Lung Abscess

Lung Abscess, Lung Abscess and Treatment of Disease

Etiology

The vast majority of lung abscesses existing upper respiratory tract infection occurs by inhalation of the material. Sinüsitis respiratory tract, oral infections (pyorea, dental caries), surgical procedures (tonsillectomy, tooth extraction), infection of the larynx and bronchial tumors, chronic bronchitis and bronchiectasis, lung abscess affecting the occurrence of sources of infection. Poor nutrition, alcoholism, smoking, chronic lung disease, diabetes mellitus, immunosuppressive drugs such as corticosteroids and immunosuppressive debilitan diseases, foreign body aspiration, epilepsy, anesthesia, facilitates the occurrence of neurological problems and surgery of lung abscess. More rarely, the lung abscess penetrating the diaphragm causes subdiyafragmatik abscesses. Aerobic or anaerobic streptococci, staphylococci, Klebsiella, pneumococci, fusiform bacilli and spirochaete main factors of lung abscesses.

Pathology

Lung abscess abscess in any part of the body is like. Tuberculosis, fungal infections, infected cysts and tumors, although it fits the definition of necrosis, abscess kavernlerinde histopathological changes related to these diseases are called lesions. The size of abscess infectious agent type, quantity and virülansına the patient's resistance is localized and vary by location. After a time, localized tissue and fibrosis developed around the granülöz parenkimasında progress will prevent lung abscess. Small abscesses may heal without leaving any residue in place. Abscess drainage is not better or untreated growing in other parts of the lungs and to focus new causes suppuration and abscess.

Clinical symptoms

Facilitate the removal of dental abscesses the occurrence of the majority of cases, surgical intervention, poisoning (such as toxic doses of drugs for suicide to be taken), alcoholism, epilepsy, determined as a result. First, shivering with fever rises, this weakness, cough, pleural pain, followed by type. Starting as pneumonia and antibiotic treatment is started many times with this diagnosis. Untreated cases, and easily extracted from the increasing sputum, dyspnea, syanoz develops. Nature of 10-500 per day or more pus is removed from sputum. Sputum many times, such as sewage or rotten eggs, cabbage, pickled or corrupted bad smell. The smell next to the patient or the doctor who examined the hit and hear. The anaerobic bacteria that cause bad breath abscess. Hemoptysis is a frequent complication. In some cases the abscess begins suddenly, in some cases, there are insidious and progressive development. Pleural cavity pleural abscess proceed serious pain, dyspnea, empyema and pneumothorax causes.

Upon examination, abscess in the dullness, decreased breath sounds, sometimes it is frotmanı crepitan Railer and pleura. Comag fingers drum cases consist of a progressive deformity.

Laboratory findings

Leukocyte 20000-30000 to exit. Leukocyte formula in particular has increased neutrophils. Bacteriological examination of sputum and the sensitivity to drugs (antibiotic) should be examined. Abscess should be suspected when the culture of both aerobic bacteria aneorob hemde. Tuberculosis bacilli directly, culture and drug sensitivity study should not be neglected. Lung abscess and the mixed flora of bacteria in mixed flora can be found in Koch's bacillus. Bronchoscopy are used in the diagnosis and treatment of lung abscess. With this method, for example, whether a foreign body or tumor are taken and the material is made ​​aneorob culture.

Radiological findings

Initially, there is a concentration pneumonia-like round. A few days after the abscess necrotic material in the liquid-air level of a typical partial discharge occurs with a cavitary appearance. Intracavernous wall is thicker and usually has a concentration around the rather homogeneous nature pneumonic. Kavernleri abscess of the right lung and lower lobes are seen more.

Differential diagnosis

Especially at the beginning of the disease is difficult to distinguish pneumonia lung abscess. However, clear signs of infectious regains abscess progresses. Tuberculosis, fungal infections and complications of bronchial cancer may develop abscesses abscess-like look and feel. The patient's background and previous films with new ones drawn by comparing the diagnosis of lung helps. Hydatid cysts and bronchogenic cysts can also abseleşme. Süpürasyonu lung abscess in trauma and is an expected complication. Intracavernous and abseleşme pneumococcal-yosis'de rarely occur. Hiatus hernia and abscess kavernlerine intrato-rasim sometimes resemble other hernias. Diafragmadaki no signs of abnormalities in the respiratory system caused by the intrathoracic these hernias, the main symptoms of the disease retrostemal pain, gastrointestinal symptoms and radiological appearance of the gastrointestinal tract unchanged and baryumla diagnosed with radiographic examination are placed.

Treatment

Abesisi a serious lung disease. Should be treated in hospital. Lung infections tend to abseleşmeye. So seriously, checking the course of antibiotic treatment should be implemented and the disease. Tonsillectomy, tooth withdrawal and prophylactic penicillin treatment of lung aspiration must be the case.

The most effective antibiotic penicillin in the treatment of abscess. The daily dose is 10-20 million units or more. In some cases, the disease can be treated with penicillin alone. In addition to clindamycin, penicillin, metronizasol also be used. Changing bacterial flora in sputum bacterial culture and antibiotic that is often examined and appropriate antibiotic therapy should be combined.

Appropriate for the study of antibiotic susceptibility of gram-negative bacteria sefope-Razon (1 gm X 3/gün, IV or IM), ampicillin (500 mg X 4/gün, oral), the snow-benisilin (12-20 gm / day, and IV), gentamicin (80 mg X 2/gün, IM), cephalothin (2-4 gm / day, and IV) are used. Complete bed rest, postural drainage, in cases of hypoxia, oxygen therapy, bronchodilator drugs, diagnostics and treatment, bronchoscopy helps to ensure drainage.

6-8 weeks despite intensive treatment unhealed or hemoptysis, and chest wall of the fistula, a complication of bronkostenoz who need surgical intervention in cases without delay. If there is a complication of drainage of pleural empyema.

Delay the effective treatment of lung abscesses and 90% will recover without significant complications. Abscess in cases of chronic anemia, malnutrition, cachexia, fluid and electrolyte imbalance, particularly in elderly heart failure and amyloidosis develops in some cases. Whether these complications should be treated carefully examined.

Karine Pnömosistis

Protozon cause of a parasite group. Diseases that reduce immunity and immunosuppressive drug use is monitored more frequently. The most serious and fatal disease, a complication of AIDS Pnömosistis wife. The disease often insidious and chronic nature. Intermittent dry cough, dyspnea, syanoz, sübfebril heard sporadic fire and physical examination, wet and dry Railer main clinical symptoms.
Chest radiography is particularly perihilar reticulo-granular appearance. The disease progresses, concentrate, consist of focal areas of atelectasis and emphysema. In some cases, bronchial aspiration may cause material to pnömosistis wife. However, the majority of cases the disease is diagnosed with lung biopsy.

Pnömosistis wife for the treatment of trimethoprim, and pentamidine isothionate toxazole sulfame-used drugs.

Lung Amibiasis

Lung Amibiasis

Histolitikadır entomoeba factor. Amoeba liver abscess is usually related to the passing of diaphragm and lung disease. Colitis symptoms such as diarrhea and tenesmus, right upper quadrant abdominal tenderness, painful hepatomegaly, weight loss, fever, dry cough, lung amibiasis'ini consider. Sputum, such as chocolate paste is removed from the period of the disease is advanced, a subsidiary of hepato-bronchial will be indicated. Some patients say it's very painful, a subsidiary of Safrabronş phlegm.

Concentration and lung abscess is a localized view of the base of Radiography monitored.
Amibiasis'inin treatment of lung and liver abscess amoeba treatment should be applied together. Liver abscess surgically drained, and metromi-dazole and iodoquinol direnle used drugs.

Ascariasis (Loeffler's Syndrome)

Parasite Ascaris eggs to people infected through food. The larva enters the small intestine mucosa lung lymph and blood circulation, causes an allergic reaction, and increases in blood eosinophils. Loeffler's syndrome can cause a lot of different character aller-antigen.

The main clinical signs of disease, dry cough, fever sübfebril, scattered sibilan and ronflan Railer, hemoptysis, and dyspnea in severe cases. Chest X-ray of one or a few places there are a few centimeters in diameter homogeneous condensation. Lobar localization of the infiltrates may be combined with more serious cases. Pulmonary infiltrates are usually transient, spontaneously disappear.
Mebendazole or albendazole are used in the treatment of Ascariasis medicine.

Hydatid cyst

3-8 mm long, is a small noise factor ekinokokkus granülaris dogs, cats and other animals are sometimes passed to people. Hydatid disease is endemic in Turkey and is followed quite often.

Placed in the lower lobes of the lung cyst several times. Clinical symptoms vary depending on the size of the cyst and settled down. The main symptom of cough many times overlooked. Cyst tears of allergic shock, hemoptysis, lung cyst, proliferation, leads to complications of multiple abscesses and empyema. By growing pressure from the cyst with dyspnea, dysphagia, Horner's syndrome, or superior vena cava syndrome may develop.
Chest X-ray one, sometimes more than one section diameter 1-10. round, around the uniform, homogeneous "ball" is a condensation. Displacement of the mediastinum, atelectasis, or pleural effusion can be monitored.

Around the cyst is thin, the former cyst kalsifıyedir circles, lotus flower is an important finding for diagnostic view. Sometimes the wall between the cyst capsule and infiltrating the halo or air meniscus sign (moon-shaped air ring seen within the cyst) is husule. Meniscus symptoms of lung tuberculosis, aspergilosis, diseases such as cancer and abscesses may also occur. Radiological appearances of hydatid cyst of lung tumors can look like. Cases of pulmonary hydatid cyst in the cyst is located in the liver by 40% in this regard, for example, abdominal ultrasound of liver should be examined.

Hydatid cyst in 30% of patients have eosinophilia. Serological tests positive for 60-90% cases. The most specific and significant serological diagnosis of hydatid cyst İmmünoelektroforez test is a test.

Hydatid cyst disease, the treatment of choice is to remove the cyst surgically. Albendazole and mebendazole (vermox) as an aid to surgery or drugs used in cases of surgical intervention is contraindicated.