Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- 28 Acute and Chronic Bronchitis
- 29 Croup, Supraglottitis, and Laryngitis
- 30 Atypical Pneumonia
- 31 Community-Acquired Pneumonia
- 32 Nosocomial Pneumonia
- 33 Aspiration Pneumonia
- 34 Lung Abscess
- 35 Empyema and Bronchopleural Fistula
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
34 - Lung Abscess
from Part V - Clinical Syndromes – Respiratory Tract
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- 28 Acute and Chronic Bronchitis
- 29 Croup, Supraglottitis, and Laryngitis
- 30 Atypical Pneumonia
- 31 Community-Acquired Pneumonia
- 32 Nosocomial Pneumonia
- 33 Aspiration Pneumonia
- 34 Lung Abscess
- 35 Empyema and Bronchopleural Fistula
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Lung abscess is a chronic or subacute lung infection initiated by the aspiration of contaminated oropharyngeal secretions. The result is an indolent, necrotizing infection in a segmental distribution limited by the pleura. Except for infections with unusual organisms such as Actinomyces, the process does not cross interlobar fissures, and pleural effusion is uncommon. The resultant cavity is usually solitary, with a thick, fibrous reaction at its periphery. So defined, lung abscess is almost always associated with anaerobic bacteria, although microaerophilic and aerobic bacteria are frequently present as well.
In contrast, necrotizing pneumonia is an acute, often fulminant, infection characterized by irregular destruction of alveolar walls and therefore multiple cavities. This infection spreads rapidly through lung tissue, frequently crossing interlobar fissures, and is often associated with pleural effusion and empyema. The duration of illness before recognition is usually only a few days. Causative organisms include Staphylococcus aureus, Streptococcus pyogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa, and, less commonly, other gram-negative bacilli, Legionella species, Nocardia species, and fungi.
The focus of this discussion will be the diagnosis and therapy of anaerobic lung abscess. Diagnosis can usually be made from the clinical presentation and chest radiograph findings. Many patients have conditions such as seizure disorders, neuromuscular diseases, alcoholism, or other causes for impaired consciousness that predispose them to aspiration of oropharyngeal secretions.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 241 - 244Publisher: Cambridge University PressPrint publication year: 2008