Lung Abscess

Question 1

What is a lung abscess?

Answer 1

A well circumscribed infection within the lung parenchyma.

Question 2

What does a lung abscess most commonly form secondary to?

Answer 2

Most commonly forms secondary to aspiration pneumonia

Question 3

What are other potential causes of a lung abscess?

Answer 3

• haematogenous spread- infective endocarditis
• direct extension
• bronchial obstruction- lung tumour

Question 4

What are possible monomicrobial causes of a lung abscess?

Answer 4

• Staphylococcus aureus
• Klebsiella pneumonia
• Pseudomonas aeruginosa

Question 5

What are possible signs of a lung abscess?

Answer 5

• systemic features such as night sweats and weight loss may be seen
• fever
• productive cough
• often foul-smelling sputum
• chest pain
• dyspnoea

Question 6

What are the symptoms of a lung abscess similar to?

Answer 6

Pneumonia- more subacute presentation

Question 7

What clinical signs may be present in someone with a lung abscess?

Answer 7

Dull percussion and bronchial breathing
Clubbing may be seen

Question 8

What investigation might you do if someone is presenting with a lung abscess?

Answer 8

Chest x-ray

Question 9

What might you see on a chest x-ray of someone presenting with a lung abscess?

Answer 9

• fluid-filled space within an area of consolidation
• an air-fluid level is typically seen

Question 10

What is the management of a lung abscess?

Answer 10

Intravenous antibiotics

Question 11

What may be required if the lung abscess doesn’t resolve wit IV antibiotics?

Answer 11

Percutaneous drainage

Question 12

What can be seen in the history of someone with a lung abscess?

Answer 12

PMH of a middle cerebral artery stroke (might indicate they have impaired swallowing- aspiration)

Question 13

How long would antibiotic therapy be given?

Answer 13

3-6 weeks