Empyema differential diagnosis: Difference between revisions
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|CT scan | |CT scan | ||
|Seen as a lung mass whose cavity is regular with smooth and regular lumen, well-defined defined boundary and shape changes with change in patient's position.<ref name="pmid7384467">{{cite journal| author=Baber CE, Hedlund LW, Oddson TA, Putman CE| title=Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography. | journal=Radiology | year= 1980 | volume= 135 | issue= 3 | pages= 755-8 | pmid=7384467 | doi=10.1148/radiology.135.3.7384467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7384467 }}</ref> Mass may resolve on antibiotics | |Seen as a lung mass whose cavity is regular with smooth and regular lumen, well-defined defined boundary and shape changes with change in patient's position.<ref name="pmid7384467">{{cite journal| author=Baber CE, Hedlund LW, Oddson TA, Putman CE| title=Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography. | journal=Radiology | year= 1980 | volume= 135 | issue= 3 | pages= 755-8 | pmid=7384467 | doi=10.1148/radiology.135.3.7384467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7384467 }}</ref> Mass may resolve on antibiotics | ||
The split pleura sign is present (most reliable sign to differentiate empyema from lung abscess) | |||
|Lung mass whose cavity is rregular with undulated lumen, irregular-poorly defined boundary and shape does not change with change in patient's position.<ref name="pmid73844672">{{cite journal| author=Baber CE, Hedlund LW, Oddson TA, Putman CE| title=Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography. | journal=Radiology | year= 1980 | volume= 135 | issue= 3 | pages= 755-8 | pmid=7384467 | doi=10.1148/radiology.135.3.7384467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7384467 }}</ref> Mass may resolve on antibiotics | |Lung mass whose cavity is rregular with undulated lumen, irregular-poorly defined boundary and shape does not change with change in patient's position.<ref name="pmid73844672">{{cite journal| author=Baber CE, Hedlund LW, Oddson TA, Putman CE| title=Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography. | journal=Radiology | year= 1980 | volume= 135 | issue= 3 | pages= 755-8 | pmid=7384467 | doi=10.1148/radiology.135.3.7384467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7384467 }}</ref> Mass may resolve on antibiotics |
Revision as of 14:49, 6 January 2017
Empyema Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differential diagnosis
Empyema must be diffrentiated from pneumonia, lung abscess, lung cancer and parapneumonic effusions as shown below:
Variable | Empyema Thoracis | Lung abscess | parapneumonic effusion | Pneumonia | Lung cancer |
---|---|---|---|---|---|
Presentation | Variable presentation but may follow long standing pneumonia | Usually has history of aspiration pneumonia, alcoholics, drug abusers, seizure disorder, have undergone recent general anesthesia, or have a nasogastric or endotracheal tube. | Usually follows pneumonia | presents with fever, pleuritc chest pain, cough | mostly asymptomatic but may have cough productive with hemoptysis |
Chest ultrasound | Ultrasound in empyema is positive for suspended microbubble sign, air fluid level, curtains sign and loss of gliding sign.[1] | Ultrasound in lung abscess is negative for suspended microbubble sign, curtains sign and loss of gliding sign but air fluid level may be seen,.[2] | |||
CT scan | Seen as a lung mass whose cavity is regular with smooth and regular lumen, well-defined defined boundary and shape changes with change in patient's position.[3] Mass may resolve on antibiotics
The split pleura sign is present (most reliable sign to differentiate empyema from lung abscess) |
Lung mass whose cavity is rregular with undulated lumen, irregular-poorly defined boundary and shape does not change with change in patient's position.[4] Mass may resolve on antibiotics | Seen as a lung mass that does not resolve on antibiotics |
References
- ↑ Lin FC, Chou CW, Chang SC (2004). "Differentiating pyopneumothorax and peripheral lung abscess: chest ultrasonography". Am J Med Sci. 327 (6): 330–5. PMID 15201646.
- ↑ Lin FC, Chou CW, Chang SC (2004). "Differentiating pyopneumothorax and peripheral lung abscess: chest ultrasonography". Am J Med Sci. 327 (6): 330–5. PMID 15201646.
- ↑ Baber CE, Hedlund LW, Oddson TA, Putman CE (1980). "Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography". Radiology. 135 (3): 755–8. doi:10.1148/radiology.135.3.7384467. PMID 7384467.
- ↑ Baber CE, Hedlund LW, Oddson TA, Putman CE (1980). "Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography". Radiology. 135 (3): 755–8. doi:10.1148/radiology.135.3.7384467. PMID 7384467.