Ver el código de «Lung abscess»

==Background==
[[File:Lung and diaphragm.jpg|thumb|Lobes of the lung with related anatomy.]]
*Localized, suppurative necrotizing process occurring within the pulmonary parenchyma
*Microbiology
**Community-acquired: [[anaerobes]] mostly aspiration, anaerobic bacteria from oral cavity: peptostreptococcus, prevotella, bacteroides, fusobacterium species
**Hospital-acquired: [[Staph]], [[E coli]], [[Klebsiella]], [[pseudomonas]], [[legionella]]

===Causes===
*Aspiration [[pneumonia]] (7-14 days to become lung abscess)
*[[Bacteremia]] from nonpulmonary infection
*[[Influenza]] leading to Bacterial superinfection (e.g. ''S. Aureus'')
*Pulmonary infarction
*Infection as a result of penetrating [[chest trauma]]
*Primary and metastatic neoplasms
*[[Granulomatosis with polyangiitis]] (Wegener's), [[sarcoidosis]]

==Clinical Features==
*[[Cough]], [[fever]], pleuritic [[chest pain]], weight loss, night sweats (generally over course of several weeks)
**[[Tachycardia]], [[tachypnea]], or [[fever]] may be absent

===Complications===
*[[Empyema]]
*Massive [[hemoptysis]]

==Differential Diagnosis==
*Cavitary lesion with air-fluid level
*Infected bullae
*Pleural fluid collection with bronchopleural fistula
*Loop of bowel extending through diaphragmatic hernia

==Evaluation==
[[File:PulmonaryabsCXR.png|thumb|Pulmonary abscess on [[CXR]]]]
[[File:XR chest - pneumonia with abscess and caverns - d0.jpg |thumb|[[CXR]] showing pneumonia with [[lung abscess]].]]
[[File:Pulmonaryabs.png|thumb|Pulmonary abscess on CT scan]]
*[[CXR]] or CT Chest
*Dense consolidation with air-fluid level inside of a thick-walled cavitary lesion
**Air-fluid level indicates communication of [[abscess]] cavity with a bronchiole

==Management==
*Medical management will successfully treat 70-90% of lung abscesses
**Drainage occurs spontaneously from communication of cavity with tracheobronchial tree
**Bronchoscopic drainage may result in seeding other parts of the lung
*Antibiotics
**[[Clindamycin]] + 2nd or 3rd gen [[cephalosporin]] '''OR'''
**[[Clindamycin]] + [[ampicillin/sulbactam]]

==Disposition==
*Admit

==See Also==
*[[Empyema]]

==References==
<References/>

[[Category:ID]]
[[Category:Pulmonary]]