Lung Abscess Flashcards
(49 cards)
Recommended initial IV dosage of clindamycin in the treatment of lung abscess caused by anaerobic infections. (Harrison’s 19th edition, pp 815)
600mg IV TID then 300mg PO QID after disappearance of fever and clinical improvement
Represents necrosis and cavitation of the lung following microbial infection. (Harrison’s 19th edition, pp 813)
Lung abscess
Size of the dominant cavity of a lung abscess in diameter. (Harrison’s 19th edition, pp 813)
> 2cm
Lung abscess that usually arise from aspiration. (Harrison’s 19th edition, pp 813)
Primary lung abscess
Lung abscess that is often caused by anaerobic bacteria. (Harrison’s 19th edition, pp 813)
Primary lung abscess
Duration for a lung abscess to be classified as acute. (Harrison’s 19th edition, pp 813)
< 4-6 weeks
Lung abscess that occur in the setting of an underlying condition. (Harrison’s 19th edition, pp 813)
Secondary lung abscess
Conditions that can cause secondary lung abscesses. (Harrison’s 19th edition, pp 813)
Postobstructive process (bronchial foreign body or tumor) Systemic process (HIV infection or another immunocompromising condition)
Proportion of lung abscess that are classified as chronic. (Harrison’s 19th edition, pp 813)
~40% of cases
Lung abscess that occur in the absence of an underlying pulmonary or systemic condition. (Harrison’s 19th edition, pp 813)
Primary lung abscess
Major risk factor for primary lung abscess. (Harrison’s 19th edition, pp 813)
Aspiration
Age and gender predilection for lung abscess. (Harrison’s 19th edition, pp 813)
Middle-aged men
Risk for aspiration. (Harrison’s 19th edition, pp 813)
Altered mental status Alcoholism Drug over dose Seizures Bulbar dysfunction Prior cerebrovascular events Prior cardiovascular events Neuromuscular disease Esophageal dysmotility Esophageal lesions (strictures or tumors) Gastric distention Gastroesophageal reflux Substantial time on recumbent position
Important factor in the development of lung abscesses in combination with a risk of aspiration. (Harrison’s 19th edition, pp 813)
Colonization of the gingival cervices with anaerobic bacteria or microaerophilic streptococci (especially in patients with gingivitis and periodontal disease)
Pathogens involved in Primary lung abscess. (Harrison’s 19th edition, pp 814)
Anaerobes (Peptostreptococcus, Prevotella, Bacteroides and Streptococcus milleri)
microaerophilic streptococci
Duration in which the anaerobic bacteria produce parenchymal necrosis and cavitation. (Harrison’s 19th edition, pp 814)
7-14 days
Pathogens involved in secondary lung abscess. (Harrison’s 19th edition, pp 814)
Staphylococcus areus Gram negative rods (pseudomonas and enterobacteriaceae) Nocardia Aspergillus Mucorales Cryptococcus Legionella Rhodococcus Pneumocystis jiroveci
Septic emboli lesions. (Harrison’s 19th edition, pp 814)
Tricuspid valve endocarditis (Staphylococcus aureus)
Lemierre’s syndrome (Fusobacterium necrophorum)
Infection that begins in the pharynx and then spreads to the neck and the carotid sheath to cause septic thrombophlebitis. (Harrison’s 19th edition, pp 814)
Lemierre’s syndrome
Fusobacterium – Jugular vein
Treatment for Lung abscess. (Harrison’s 19th edition, pp 815)
Clindamycin 600mg/IV TID then 300mg PO QID after disappearance of fever and clinical improvement
IV BLIC then oral co-amoxiclav once patient condition is stable
Treatment duration for lung abscess. (Harrison’s 19th edition, pp 815)
Continued until imaging demonstrates that the lung abscess has cleared or regressed to a small scar. (3-4 weeks to 14 weeks)
This agent is suggested to be as effective and well tolerated as ampicillin-sulbactam. (Harrison’s 19th edition, pp 815)
Moxifloxacin 400mg/PO
Size of lung abscess that is less likely to respond to antibiotic therapy. (Harrison’s 19th edition, pp 815)
> 6-8cm in diameter
Options for patients with lung abscess who do not respond to antibiotics. (Harrison’s 19th edition, pp 815)
Surgical resection
Percutaneous drainage
