secondary to neoplasm (LASN). PATIENTS AND METHOD: One hundred thirteen consecutive patients diagnosed of LA were enrolled. Radiologically guided TNB was performed on all patients using 20-22 G needles. Microbiological and cytological samples were processed. Fiberoptic bronchoscopy (FB) was performed if there were risk factors for lung cancer. TNB-diagnosed cases were compared with the remaining cases of LA. RESULTS: Neoplasia was found in 21 LA patients. TNB samples provided diagnostic information in 15 cases, there were 2 false negatives, and no cytology sample was processed in 4 cases. Diagnosis was based on FB in 17 cases. All neoplasias were diagnosed with one technique or the other. TNB culture was positive in 90% (19/21) of the LASN patients, H. influenzae being the most frequently isolated bacterium. The number of cultures that presented a single microbe was significantly greater (p < 0.02) among LASN patients (14/19 versus 33/79). These patients also had significantly more aerobic bacteria (19/19 versus 45/79; p < 0.001) and fewer anaerobies (4/19 versus 52/79; p < 0.001) than did the primary LA patients. CONCLUSIONS: 1) TNB is highly useful for arriving at a bacteriologic diagnosis of LASN and in associated cancer. 2) TNB complements FB for the diagnosis of neoplasia underlying LA and helps to reduce the number of unnecessary thoracotomies. 3) A great variety of germs, particularly aerobic bacteria, are implicated in LASN.

Adult↗
PubMed1991

Percutaneous needle aspiration of neonatal lung abscesses.

Three premature infants (mean gestational age 27 weeks) ranging in age from 3 to 11 weeks, were treated for lung abscesses, with a combination of antibiotics and percutaneous needle aspiration under either ultrasound or fluoroscopic guidance. Antibiotics, to which microorganisms cultured from aspirated pus were sensitive, were continued for a further period of two weeks, with no relapse in any of the patients. The lung abscesses resolved in all cases without the need for catheter drainage or surgery. In conclusion, needle aspiration under either ultrasound or fluoroscopic guidance is a simple and effective diagnostic and therapeutic method of managing neonatal lung abscesses. Its early use allows selection of the most appropriate antibiotics and may hasten recovery, prevent further complications and obviate the need for surgery. The use of a drainage catheter does not appear to be necessary for resolution of the abscesses. The procedure appears reasonably safe, since complications arising from the procedure were benign.

Female↗
PubMed1983

Penicillin failure in the treatment of Bacteroides fragilis lung abscess. Experimental study in rabbits.

Carbenicillin, chloramphenicol, doxycycline, and clindamycin were compared with penicillin for the treatment of lung abscess in an animal model produced by transtracheal inoculation of a mixture of anaerobes: Bacteroides fragilis, Peptococcus morbillorum, Eubacterium lentum and Fusobacterium nucleatum. Both chloramphenicol and doxycycline eliminated the bacteria but failed to close the abscess cavity. Carbenicillin, although it eradicated B. fragilis, failed to close the abscess cavity in 3 of 6 animals. In all animals tested, clindamycin sterilized the abscess cavities and healed the lung abscesses, while penicillin failed to eradicate the infection. Clindamycin was significantly more effective than penicillin in the elimination of anaerobic bacteria from the lung (p less than 0.05). Clindamycin also closed the abscess cavity faster than penicillin (p less than or equal to 0.02). The superior efficacy of clindamycin may have been the result of accumulation in the lung tissue in concentrations four- to eightfold higher than in the serum.

Animals↗
PubMed1986

Review of Corynebacterium (Rhodococcus) equi lung abscesses in foals: pathogenesis, diagnosis and treatment.

Corynebacterium (Rhodococcus) equi is becoming increasingly significant as a cause of bronchopneumonia and lung abscessation in foals. The organism can survive within macrophages and may thus escape normal pulmonary defence mechanisms, particularly in immunocompromised animals. The disease has hitherto been associated with mortality rates as high as 80 per cent, partly as a result of inappropriate therapy. The selection of lipid-soluble antibiotics capable of intracellular penetration is critical for the successful treatment of C equi lung abscesses. A combination of two such antibiotics, erythromycin (25 mg/kg three times daily) and rifampicin (5 mg/kg twice daily) has been used on foals since 1981. Most of these animals had radiographic evidence of extensive lung abscessation, and in all cases the presence of C equi was confirmed on culture of tracheal aspirates. The duration of therapy ranged from four to nine weeks. Mild gastritis and diarrhoea were occasionally noted, but never such as to require termination of the therapy. No other adverse side effects were encountered. The success rate, as judged by a return to normal of chest radiographs and plasma fibrinogen concentrations, has exceeded 80 per cent.

Actinomycetales Infections↗
PubMed1995

Aeromonas hydrophila lung abscess in a previously healthy man.

We present a case of multilocular lung abscess caused by Aeromonas hydrophila, found in both sputum and bronchial washing. No aspiration or other significantly contributory medical conditions were found. We believe this to be the first report of lung abscess caused by this organism in a previously healthy individual.

Aeromonas↗
PubMed2002

Lung abscess in adults: clinical comparison of immunocompromised to non-immunocompromised patients.

Information related to the clinical characteristics and isolated microbes associated with lung abscesses comparing immunocompromised (IC) to non-immunocompromised (non-IC) patients is limited. A retrospective review for 1984-1996 identified 34 consecutive adult cases of lung abscess (representing 0.2% of all cases of pneumonia), including 10 non-IC and 24 IC patients. Comparison of age, gender, tobacco use, pre-existing pulmonary disease or recognized aspiration risk factors were not significantly different between the two groups. Upper lobe involvement accounted for the majority of cases, although multi-lobe involvement was limited to IC patients. There were no differences in the need for surgical intervention, and mortality was very low for both groups. Anaerobes were the most frequent isolates for non-IC patients (30%), whereas aerobes were the most frequent isolate for IC patients (63%). Importantly, certain organisms were exclusively isolated in the IC group and multiple isolates were obtained only from the IC patients.Thus, comparing non-IC to IC patients, clinical characteristics may be similar whereas important differences may exist in the microbiology associated with lung abscess. These findings have important implications for the clinical management of these patient groups, and support a strategy to aggressively identify microbial agents in abscess material.

Adult↗
PubMed1989

Sudden death from primary lung abscess in middle-aged diabetic men--two case reports.

We describe the course of illness in two middle-aged diabetic men who died suddenly from primary lung abscesses. They were in apparent good health and presented with fever, cough and small lung abscess [less than 5 cm] on chest radiographs. While receiving standard antimicrobial therapy in hospital, they experienced sudden respiratory arrest from aspiration of purulent material presumably following the drainage of lung abscess contents. This is a very unusual complication and the similar clinical features between these two cases prompted this report.

Adult↗
PubMed1979

Carcinomatous lung abscess. Diagnosis by bronchoscopy and cytopathology.

We compared the roentgenographic, bronchoscopic, and cytopathologic findings from 26 patients with carcinomatous lung abscesses (23 of which were within the tumor) with findings from 31 patients with simple lung abscesses. Despite well-described roentgenographic characteristics of the carcinomatous abscess, differentiation from a simple abscess was frequently not possible. Direct visual findings at the time of bronchoscopy were not helpful in the absence of an endobronchial lesion. Using sputums and cytological specimens from a single fiberoptic bronchoscopy, a diagnosis was made by cytopathology on initial hospitalization in 22 (88%) of 25 patients with carcinoma. No false-positive cytological studies were reported in the nonmalignant group despite the frequent presence of inflammation and infection.

Biopsy↗
PubMed1988

Endobronchial drainage of undiagnosed lung abscess during chest physical therapy. A case report.

Bronchial drainage, positive-pressure lung inflation, chest-wall percussion, and suctioning were performed in a patient with postoperative atelectasis, lung infection, and respiratory failure. A previously undiagnosed posterior lung abscess subsequently drained into the bronchial tree, causing dissemination of the infection and a severe deterioration of pulmonary function. Dissemination of pulmonary infection from a lung abscess is a possible complication that should be considered when prescribing and administering chest physical therapy.

Drainage↗
PubMed1991

Lung abscesses: US examination and US-guided transthoracic aspiration.

Examinations with ultrasound (US) and US-guided transthoracic aspiration were conducted in 35 patients to enable diagnosis of lung abscesses. Thirty-three of the abscesses (94%) were demonstrated at US, while two lesions were not depicted. At US, lung abscesses were depicted as hypoechoic lesions with irregular outer margins and an abscess cavity that was manifested as a hyperechoic ring. Twenty-five abscesses (71%) had local adhesion to parietal pleura (lesion-pleura symphysis). US-guided transthoracic needle aspiration of fluid from the abscess cavity was performed successfully in 31 of 33 patients (94%). A total of 65 pathogens were isolated from 31 aspirates (41 anaerobes and 24 aerobes), not-withstanding the fact that 23 of the patients had been previously treated with antibiotics. Only two of 65 pathogens (3%) could be recovered from blood culture, seven (11%) from sputum culture, and two from bronchoalveolar lavage (3%). Two patients developed minimal pneumothorax. The authors conclude that US examination and US-guided transthoracic aspiration are useful and safe diagnostic methods of collecting specimens to enable accurate diagnosis of lung abscesses.

Adolescent↗
PubMed1985

The role of bronchial circulation in lung abscess.

We studied the anatomy of bronchial circulation in 6 sheep with multiple lung abscesses. After anesthesia, the animals were heparinized and exsanguinated. The bronchial artery, pulmonary artery, and tracheobronchial tree were filled with Batson's solution of varying colors. The cast was dissected and the anatomy was studied with a dissecting microscope as well as a scanning electron-microscope. The bronchial arteries were found to be enlarged and hypertrophied in all infected animals. The abscess cavities were surrounded with a dense vascular plexus that was being supplied exclusively by the bronchial arteries. The pulmonary capillaries were sparse and were filled entirely by the bronchial artery. The pulmonary circulation did not supply the walls of lung abscess cavity. Our findings indicate that the bronchial circulation may be more important than the pulmonary circulation in resolution and repair after certain lung infections.

Animals↗
PubMed1982

Computed tomographic findings of neonatal lung abscess.

A 3-week-old child with respiratory distress had an air-fluid level on chest roentgenogram. Computed tomography of the chest distinguished the mass as a discrete lung abscess, without underlying abnormality. Due to failure of the child's condition to improve with medical therapy, a limited thoracotomy and drainage of the lung abscess was performed; Escherichia coli and no anaerobic organisms grew from cultures of abscess material. We believe computed tomography to be of great benefit in defining suspected lung abscess in the neonate.

Drainage↗
PubMed1993

[A case of Kartagener's syndrome with S. pneumoniae lung abscess].

A 38-year-old male with Kartagener's syndrome (KS) was admitted to our department for evaluation of recurrent pneumonia. Before admission the patient was diagnosed as having pneumonia in another hospital and received ofloxacin (300 mg/day). Fever and production of purulent sputum decreased initially but again increased in the middle of April. On admission the films of both X-ray and CT scan of the chest revealed several air-fluid levels and infiltrative shadows on the left lower lung field. The patient was diagnosed as lung abscess using bronchofiberscopy. Gram staining of the intrabronchial specimens revealed many Gram-positive cocci and neutrophils including phagocytosed bacteria. A new carbapenem (L-627, 600 mg/day), was started intravenously. After the therapy Streptococcus pneumoniae were eradicated soon from the sputum. At the same time the above symptoms including dyspnea on exertion subsided, and the findings of the chest X-ray and CT scan were also improved. Regarding KS the electron micrograph of the cilia showed the absence of the outer-dynein arms. While by both the saccharin test and the sputum cytology impaired mucociliary clearance was found. Lung abscess infrequently accompany KS. There are reports of respiratory infections in KS, but to our knowledge no report of lung abscess was found in KS. We present this case report describing lung abscess in KS.

Adult↗