Suppurative lung Flashcards
1
Q
What is the pathogenesis of suppurative lung?
A
- aspiration -> stroke, seizure, alcohol -> polymicrobial (oral normal flora)
- hematologic spread -> Staph aureus bacteremia, Lemier’s syndrome
- direct extension -> mediastinal abscess, trachea-esophageal fistula
- bronchial obstruction -> bronchogenic carcinoma, foreign body
2
Q
What are the investigations done for identification of lung abscess?
A
- CBC
- electrolytes
- sputum gram stain & culture -> bronchoalveolar lavage
- CXR +- CT chest -> to rule out malignancy
3
Q
How is a lung abscess treated?
A
- in patient -> IV ampicillin-Sulbactam OR IV ceftriaxone + metronidazone
- out patient -> oral moxifloxacin OR oral Amoxicillin-clavulanate
duration -> until resolution of abscess clinically & radiologically (3-4 weeks)
- surgical drainage if no response to medical
4
Q
What are the factors that lead to induction of bronchiectasis?
A
- infectious insult
- impaired drainage, airway obstruction, defect in host defense
leads to chronic productive cough & chronic shortness of breath
5
Q
What are the risk factors for bronchiectasis?
A
- foreign body aspiration
- tumors
- COPD
- mucoid impaction
- ciliary defects of airways mucosa -> Kartagener syndrome
- cystic fibrosis
- childhood infections
- bacterial infections
- viral infections
6
Q
What are the clinical features of bronchiectesis?
A
- productive cough & history of exacerbation
- hemoptysis during exacerbation
- crackles, wheezing, clubbing
7
Q
What is the imaging modality of choice in bronchiectasis?
A
MULTIDETECTOR COMPUTED TOMOGRAPHY (MDCT)
- dilated bronchioles will be seen
8
Q
What investigations are done for differentiation of the cause of bronchiectasis?
A
- CXR
- MDCT
- CBC -> eosinophilia with asthma or COPD
- Spirometry -> obstructive
- Sweat chloride test -> cystic fibrosis
- alpha-1 antitrypsin level -> emphysema
- rheumatoid factor -> autoimmune
- sputum smear & culture
only treat the cause to prevent exacerbation
