UMEM Educational Pearls


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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