Intrapulmonary Abscess Flashcards
what is it?
abscess is a localised suppuration associated with cavity formation on CXR/CT
what differential does it come from?
the same as cancer and TB
what are the causes?
aspiration pneumonia - lung abscess is a complication of pneumonia. This is quite rare though
TB
Pneumonia caused by certain species
Septic emboli usually containing staphylococci
what does a history of alcohol consumption or impaired sawllowing in a patient with pneumonia indicate?
aspiration pneumonia
what organisms cause abscess by pneumonia ?
bacteria and fungi
which bacteria cause abscess by pneumonia ?
particularly staph aureus or klebsiella pneumonia
staphylococcus - particularly post flu
e.coli
gram negative organisms
which fungi cause abscess by pneumonia?
aspergillus : this will generally cause abscess in existing cavities but can cause them too
what bacteria do septic embolie usually contain?
staphylococci
these cause multiple emboli.
when would you get septic embolli?
if you are bacteraemic
if you have right sided endocarditis
if you have infected DVT
which group if suscptible to septic emboli?
IV drug users
they inject into groin and get DVT, get infection
what can happen to the infection in IV drug users DVT?
can get PE or abscesses, these cause massive mortality and haemoptysis
what are the symptoms?
indolent presentation
weight loss
lethargy
cough may have sputum
usually there is a preceding illness of some sort
swinging fever
what are the signs?
high inflammatory markers
little to find in the chest
clubbing occurs in chronic suppuration
foul smelling sputum in large quantities
why does the sputum smell bad?
because of the anaerobic organisms
what may the preceding illnesses be ?
pneumonic infection
post viral
foreign body
