Suppurative Lung Diseases

Question 1

Bronchiectasis

Answer 1

defined as
permanent and abnormal dilation of
the bronchi
• Bronchus is considered to be dilated if the
broncho-arterial ratio (its internal diameter
divided by the diameter of its accompanying
artery) exceeds 1
• It is a radiological/pathological diagnosis
• Affects lower lobes preferentially

Question 2

Lung abscess definition

Answer 2

is defined as necrosis of the pulmonary tissue
and formation of cavities containing necrotic
debris or fluid caused by microbial infection
• is a necrotizing lung infection characterized by
a pus-filled cavitary lesion

Question 3

Lung gangrene definition

Answer 3

The formation of multiple small (<2 cm)
abscesses is occasionally referred to as
necrotizing pneumonia or lung gangrene.
– Both lung abscess and necrotizing pneumonia are
manifestations of a similar pathologic process

Question 4

Stages of lung abscess

Answer 4

Lung abscess has two clinical stages . The first one is formation of abscess and the second is drainage of abscess to bronchus

Question 5

Stage one

Answer 5

1st period - Initial phase
(formation of abscess)
Symptoms progress over weeks to months:
1. Fever, night sweats
2. Cough and sputum production
3. Weight loss and anemia
4. Chest pain, dyspnoe
5. Hemoptysis

1st period - Initial phase
(formation of abscess)
Physical signs include:
1. Unilateral thoracic lagging to inspection
2. Exaggerated vocal fremitus to palpation
3. Dullness to percussion
4. Bronchial breath sounds over affected area

Question 6

Second stage

Answer 6

2nd period – Phase of abscess
drainage into the bronchus

Symptoms:
1. Cough with production of purulent foul smell
sputum which layers on standing
2. Fetor
Physical signs:
1. Amphoric/cavernous breath sounds
2. Coarse moist (large bubbling) rale

Question 7

Complications of pulmonary
abscess

Answer 7

• Rupture into pleural space causing
empyema
• Pleural fibrosis
• Trapped lung
• Respiratory failure
• Bronchopleural fistula
• Pleural cutaneous fistula