ID
Lung Abscess
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Lung Abscess
Definition
Localized lung cavity filled with pus
Product of lung necrosis
Cavity is often surrounded by infection
Causes
See
Pneumonia Causes
Anaerobic flora
Staphylococcus aureus
Mycobacterium tuberculosis
Nontuberculous
Mycobacteria
Fungal infection
Symptoms
Fever
Chills
Night Sweats
Productive cough of foul
Sputum
Dyspnea
Fatigue
Weight loss
Pleuritic Chest Pain
Hemoptysis
Signs
Localized dullness over involved lung
Bronchi
al breath sounds or absent breath sounds
Fingernail
Clubbing
Differential Diagnosis
Foreign Body Aspiration
Pulmonary Infarction
Lung Cancer
Imaging
Chest XRay
Solitary cavitary lesion with air-fluid level
Lesion surrounded by pneumonitis
Labs
Sputum
examination
Microscopy
Gram Stain
Mycobacteria
l stains
Fungal stains
Sputum
layers on standing
Sputum Culture
s are usually not helpful
Complete Blood Count
Leukocytosis
Diagnosis
Bronchoscopy if proximal obstructing tumor is suspected
Management
Antibiotics
Initial IV Dose
Penicillin
10-12 MU IV for 1 dose
Subsequent IV Doses
Penicillin
V 750-1000 mg IV qid or
Clindamycin
600 mg q8h IV
Subsequent home dosing
Clindamycin
300 mg PO qid for 6 weeks
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