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17 Cards in this Set
- Front
- Back
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Lung Abscess
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An area of necrotic tissue resulting from an infection
Localized air and fluid filled cavity -Fluid is a collection of purulent exudate -liquified white blood cell remains -Proteins -Tissue debris The cavity is encapsulated (pyogenic membrane) -layer of fibrin -inflammatory -granulation tissue |
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Lung Etiology (cause)
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A complication of pneumonia caused by aspiration of anaerobic organisms from the gastrointestinal tract and saliva (repeated pneumonias and infection)
-klebsiella -staphylococcus -peptococcus -peptostreptococcus -bacteroides |
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How many bacterium are involved in Lung Abscesses?
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Typically more than one
-anaerobic -aerobic |
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Mycobacterium
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May also cause LA
-TB -M. kansasii |
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LA caused by Fungi
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Aspergillus fumigatus
Histoplasma capsulatum |
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LA caused by Parasites
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Entamoeba histolytica
Echinococcus |
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Lung Abscess caused by aspiration
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Right Lung more than Left Lung
Superior segments of lower lobes Posterior segments of upper lobes |
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LA Predisposing Factors
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Alcohol Abuse
Seizure Disorder General Anethesia - dull airway reflexes Head Trauma Cerebrovascular accident (stroke - lose ability to swallow) Swallowing disorders |
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LA Pathophysiology
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Alv. Infection/inflammation leading to consolidation
leads to alv capillary and bronchial wall destruction leads to tissue necrosis leads to cavity formation leads to fibrosis and calcification of lung parenchyma |
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Rupture of the abscess may result in the following potential complications...
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Bronchus - excessive airway secreations
Intrapleural space - emphysema. atelectasis |
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LA Clinical Manifestations
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The pt usually presents with cough
Early - Nonproductive cough Later - Abscess ruptures and creates a productive bronchus cough -lrg amt of sputum -foul-smelling -colored: green, yellow, brown, gray -blood streaked or frank hemoptysis -pleuritic chest pain -fever -anxiety -tachycardia -increased blood pressure -tachypnea |
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Palpation with LA
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Decreased movement over area involved
Increased tactile fremitus |
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Percussion with LA
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Dull sound over area
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Auscultation with LA
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Bronchial - if consolidated
Diminished - if obstructed Crackles and Rhonchi - if ruptured |
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LA CXR
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Increased Opacity
Cavity formation -air fluid level -straight line Fibrosis and calcification Pleural effusion |
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Diagnosis of LA is based on...
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History
PE CXR Lab studies |
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Treatment of LA
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Hypoxemia
-O2 Therapy -Decrease PCR stim -WOB and WOH Decreased Lung Compliance -BHT Increased WOB -BHT and O2 Therapy Infection -Antibiotic or surgery if Rx doesnt work Fever -Anti-pyretic Pleuritic Chest pain -Analgesic |
