Lung cavity syndrome + lung abscess Flashcards
Lung cavity syndrome causes
Lung abscess
Cavities of TB
primary bronchogenic carcinoma
Lung cavity syndrome Complaints
Chronic cough with sputum (purulent)
Hemoptysis
Lung cavity syndrome pathpysiology
Supperative necrosis (lung abscess) Caseous necrosis (TB) Ischemic necrosis (pulmonaryinfarction)
Physical examination of lung cavity syndrome
Infected side lags Decrease elasticity Increase TF pympanic sound Amphoric sound if > 5-6cm Quite bronchial sound small cavity (loud coarse crackles plus rhonchi Bronchophony increase E -> Ayaz
Investigation of lung cavity syndrome
Sputum - purulent or putrid and maybe blood streaked
Necrotic lung tissue with elastic fibers large no.of leukocytes and alveolar cells
X- ray- cavity containing gas/fluid
Abscess round in shape
Causes of lung abscess
Acute pneumonia
Infected materials aspired
Anaerobes : pepto streptococcus, microaerophilic staphylococcus, bacteroids
Others Staphylococcus aureus Streptococcus pyogenes Streptococcus pneumonia Klebsiella pneumonia Gram -ve bacilli
Less common : pulmonary emboli
Pre existing bulla
Lung cyst
Risk factors of lung abscess
Poor detention Absent cough reflex Alcohol Seizure disorders Primary lung diseases Pulmonary cystic diseases
Pathology of lung abscess
Abscess usually ruptures into the bronchus and contents released leaving the cavity filled with air and fluid
Sometimes the abscess rupture into pleural cavity causing emyema
Usually right side lower lobe or post upper lobe
Classification of lung abscess
Acute (less than 4-6 weeks )
Chronic (longer)
Primary : infectious origin caused by aspiration or pneumonia
Secondary : pre existing pathogenic condition (obstruction) spread from extra pulmonary site / bronchiechtasis / immuno compromised state
Clinical features of data BEFORE abscess perforation
Onset- acute / insidious
Hectic fever with chills and night sweat( remittent fever)
Complications of acute pneumonia
Shortness of breath frequent and shallow
Cough dry at first
Chest pain when deep breathing and coughing
Anorexia, weight loss and weakness
Severe state Rappid difficult breathing (30-35 minutes) Forced position Affected side lags Increased TF Dull decreased resonance Decreased vesicular breath sound / bronchial sound (in large abscess) Pleural run if abscess is superficial
Clinical features of data AFTER abscess perforation
Abscess perforate bronchus
Cough with large amount of sputum (purulent / putrid), foul smelling and bad taste, maybe blood streaked
Gained appetite
State improved Amount of sputum increase when change of position Forced position Affected side lags Increased TF tympanic sound Amohoric breath sound if large Bronchial sound is small Loud coarse crackles or rhonchi
Investigation of lung abscess
1) blood test
Pronounced leukocytosis with left shift
Anemia
Increased ESR
2) sputum analysis
Purulent maybe blood streaks
Sometimes putrid in large amount
Necrotic tissues elastic fibers and increased leukocytes and alveolar cells
3) chest x ray
Irregular shaped cavity with air filled level inside
Complications of lung abscess
Chronic lung abscess Pleural fibrosis Empyema Pulmonary hemorrhage Respiratory failure Pyopneumothorax Death
Chronic lung abscess
Lung does not collapse Pus constantly present Purulent sputum foul breath Increase temp Diffuse cyanosis Digital clubbing Pneumosclerosis lung emphysema Metastasis of abscess
Empyema
Pus is pleural cavity
State is more severe
High remittent fever
Rigors, sweating, malaise, weight loss, pleural pain , breathlessness
Dullness in percussion contralateral shift of mediastinum
