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Lung Abscess

  • Dragan Subotic
Chapter

Abstract

Pulmonary/lung abscess is encountered either as result of primary necrotising lower respiratory tract infections or secondary infection within metastasis, congenital or acquired lung lesions, tuberculous cavities or traumatic lung contusion. With the advent of antibiotics and good early medical supportive management, need for surgery is rare in immunocompetent individuals. However, due to increase of the bacterial resistance rate, of the number of immunocompromised patients, due to still high HIV incidence and need to achieve diagnosis of lung cancer, surgical resection may be required. Surgical resection should preserve as much parenchyma as possible as likely chance of subsequent infection is significant. Surgery in patients with poor pulmonary reserve and generalised parenchymal involvement is associated with significant morbidity and mortality. Patient selection and adequate preoperative preparations are vital to the outcome.

Keywords

Pulmonary abscess Necrotising pneumonia Chronic lung abscess Fungal infection Lung cancer Inhaled foreign body Bronchiectasis Lobectomy Pneumonectomy Post-lobectomy and post-pneumonectomy empyema 

References

  1. 1.
    Bartlett JG. Lung abscess. In: Baum GL, Wolinsky E, editors. Textbook of pulmonary diseases. 5th ed. Boston: Little Brown; 1994. p. 607–20.Google Scholar
  2. 2.
    Lilienthal HIV. The first case of thoracotomy in a human being under anaesthesia by intratracheal insufflations. Ann Surg. 1910;52:30–3.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lilienthal HIX. Pulmonary abscess and bronchiectasis: a clinical report. Ann Surg. 1914;59:855–83.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Neuhof H, Hurwitt E. Acute putrid abscess of the lung: VII (Relationship of the technic of the one-stage operation to results). Ann Surg. 1943;118:656–64.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Schweppe HI, Knowles JH, Kane L. Lung abscess (An analysis of the Massachusetts General Hospital cases from 1943 through 1956). N Engl J Med. 1961;265:1039–43.CrossRefPubMedGoogle Scholar
  6. 6.
    Shaw RR. Pulmonary abscess: value of early one-stage drainage. J Thorac Surg. 1942;11:453–66.Google Scholar
  7. 7.
    Neuhof H, Touroff AS, Aufses AH. The surgical treatment, by drainage, of subacute and chronic putrid abscess of the lung. Ann Surg. 1941;113:209–20.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Shaw RR, Paulson DL. Pulmonary resection for chronic abscess of the lung. J Thorac Surg. 1948;17:514–22.PubMedGoogle Scholar
  9. 9.
    Myers RT, Bradshaw HH. Conservative resection of chronic lung abscess. Ann Surg. 1950;131:985–93.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Waterman DH, Domm SE. Changing trends in the treatment of lung abscess. Dis Chest. 1954;25:40–53.CrossRefPubMedGoogle Scholar
  11. 11.
    Merritt RE, Shrager JB. Indications for surgery in patients with localised pulmonary infection. Thorac Surg Clin. 2012;22:325–32.CrossRefPubMedGoogle Scholar
  12. 12.
    Athanassiadi K, Jakovic R, Siafakas N. Abscess of the lung: current therapeutic options. Eur Res Mono. 2013;61:81–9.Google Scholar
  13. 13.
    Davis B, Systrom DM. Lung abscess: pathogenesis, diagnosis and treatment. Curr Clin Top Infect Dis. 1998;18:252–73.PubMedGoogle Scholar
  14. 14.
    Hood MR. Bacterial diseases of the lung. In: Shields TW, editor. General thoracic surgery. 4th ed. Philadelphia: Lea and Febiger; 1989. p. 751–71.Google Scholar
  15. 15.
    Wallace RJ Jr, Cohen A, Awe RJ, Greenberg D, Hadlock F, Park Carcinomatous SK. lung abscess. Diagnosis by bronchoscopy and cytopathology. JAMA. 1979;242(6):521–2.CrossRefPubMedGoogle Scholar
  16. 16.
    Honda O, Tsubamoto M, Inoue A, et al. Pulmonary cavitary nodules on computed tomography: differentiation of malignancy and benignancy. J Comput Assist Tomogr. 2007;31(6):943–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Yamada Y, Sekine Y, Suzuki H, et al. Trends of bacterial colonisation and the risk of postoperative pneumonia in lung cancer patients with COPD. Eur J Cardiothorac Surg. 2010;37:752–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Sethi S, Evans N, Grant BJ, et al. New strains of bacteria and exacerbations of COPD. N Engl J Med. 2002;347:465–71.CrossRefPubMedGoogle Scholar
  19. 19.
    Chaudhuri MR. Primary pulmonary cavitating carcinomas. Thorax. 1973;28:354–66.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Benumof JL, Alfery DD. Anesthesia for thoracic surgery. In: Miller RD, editor. Anesthesia. 5th ed. Philadelphia: Churchill Livingstone; 2000. p. 1665–75.Google Scholar
  21. 21.
    Pfitzner J, Peakock MJ, Tsirgiotis E, Walkey H. Lobectomy for cavitating lung abscess with haemoptysis: strategy for protecting the contralateral lung and also the non-involved lobe of the ipsilateral lung. Br J Anaesth. 2000;85:791–4.CrossRefPubMedGoogle Scholar
  22. 22.
    Pfitzner J, Peacock MJ, McAleer PT. Gas movement in the non-ventilated lung at the onset of single-lung ventilation for video-assisted thoracoscopy. Anaesthesia. 1999;54:437–43.CrossRefPubMedGoogle Scholar
  23. 23.
    Parker LA, Melton JW, Delany DJ, Yankeskas BC. Percutaneous small bore catheter drainage in the management of lung abscesses. Chest. 1987;92:213–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Mengoli L. Giant lung abscess treated by tube thoracostomy. J Thorac Cardiovasc Surg. 1985;90:186–94.PubMedGoogle Scholar
  25. 25.
    Weissberg D. Percutaneous drainage of lung abscess. J Thorac Cardiovasc Surg. 1984;87:308–12.PubMedGoogle Scholar
  26. 26.
    Wali SO, Shugaeri A, Samman YS, Abdelaziz M. Percutaneous drainage of pyogenic lung abscess. Scand J Infect Dis. 2002;34:673–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Shim C, Santas GH, Zelefsky M. Percutaneous drainage of lung abscess. Lung. 1990;168:201–7.CrossRefPubMedGoogle Scholar
  28. 28.
    vanSonnenberg E, D’Agostino HB, Casola G, Wittich GR, Varney RR, Harker C. Lung abscess: CT-guided drainage. Radiology. 1991;178:347–51.CrossRefPubMedGoogle Scholar
  29. 29.
    Ha HK, Kang MW, Park JM, Yang WJ, Shinn KS, Bahk YW. Lung abscess: percutaneous catheter therapy. Acta Radiol. 1993;34:362–5.CrossRefPubMedGoogle Scholar
  30. 30.
    Yunus M. CT-guided transthoracic catheter drainage of intrapulmonary abscess. J Pak Med Assoc. 2009;59:703–9.PubMedGoogle Scholar
  31. 31.
    Hirshberg B, Sklair-Levi M, Nir-Paz R, Ben-Sira L, Krivoruk V, Kramer MR. Factors predicting mortality of patients with lung abscess. Chest. 1999;115:746–50.CrossRefPubMedGoogle Scholar
  32. 32.
    Metras H, Chapin J. Lung abscess and bronchial catheterization. J Thorac Surg. 1954;27:157–9.PubMedGoogle Scholar
  33. 33.
    Herth F, Ernst A, Becker HD. Endoscopic drainage of lung abscesses: technique and outcome. Chest. 2005;127:1378–81.PubMedGoogle Scholar
  34. 34.
    Connors JP, Roper CL, Ferguson TB. Transbronchial catheterisation of pulmonary abscess. Ann Thorac Surg. 1975;19:254–60.CrossRefPubMedGoogle Scholar
  35. 35.
    Rowe LD, Keane WM, Jafek BW, Atkins JP Jr. Transbronchial drainage of pulmonary abscesses with the flexible fiberoptic bronchoscope. Laryngoscope. 1979;89:122–8.PubMedGoogle Scholar
  36. 36.
    Schmitt GS, Ohar JM, Kanter KR, Naunheim KS. Indwelling transbronchial catheter drainage of pulmonary abscess. Ann Thorac Surg. 1988;45:43–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Dragan Subotic
    • 1
  1. 1.Clinic for Thoracic Surgery, Clinical Center of SerbiaUniversity of Belgrade School of MedicineBelgradeSerbia

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