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| {{Lung abscess}} | | {{Lung abscess}} |
| {{CMG}} | | {{CMG}};{{AE}}{{ADG}} |
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| {{SK}} Pulmonary abscess | | {{SK}} Pulmonary abscess |
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| == [[Lung abscess historical perspective|Historical Perspective]] == | | == [[Lung abscess historical perspective|Historical Perspective]] == |
| *In 1904 Guillemot first put weight to the theory that aspirated oropharyngeal organisms were responsible for cause of lung abscess
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| *In 1938 first Percutaneous drain of lung abscess was performed.
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| *In 1942 Brock added evidence in stating that aspirated contents gravitated to the dependents part of the lungs
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| *In early 19th century arsenicals and physiotherapy were the mainstay of treatment of lung abscess
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| == [[Lung abscess classification|Classification]] == | | == [[Lung abscess classification|Classification]]== |
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| == [[Lung abscess pathophysiology|Pathophysiology]] == | | == [[Lung abscess pathophysiology|Pathophysiology]] == |
| *Aspiration of anerobic bacteria from the oro-pharnynx, due to altered level of consciousness, absent gag reflex or inability to swallow is the inciting event for the development of primary lung abscess.<ref name="pmid936601">{{cite journal |vauthors= |title=Lung abscess |journal=West. J. Med. |volume=124 |issue=6 |pages=476–82 |year=1976 |pmid=936601 |pmc=1130102 |doi= |url=}}</ref>
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| *In healthy individuals, defense mechanisms cope up with the small amounts of aspirates with no effects, however, in conditions like alcoholism, DM, and immunocompromised state these defense mechanisms can be compromised leading to decreased activity of alveolar macrophages and mobility of leucocytes. <ref name="pmid5683476">{{cite journal |vauthors=Green LH, Green GM |title=Differential suppression of pulmonary antibacterial activity as the mechanism of selection of a pathogen in mixed bacterial infection of the lung |journal=Am. Rev. Respir. Dis. |volume=98 |issue=5 |pages=819–24 |year=1968 |pmid=5683476 |doi=10.1164/arrd.1968.98.5.819 |url=}}</ref>.
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| *In secondary lung abscess, abscess formation depends on the underlying lung disease and predisposing factors,for example, bronchial obstruction from benign or malignant intrabronchial lesions or extrinsic compression of bronchus as in middle lobe syndrome results in distal abscess formation due to decrease oropharyngeal clearance due to decreased clearance meachanisms and favouring abscess formation.
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| *Once the aspirate is localized it results in pneumonitis <ref name="pmid15599270">{{cite journal |vauthors=Brook I |title=Anaerobic pulmonary infections in children |journal=Pediatr Emerg Care |volume=20 |issue=9 |pages=636–40 |year=2004 |pmid=15599270 |doi= |url=}}</ref>
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| *Inflammatory mediators are released along with various bacterial toxins, leading to disrupture of small blood vessels and release of various proteolytic enzymes from the neutrophils resulting in the formation of colliquative necrosis <ref name="pmid22388585">{{cite journal |vauthors=Tsai YF, Ku YH |title=Necrotizing pneumonia: a rare complication of pneumonia requiring special consideration |journal=Curr Opin Pulm Med |volume=18 |issue=3 |pages=246–52 |year=2012 |pmid=22388585 |doi=10.1097/MCP.0b013e3283521022 |url=}}</ref><br>
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| ====Location of abscess====
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| *The right lung is more commonly affected than the left lung because is of it more angulation than the left bronchi.
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| *The most common location is the posterior segment of the right apical lobe or apical segments of lower lobes of both the lungs.<ref name="pmid8324127">{{cite journal |vauthors=Bartlett JG |title=Anaerobic bacterial infections of the lung and pleural space |journal=Clin. Infect. Dis. |volume=16 Suppl 4 |issue= |pages=S248–55 |year=1993 |pmid=8324127 |doi= |url=}}</ref>
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| *Lateral part of the posterior segment of upper lobe of the right lung is more commonly involved in alcoholics.
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| ===Genetics===
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| *Congenital diseases such as cystic fibrosis, vasculitis, pulmonary sequestration and bronchial cysts are associated with increased the risk of lung abscess in children.<ref name="pmid3715782">{{cite journal |vauthors=Canny GJ, Marcotte JE, Levison H |title=Lung abscess in cystic fibrosis |journal=Thorax |volume=41 |issue=3 |pages=221–2 |year=1986 |pmid=3715782 |pmc=460300 |doi= |url=}}</ref>
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| ===Gross Morphology===
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| *In acute lung abscess, the lesions are well circumscribed filled with necrotic debris and do not demonstrate well-defined borders with the surrounding lung parenchyma.<ref name="pmid26366400">{{cite journal |vauthors=Kuhajda I, Zarogoulidis K, Tsirgogianni K, Tsavlis D, Kioumis I, Kosmidis C, Tsakiridis K, Mpakas A, Zarogoulidis P, Zissimopoulos A, Baloukas D, Kuhajda D |title=Lung abscess-etiology, diagnostic and treatment options |journal=Ann Transl Med |volume=3 |issue=13 |pages=183 |year=2015 |pmid=26366400 |pmc=4543327 |doi=10.3978/j.issn.2305-5839.2015.07.08 |url=}}</ref>
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| *In chronic long standing abscess, the lesions are irregular and filled with grayish thick debris.
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| ===Microscopic Findings===
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| *In acute lung abscess, neutrophilic granulocytes are demonstrated with dilated blood vessels and inflammatory edema.<ref name="pmid26366400">{{cite journal |vauthors=Kuhajda I, Zarogoulidis K, Tsirgogianni K, Tsavlis D, Kioumis I, Kosmidis C, Tsakiridis K, Mpakas A, Zarogoulidis P, Zissimopoulos A, Baloukas D, Kuhajda D |title=Lung abscess-etiology, diagnostic and treatment options |journal=Ann Transl Med |volume=3 |issue=13 |pages=183 |year=2015 |pmid=26366400 |pmc=4543327 |doi=10.3978/j.issn.2305-5839.2015.07.08 |url=}}</ref>
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| *In chronic lung abscess, biopsy specimen demonstrates lymphocytes, plasma cells, and histiocytes around a layer of pyogenic membrane surounding the abscess cavity which is filled with pus.
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| == [[Lung abscess causes|Causes]] == | | == [[Lung abscess causes|Causes]] == |
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| == [[Lung abscess differential diagnosis|Differentiating Lung abscess from other Diseases]] == | | == [[Lung abscess differential diagnosis|Differentiating Lung abscess from other Diseases]] == |
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| == [[Lung abscess epidemiology and demographics|Epidemiology and Demographics]] == | | == [[Lung abscess epidemiology and demographics|Epidemiology and Demographics]]== |
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| == [[Lung abscess risk factors|Risk Factors]] == | | == [[Lung abscess risk factors|Risk Factors]] == |
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| | == [[Lung abscess screening|Screening]]== |
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| == [[Lung abscess natural history, complications and prognosis|Natural History, Complications and Prognosis]] == | | == [[Lung abscess natural history, complications and prognosis|Natural History, Complications and Prognosis]] == |
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| [[fi:Keuhkopaise]] | | [[fi:Keuhkopaise]] |
| [[ru:Абсцесс лёгких]] | | [[ru:Абсцесс лёгких]] |
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| [[Category:Pulmonology]]
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| [[Category:Infectious disease]]
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| [[pl:Ropień płuc]] | | [[pl:Ropień płuc]] |
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