- Lung abscess is defined as collection of pus in the lung parenchyma or there is a cavity lined by pyogenic membrane from where pus is expectorated into bronchus.
CAUSES
- Infectious Cause:-
- Staphylococcus aureus, Klebsiella
- Anaerobes, Mixed flora, Actinomyces – These infections are acquired as a result of dental surgery, tonsillectomy, or other surgeries in oral cavity
- Aspiration of fluids from GIT when patient is unconscious following GAs, patient with vocal cord palsies, reflux esophagitis
- Another rare causes:-
- Pulmonary infarction
- Trauma
- Carcinoma lung or metastasis
- Amebic liver abscess
SYMPTOMS & SIGNS
- Localized pain at the site
- High fever with chills & rigors
- Pathognomonic Feature- cough with putrid foul smelling sputum
- Rapid weight loss
- Clubbing
- On Examination:-
- Abscess site is tender
- Stony dullness on percussion
- Loss of breath sound at abscess site
- Bronchial Breath sound
- Increased Vocal Resonance
- Increased Tactile Vocal Fremitus
INVESTIGATION
- X-ray (PA Chest)
- lung abscess can be readily observed in form of pus-filled cavity with fluid & air level
- if abscess cavity doesn’t contain air, it is difficult to distinguish from tubercular mass or a tumor mass
- CT Scan
- it is done when diagnosis of lung abscess is doubtful
- Culture & Sensitivity Of Sputum
- important to know the type of bacteria involved and antibiotics required
MANAGEMENT
- Improvement of general health
- Postural drainage of pus
- the patient should tilt on opposite side of the lung abscess
- if postural drainage doesn’t drain pus, it should be drained by help of bronchoscope
- Specific antibiotics (based on culture & sensitivity) given for 10-14 days
- Physiotherapy is vey important
- Breathing exercises
List of important General Medicine questions – https://dentaledge.co.in/general-medicine-important-questions-for-dental-students/
- Image Attribution – Wikipedia