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Lung abscess I
OVERVIEW: A localized cavity in the lung with pus resulting from necrosis of lung tissue surrounded by lung infection. May be caused by aerobic or anaerobic infection. Usual course is sub-acute; progressive.
System(s) affected: Pulmonary
Genetics: No known genetic pattern
Incidence/Prevalence in USA: Unknown, relatively rare
Predominant age: Mainly 4th-6th decades
Predominant sex: Male > Female (4:1)
SIGNS AND SYMPTOMS: • Cough
• Sputum (purulent, foul-smelling)
• Fever
• Chest pain
• Dyspnea
• Chills, rigors
• Malaise
• Weight loss
• Anorexia
• Night sweats
• Hemoptysis
• Decreased breath sounds
• Crackles
• Wheezing
• Tachypnea
• Tachycardia
• Diaphoresis
• Dullness to percussion
• Consolidation by auscultation
• Cavernous breath sounds
CAUSES: • Lung infection
• Aspiration pneumonia
• Necrotizing pneumonia
• Cavitary infarction
• Septic embolism
• Bacteremia
• Bronchial stenosis or obstruction
• Tumors
• Dental abscess in loose tooth
RISK FACTORS: • Periodontal disease (gingivitis)
• Alcoholism
• Drug abuse
• Epilepsy
• Unconsciousness
• Lung neoplasia
• Immunosuppression/immunocompromised
• Diabetes mellitus
• Airway foreign body
• Gastroesophageal reflux with aspiration
• Sinusitis
• Gastric and esophageal surgery
• Dental and oropharyngeal surgery
DIAGNOSIS DIFFERENTIAL DIAGNOSIS: • Bronchogenic carcinoma
• Bronchiectasis
• Empyema with bronchopulmonary fistula
• Tuberculosis
• Mycotic lung infections
• Actinomycosis
• Nocardiosis
• Infected pulmonary bulla
• Wegener's granulomatosis
• Pulmonary sequestration
• Subphrenic or hepatic abscess with perforation into a bronchus
• Bronchogenic or parenchymal cyst
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