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REVIEW
Diagnosis, treatment and prognosis of lung abscess
1
Respiratory Intensive Care Unit, ‘Sotiria’ General Hospital of Athens, Greece
2
Second Department of Propaedeutic Surgery, University of Athens Medical School, General Hospital “Laiko”, Athens, Greece
3
“Iatriko” Hospital, Respiratory Department, P. Faliron, Piraeus, Greece
4
4th Respiratory Clinic, ‘Sotiria’ General Hospital of Athens, Greece
Corresponding author
Christos F. Kampolis
Second Department of Propaedeutic Surgery, General Hospital “Laiko” 17 Ag. Thoma str., 11527, Athens, Greece
Second Department of Propaedeutic Surgery, General Hospital “Laiko” 17 Ag. Thoma str., 11527, Athens, Greece
Pneumon 2015;28(1):54-60
KEYWORDS
ABSTRACT
Lung abscesses are usually caused by anaerobic or mixed bacterial infection of the lower respiratory tract. Conservative treatment with broad-spectrum antibiotics is established as the therapy of choice for most patients, with 80-95% responding to antimicrobial therapy. Conservative management failure, manifested by sepsis persistence and/or abscess complications, requires drainage with invasive techniques (percutaneous, endoscopic or surgical) or open surgical removal of the affected lung tissue (segmentectomy, lobectomy or rarely pneumonectomy) in patients with good performance status and sufficient respiratory reserve. Although surgical intervention is accompanied by relatively high mortality rates (11%-28%), it remains the most effective method in preventing complications or future relapses.
CONFLICTS OF INTEREST
None.
REFERENCES (53)
1.
Hagan JL, Hardy JD. Lung abscess revisited. A survey of 184 cases. Ann Surg 1983;197:755–62.
2.
Bartlett JG, Finegold SM. Anaerobic infections of the lung and pleural space. Am Rev Respir Dis 1974;110:56–77.
3.
Mori T, Ebe T, Takahashi M, Isonuma H, Ikemoto H, Oguri T. Lung abscess: analysis of 66 cases from 1979 to 1991. Intern Med 1993;32:278–84.
4.
Bartlett JG. The role of anaerobic bacteria in lung abscess. Clin Infect Dis 2005;40:923–5.
6.
Bartlett JG. Anaerobic bacterial infections of the lung and pleural space. Clin Infect Dis 1993;16 Suppl 4:S248–55.
7.
Takayanagi N, Kagiyama N, Ishiguro T, Tokunaga D, Sugita Y. Etiology and outcome of community-acquired lung abscess. Respiration 2010;80:98–105.
8.
Wang J-L, Chen K-Y, Fang C-T, Hsueh P-R, Yang P-C, Chang S-C. Changing bacteriology of adult community-acquired lung abscess in Taiwan: Klebsiella pneumoniae versus anaerobes. Clin Infect Dis 2005;40:915–22.
9.
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.
10.
Davis B, Systrom DM. Lung abscess: pathogenesis, diagnosis and treatment. Curr Clin Top Infect Dis 1998;18:252–73.
11.
Gillet Y, Issartel B, Vanhems P, et al. Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet 2002;359:753–9.
12.
Francis JS, Doherty MC, Lopatin U, et al. Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin Infect Dis 2005;40:100–7.
13.
Bubeck Wardenburg J, Palazzolo-Ballance AM, Otto M, Schneewind O, DeLeo FR. Panton-Valentine leukocidin is not a virulence determinant in murine models of community-associated methicillin-resistant Staphylococcus aureus disease. J Infect Dis 2008;198:1166–70.
14.
Stark DD, Federle MP, Goodman PC, Podrasky AE, Webb WR. Differentiating lung abscess and empyema: radiography and computed tomography. AJR Am J Roentgenol 1983;141:163–7.
15.
Bartlett JG. Diagnostic accuracy of transtracheal aspiration bacteriologic studies. Am Rev Respir Dis 1977;115:777–82.
16.
Sosenko A, Glassroth J. Fiberoptic bronchoscopy in the evaluation of lung abscesses. Chest 1985;87:489–94.
17.
Levison ME, Mangura CT, Lorber B, et al. Clindamycin compared with penicillin for the treatment of anaerobic lung abscess Ann Intern Med 1983;98:466–71.
18.
Gudiol F, Manresa F, Pallares R, et al. Clindamycin vs penicillin for anaerobic lung infections. High rate of penicillin failures associated with penicillin-resistant Bacteroides melaninogenicus. Arch Intern Med 1990;150:2525–9.
19.
Germaud P, Poirier J, Jacqueme P, et al. [Monotherapy using amoxicillin/clavulanic acid as treatment of first choice in community-acquired lung abscess. Apropos of 57 cases]. Rev Pneumol Clin 1993;49:137–41.
20.
Fernández-Sabé N, Carratalà J, Dorca J, et al. Efficacy and safety of sequential amoxicillin-clavulanate in the treatment of anaerobic lung infections. Eur J Clin Microbiol Infect Dis 2003;22:185–7.
21.
Eykyn SJ. The therapeutic use of metronidazole in anaerobic infection: six years’ experience in a London hospital. Surgery 1983;93:209–14.
22.
Perlino CA. Metronidazole vs clindamycin treatment of anerobic pulmonary infection. Failure of metronidazole therapy. Arch Intern Med 1981;141:1424–7.
23.
Wunderink RG, Niederman MS, Kollef MH, et al. Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study. Clin Infect Dis 2012;54:621–9.
24.
DeLeo FR, Otto M, Kreiswirth BN, Chambers HF. Communityassociated meticillin-resistant Staphylococcus aureus. Lancet 2010;375:1557–68.
25.
Bartlett JG, Gorbach SL, Tally FP, Finegold SM. Bacteriology and treatment of primary lung abscess. Am Rev Respir Dis 1974;109:510–8.
26.
Mwandumba HC, Beeching NJ. Pyogenic lung infections: factors for predicting clinical outcome of lung abscess and thoracic empyema. Curr Opin Pulm Med 2000;6:234–9.
27.
Alifano M, Gaucher S, Rabbat A, et al. Alternatives to resectional surgery for infectious disease of the lung: from embolization to thoracoplasty. Thorac Surg Clin 2012;22:413–29.
28.
vanSonnenberg E, D’Agostino HB, Casola G, Wittich GR, Varney RR, Harker C. Lung abscess: CT-guided drainage. Radiology 1991;178:347–51.
29.
Yellin A, Yellin EO, Lieberman Y. Percutaneous tube drainage: the treatment of choice for refractory lung abscess. Ann Thorac Surg 1985;39:266–70.
30.
Erasmus JJ, McAdams HP, Rossi S, Kelley MJ. Percutaneous management of intrapulmonary air and fluid collections. Radiol Clin North Am 2000;38:385–93.
31.
Silverman SG, Mueller PR, Saini S, et al. Thoracic empyema: management with image-guided catheter drainage. Radiology 1988;169:5–9.
32.
Kelogrigoris M, Tsagouli P, Stathopoulos K, Tsagaridou I, Thanos L. CT-guided percutaneous drainage of lung abscesses: review of 40 cases. JBR-BTR 2011;94:191–5.
33.
Wali SO, Shugaeri A, Samman YS, Abdelaziz M. Percutaneous drainage of pyogenic lung abscess. Scand J Infect Dis 2002;34:673–9.
34.
Metras H, Charpin J. Lung abscess and bronchial catheterization. J Thorac Surg 1954;27:157–72.
35.
Connors JP, Roper CL, Ferguson TB. Transbronchial catheterization of pulmonary abscesses. Ann Thorac Surg 1975;19:254–60.
36.
Rowe LD, Keane WM, Jafek BW, Atkins JP. Transbronchial drainage of pulmonary abscesses with the flexible fiberoptic bronchoscope. Laryngoscope 1979;89:122–8.
37.
Schmitt GS, Ohar JM, Kanter KR, Naunheim KS. Indwelling transbronchial catheter drainage of pulmonary abscess. Ann Thorac Surg 1988;45:43–7.
38.
Herth F, Ernst A, Becker HD. Endoscopic drainage of lung abscesses: technique and outcome. Chest 2005;127:1378–81.
39.
Shlomi D, Kramer MR, Fuks L, Peled N, Shitrit D. Endobronchial drainage of lung abscess: the use of laser. Scand J Infect Dis 2010;42:65–8.
40.
Schweigert M, Dubecz A, Stadlhuber RJ, Stein HJ. Modern history of surgical management of lung abscess: from Harold Neuhof to current concepts. Ann Thorac Surg 2011;92:2293–7.
41.
Neuhof H, Hurwitt E. Acute putrid abscess of the lung: VII. Relationship of the thechnic of the one-stage operation to results. Ann Surg 1943;118:656–64.
42.
Monaldi V. Endocavitary aspiration in the treatment of lung abscess. Dis Chest 1956;29:193–201.
43.
Wali SO. An update on the drainage of pyogenic lung abscesses. Ann Thorac Med 2012;7:3–7.
44.
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.
45.
Shaw RR, Paulson DL. Pulmonary resection for chronic abscess of the lung. J Thorac Surg 1948;17:514–22.
46.
Myers RT, Bradshaw HH. Conservative resection of chronic lung abscess. Ann Surg 1950;131:985–93.
47.
Waterman DH, Domm SE. Changing trends in the treatment of lung abscess. Dis Chest 1954;25:40–53.
48.
Postma MH, le Roux BT. The place of external drainage in the management of lung abscess. S Afr J Surg 1986;24:156–8.
49.
Refaely Y, Weissberg D. Gangrene of the lung: treatment in two stages. Ann Thorac Surg 1997;64:970–3; discussion 973–4.
50.
Chen C-H, Huang W-C, Chen T-Y, Hung T-T, Liu H-C, Chen C-H. Massive necrotizing pneumonia with pulmonary gangrene. Ann Thorac Surg 2009;87:310–1.
51.
Philpott NJ, Woodhead MA, Wilson AG, Millard FJ. Lung abscess: a neglected cause of life threatening haemoptysis. Thorax 1993;48:674–5.
52.
Nakada T, Akiba T, Inagaki T, Morikawa T, Ohki T. Simplified cavernostomy using wound protector for complex pulmonary aspergilloma. Ann Thorac Surg 2014;98:360–1.
53.
Nagasawa KK, Johnson SM. Thoracoscopic treatment of pediatric lung abscesses. J Pediatr Surg 2010;45:574–8.
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