Lung abscess: Difference between revisions

Revision as of 15:52, 18 August 2020

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
- Seizures, stroke, drug overdose, general anesthesia
Dysphagia or respiratory dysfunction from ALS, Parkinson’s disease, or stroke
Tooth extraction

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

@@ Line 1: / Line 1: @@
-== Microbiology ==
+==Background==
+===Microbiology===
-* Usually polymicrobial, including oral anaerobes
+*Usually polymicrobial, including oral [[anaerobes]]
-* Can also be monomicrobial, caused by ''Klebsiella'', ''Staphylococcus aureus'', ''Pseudomonas aeruginosa'', ''Burkholderia pseudomallei'' (melioidosis), ''Pasteurella multocida'', group A streptococcus, ''Haemophilus influenzae'' types b and c, ''Legionella'' spp., ''Rhodococcus equi'', ''Actinomyces'' spp., and ''Nocardia'' spp.
+*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|''Legionella'' species]], ''[[Rhodococcus equi]]'', [[Actinomyces species|''Actinomyces'' species]], and [[Nocardia species|''Nocardia'' species]]
-== Pathophysiology ==
+===Pathophysiology===
-* Mostly from chronic aspiration
+*Mostly from chronic aspiration
-== Risk Factors ==
+===Risk Factors===
-* Chronic aspiration from any etiology
+*Chronic aspiration from any etiology
-** '''Alcohol use disorder'''
+**'''Alcohol use disorder'''
-** Seizures, stroke, drug overdose, general anesthesia
+**Seizures, stroke, drug overdose, general anesthesia
-* Dysphagia or respiratory dysfunction from ALS, Parkinson’s disease, or stroke
+*Dysphagia or respiratory dysfunction from ALS, Parkinson’s disease, or stroke
-* Tooth extraction
+*Tooth extraction
-== Management ==
+==Management==
+*Unless clearly monomicrobial, should treat broadly and include good anaerobic coverage
-* Antibiotics
+**Either a β-lactam plus [[metronidazole]], or [[clindamycin]]
-* Rarely, surgical intervention
+*Antibiotics usually for 6 to 8 weeks
+*Can follow progress radiographically
+*Rarely, surgical intervention
 [[Category:Respiratory infections]]