LUNG ABSCESS

DEFINATION :-
It is a subacute suppurative disease of lung resulting in the
formation of cavity containing purulent material.

PATHOLOGY :-
* Most comman predisposing condition are :
- seizure disorder
- unconscious state
- poor oral hygein
- immuno deficiency
- aspiration
* Single abscess is usually due to
- pneumonia
- foreign body
- tuberculosis
- rupture of amophic liver abscess
* Multiple abscess are due to
- severe pneumonia
- tuberculosis
- cystic fibrosis
-fungal infections
- leukemia
* Posterior segment pf upper lobes & superior segments of
lower lobe are affected during aspiration &recumbent
position.

CLINICAL FEATURES :-
- Onset is often insidious with high grade unresolving fever,
chronic cough, dyspnea, chest pain, foul smelling sputum & hemoptysis.
- Physical examinationreveals dullness of percussion,
Decreased breath sounds and egophony.

DIAGNOSIS :-
(1) TC :- WBC count is elevated with neutrophilia.
(2) Chest X- ray :-one or more thick walled cavities with
Air-fluid level.
(3) Gram staining &microscopy of sputum.
TREATMENT :-
(1) Appropriate parenteral antibiotics covering staphylococcus
aureus, H. influenzae &anaerobes for 3-4 wks. Antibiotics used are :- amoxy
–clavulanic acid, penicillin, cephalosporin (3rd-4th generation) and
metronidazole.
(2) Postural drainage
(3) Breathing exercise & chest physiotherapy.
(4) Lobar or segmental resection.

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