Lung Abscess Flashcards
(25 cards)
What is a lung abscess?
Necrosis and cavitation of the lung following microbial infection
What typically characterizes lung abscesses?
Single dominant cavity >2 cm in diameter
What is the most common cause of lung abscesses?
Complications of aspiration pneumonia by anaerobic microorganisms
Which demographic is more commonly affected by lung abscesses?
Middle-aged men
Name a poor prognostic sign for lung abscess.
Age > 60
What is the major risk factor for primary lung abscesses?
Aspiration
List some patients at particular risk for aspiration.
- Altered mental status
- Prior cerebrovascular or cardiovascular events
- Seizures
- Esophageal dysmotility or lesions
- Gastric distention or GERD
- Alcoholism
- Drug overdose
- Bulbar dysfunction
- Neuromuscular disease
What percentage of lung abscesses are classified as primary?
~80%
What causes primary lung abscesses?
Aspiration of anaerobic bacteria from gingival crevices
How does pneumonitis develop in primary lung abscesses?
It develops initially and is exacerbated by tissue damage from gastric acid
What are secondary lung abscesses associated with?
An underlying condition, such as bronchial obstruction or immunocompromising conditions
What is a characteristic symptom of lung abscesses due to anaerobic infection?
Copious putrid or malodorous sputum
What are some clinical features of lung abscesses?
- Fevers
- Poor dentition
- Amphoric or cavernous breath sounds
- Digital clubbing
- Absence of gag reflex
Which pathogens are commonly associated with primary lung abscesses?
- Anaerobes (e.g., Peptostreptococcus spp, Bacteroides spp)
- Microaerophilic streptococci
What are some complications of lung abscesses?
- Persistent cystic changes
- Recurrence of abscesses
- Extension to pleural space
- Life-threatening hemoptysis
- Massive aspiration
What does a chest X-ray typically show in lung abscess diagnosis?
A thick-walled cavity with an air-fluid level
What is the first-line treatment for lung abscess?
Ampicillin-sulbactam 1.5 - 3 g IV QID
What is the duration of treatment for a lung abscess?
3 - 14 weeks, usually 4-8 weeks
What are poor prognostic factors for lung abscesses?
- Age > 60 years
- Presence of aerobic bacteria
- Sepsis at presentation
- Symptom duration > 8 weeks
- Abscess size > 6 cm
What is a key preventive measure for lung abscesses?
Mitigation of underlying risk factors
Fill in the blank: The pathogenesis of secondary lung abscesses depends on the _______.
[predisposing factor]
True or False: Hemoptysis is a common symptom of lung abscess.
True
What imaging technique provides better anatomical definition than CXR for lung abscess?
CT scan
What is the significance of anaerobic coverage in antibiotic therapy for lung abscess?
It is imperative regardless of culture results
