UMEM Educational Pearls

Title: What's the Diagnosis?

Posted: 12/9/2013 by Haney Mallemat, MD
Click here to contact Haney Mallemat, MD

37 year-old male presents with cough and a fever. What's the diagnosis and name three risk factors assiciated with disease?

Answer: Lung Abscesses

Lung Abscess

Necrosis of lung parenchyma with pus and debris-filled cavities
Caused by
- direct injury (e.g., aspiration pneumonia)
- secondary causes (e.g., tricuspid endocarditis, bacteremia, etc.)
Risk factors for disease:
- Loss of airway reflexes (e.g., CVA, seizures, alcohol / narcotic abuse, etc)
- Poor dentition
- Immunosuppression (Diabetes, chronic steroids, etc.)
- IVDA
Gram positives (especially Staph), negatives, and anaerobic bacteria have been implicated.
CXR may suggest, but CT scan better identifies abscess, necrotic tissue, empyema, or other pathology
Start broad-spectrum antibiotics and address potential underlying cause

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