Lung abscess: Difference between revisions
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===Risk Factors=== |
===Risk Factors=== |
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*Chronic aspiration from any etiology |
*[[Chronic aspiration]] from any etiology |
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**'''Alcohol use disorder''' |
**'''[[Alcohol use disorder]]''' |
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** |
**[[Seizure disorder]], [[stroke]], drug overdose, general anesthesia |
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*Dysphagia or respiratory dysfunction from ALS, |
*[[Dysphagia]] or respiratory dysfunction from [[ALS]], [[Parkinson disease]], or [[stroke]] |
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*Tooth extraction |
*Tooth extraction |
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== Differential Diagnosis == |
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* See [[cavitary lung lesion]] |
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==Management== |
==Management== |
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Revision as of 19:51, 3 January 2021
Background
Microbiology
- Usually polymicrobial, including oral anaerobes
- Can also be monomicrobial, caused by Klebsiella, Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia pseudomallei (melioidosis), Pasteurella multocida, Streptococcus pyogenes, Haemophilus influenzae types b and c, Legionella species, Rhodococcus equi, Actinomyces species, and Nocardia species
Pathophysiology
- Mostly from chronic aspiration
Risk Factors
- Chronic aspiration from any etiology
- Alcohol use disorder
- Seizure disorder, stroke, drug overdose, general anesthesia
- Dysphagia or respiratory dysfunction from ALS, Parkinson disease, or stroke
- Tooth extraction
Differential Diagnosis
Management
- Unless clearly monomicrobial, should treat broadly and include good anaerobic coverage
- Either a β-lactam plus metronidazole, or clindamycin
- Antibiotics usually for 6 to 8 weeks
- Can follow progress radiographically
- Rarely, surgical intervention
