scholarly journals 1303. A Rare Case of Legionella micdadei Lung Abscess in an Immunocompromised Patient

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S739-S740
Author(s):  
Fadi Samaan ◽  
Andriy Barchuk ◽  
Yasmin Bata ◽  
Rachael Biancuzzo ◽  
Elias Jabbour ◽  
...  
Keyword(s):  
Hematologic Malignancy ◽  
White Cell Count ◽  
Lower Lobe ◽  
Immunocompromised Host ◽  
Lung Abscess ◽  
Cavitary Lesion ◽  
Amoxicillin Clavulanate ◽  
Artery Disease ◽  
Upper Abdominal ◽  
Legionella Micdadei

Abstract Background Legionella micdadei is the most common legionella species causing infection after L. pneumophila. It usually causes infection in immunocompromised hosts and leads to nodules with tendency to cavitate. It is difficult to culture which makes diagnosis challenging. We report a case or L. micdadei in an immunocompromised host with cavitary pneumonia. Methods Case Report. An 82 year-old female presented with upper abdominal pain for one day duration. She has history of hypertension, coronary artery disease, hyperlipidemia, heart failure, and hypothyroidism. She was diagnosed with hypersensitivity pneumonia 5 months prior, treated with prednisone (40 mg daily). The pain was not associated with nausea, vomiting or diarrhea. She was found with hypoxia despite she denied shortness of breath, cough, hemoptysis or chest pain. There was no fever, chills, headache, myalgia or upper respiratory symptoms. She was afebrile, tachycardic 134/min and hypoxic to 88% on room air. White cell count was 22x10(3) /mcL (90% neutrophils), hemoglobin was 10.4 g/dL, creatinine was 1.23 mg/dL and lactic acid was 3.6 mmol/L. Chest CT scan showed left lower lobe cavitary lesion with surrounding infiltrates (image 1). Quantiferon gold, serum galagtomannan, B-D-glucan, and vasculitis work-up were negative. Bronchoscopy showed a patent airway. Bronchial smears and cultures were negative for bacteria, fungi and mycobacteria. The patient was treated with ceftriaxone and metronidazole with de-escalation to amoxicillin/clavulanate. Bronchial culture was positive for legionella micdadei after discharge, azithromycin was added. Image 1. Cavitary lesion on thoracic CT Results Our patient was considered immunocompromised given steroid use, predisposing her for L. micdadei infection. L. micdadei is considered an opportunistic infection and was reported in hematologic malignancy population. It can cause an invasive lung disease with lung cavities. It needs special media for growth making it difficult to diagnose especially it is not detected by legionella urine antigen. Conclusion L. micdadei should be considered in the differential diagnosis for cavitary lung lesions in immunocompromised patients. Disclosures All Authors: No reported disclosures

Lung abscess due to aspirated vomitus

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Saad Farooq ◽  
◽  
Ebrahim Hasan Khan ◽  
Keyword(s):  
African American ◽  
Physical Examination ◽  
African American Male ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Chest Ct ◽  
Amoxicillin Clavulanate ◽  
The Right

Our patient was a 41-year-old African American male who came in with a cough, hemoptysis, and body aches for two days. He was vitally stable and physical examination did not reveal any abnormality. A Chest CT revealed a lung abscess at base of the right lower lobe. He was initially treated with ampicillin-sulbactam which was then converted to amoxicillin-clavulanate and he completely recovered on this regimen.Further history revealed that he was using marijuana and had an episode of vomiting which he aspirated and that was the likely cause of his lung abscess.

scholarly journals Empyema and lung abscess: An unusual presentation of pulmonary actinomycosis

2017 ◽  
Vol 4 (2) ◽  
pp. 60
Author(s):  
Matthew A. Robinson ◽  
Avinesh S. Bhar
Keyword(s):  
Chest Tube ◽  
Lower Lobe ◽  
Pulmonary Involvement ◽  
Lung Abscess ◽  
Tube Placement ◽  
Penicillin G ◽  
Computed Tomographic ◽  
History Of ◽  
Artery Disease ◽  
Disseminated Disease

Actinomyces spp. are an infrequent cause of pulmonary infections. Actinomyces spp. comprise part of the normal flora of the oral cavity and gastrointestinal tract. A. meyeri is especially known for pulmonary involvement and disseminated disease. The authors present a case of a polymicrobial pulmonary abscess containing A. meyeri. The patient was a 58-year-old man with a history of coronary artery disease, alcohol abuse and hypertension. He presented with progressive dyspnea and cough productive of grey-colored foul smelling sputum. Upon admission, a chest computed tomographic (CT) scan revealed a right-lower-lobe lung abscess, with an associated loculated empyema. The following day, the patient underwent a thoracostomy with chest tube placement. The chest tube drained several hundred milliliters of purulent pleural fluid, but a follow up chest CT showed little change in the size of the underlying empyema. A subsequent thoracotomy with decortication was performed, which evacuated 100 ml of thick purulent fluid. Fourteen days after admission, the patient was discharged on a 6- to 12-week course of intravenous penicillin G, followed by a 6-month course of oral penicillin V.

scholarly journals Surgical Treatment in Bronchiectasis: Analysis of Our Patients.

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Fadil Gradica ◽  
Lutfi Lisha ◽  
Dhimitraq Argjiri ◽  
Fahri Kokici ◽  
Alma Cani ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pulmonary Resection ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Duration Of Symptoms ◽  
Operative Morbidity ◽  
Massive Haemoptysis ◽  
Localized Disease ◽  
The Mean

Background: Bronchiectasis is usually caused by pulmonary infections and bronchial obstructions. It is still a serious problem in developing countries, as our country. We reviewed the morbidity and mortal-ity rates and outcomes of bronchiectasis surgical treatment. Patients and methods: Between years 2000 and 2016, one hundred and seven (107) patients, sixty nine (69) of whom female and thirty eight (38) male underwent pulmonary resection for bronchiecta-sis. The mean age was 35years (range, 13–66 years). Mean duration of symptoms was 12 years. Results: Symptoms were copious amount of purulent sputum in 84 patients, expectoration of foul-smelling sputum in 72, haemoptysis in 21 and cough in all patients. The indications for pulmonary resection were: medical therapy failure in eighty two (82) patients, massive haemoptysis in eighteen and lung abscess in seven (7) patients. The disease was bilateral in twenty seven (27) patients and mainly confined in the lower lobe. Eighty six (86) patients had a lobectomy, 7 had a segmentectomy, two patients right pneumonectomy. Operative morbidity was seen in 47 patients (43.9 %) and mor-tality in two (2) patients. Follow-up was complete in 97 patients with a mean of 5 years. Overall, 78 patients were asymptomatic after surgical treatment; symptoms were improved in 24, and unchanged or worse in 5. Conclusions: Surgical treatment of bronchiectasis is more effective in patient with localized disease. It is satisfactory with acceptable ratio of morbidity and mortality.

scholarly journals Pulmonary abscess as a complication of COVID-19 associated pneumonia: a clinical case

2022 ◽  
Vol 99 (12) ◽  
pp. 7-12
Author(s):  
T. I. Kalenchits ◽  
S. L. Kabak ◽  
S. V. Primak ◽  
N. M. Shirinaliev
Keyword(s):  
Clinical Laboratory ◽  
Lower Lobe ◽  
Pleural Empyema ◽  
Lung Abscess ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pulmonary Abscess ◽  
Causative Factors ◽  
The Right ◽  
Test Result

The article describes a case of polysegmental destructive viral-bacterial pneumonia complicated with acute pulmonary abscess, pleural empyema, and pneumopleurofibrosis in a 50-year-old female patient infected with the SARS-CoV-2 virus. The first clinical, laboratory and radiological signs of purulent-necrotic inflammation appeared only 20 days after receiving a positive RT-PCR test result with a nasopharyngeal swab. A month later, an emerging abscess in the lower lobe of the right lung was diagnosed. Subsequently, it spontaneously drained into the pleural cavity.Coagulopathy with the formation of microthrombi in small pulmonary vessels is one of the causative factors of lung abscess in patients infected with the SARS-CoV-2 virus.

Rare case of Prevotella pleuritidis lung abscess

2020 ◽  
Vol 13 (9) ◽  
pp. e235960
Author(s):  
Abuzar Ali Asif ◽  
Moni Roy ◽  
Sharjeel Ahmad
Keyword(s):  
Rare Case ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Vaginal Mucosa ◽  
Pulmonary Infections ◽  
Next Generation ◽  
Dna Testing ◽  
Cell Free Dna ◽  
Free Dna ◽  
Obligate Anaerobic

Prevotella genus comprises of obligate anaerobic, gram-negative bacteria that are commensal organisms of oral cavity, gut and vaginal mucosa. Although many Prevotella species have well-established pathogenicity with respect to pulmonary infections, rarely has Prevotella pleuritidis been isolated as a cause of lung abscess. We present a rare case of left lower lobe lung abscess due to P. pleuritidis identified using next-generation sequencing of microbial cell-free DNA testing. A brief review of the literature regarding Prevotella species pulmonary infections, use of next-generation cell-free DNA testing early in the evaluation, antibiotic susceptibility and resistance is also a part of this report.

Surgical treatment of broncho­­pulmonary purulent­inflammatory complications due to permanent coronaviral ihfection — the first experience

2021 ◽  
pp. 7-14
Author(s):  
M.S. Opanasenko ◽  
B.M. Konik ◽  
S.M. Bilokon ◽  
O.V. Tereshkovich ◽  
S.M. Shalagay ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory System ◽  
Pleural Cavity ◽  
Left Lung ◽  
Lower Lobe ◽  
Pleural Empyema ◽  
Lung Abscess ◽  
Sublobar Resection ◽  
Surgical Interventions ◽  
Coronavirus Infection

Objective — to acquaint doctors of different profiles with thoracic pathology in patients with coronavirus infection. Materials and methods. Since the beginning of the SARSCoV-2 pandemic, on the basis of the clinical department for the surgical treatment of tuberculosis and NZL complicated by purulent septic infections 70 patients were treated, of which 39 (55.7 %) had various broncho-pulmonary purulent-inflammatory complications of coronavirus infection. Results and discussion. The distribution of treated patients with bronchopulmonary purulent-inflammatory complications of coronavirus infection by nosology is presented in Table 1. According to the table presented, pleural empyema was a frequent bacterial complication of the respiratory system — 18 (46.1 %) cases; only 6 (33.3 %) patients were diagnosed with broncho-pleural communication, while in 12 (66.7 %) patients, already at the stage of hospitalization, a functioning broncho-pleural fistula was observed.17 (94.4 %) patients with empyema underwent videothoracoscopic (VATS) debridement of the pleural cavity with polydrainage and the use of prolonged active aspiration in the postoperative period. The management of such patients was no different, except for 2 points: the need to continue GCS therapy and the obligatory long-term prescription of anticoagulants and antiplatelet drugs.In 1 (5.6 %) case, due to the extremely serious condition of the patient, only drainage of both pleural cavities was performed (this case was fatal). In another case, after 2 VATS of the pleural cavity, bronchial blocking of the upper lobe and intermediate bronchi of the right lung was performed, followed by active aspiration. Nonspecific exudative pleurisy was diagnosed in 8 (20.5 %) patients after coronavirus infection. There were 13 patients with abscess pneumonia and abscesses (33.3 %). This group of patients underwent drug therapy for a long time, which consisted in the appointment of broad-spectrum antibiotics, anticoagulants, pathogenetic therapy and symptomatic treatment.After a course of conservative treatment, 9 (69.2 %) patients underwent the following surgical interventions — sublobar resection for a sanitized lung abscess in 4 (44.5 %) cases, lobectomy in the presence of sanitized residual large cavities in 3 (33.3 %) patients, partial pleurectomy with decortication of the lung and sublobar resection of the lower lobe of the left lung in 2 (22.2 %) patients.Conservative therapy was successful only in 4 (30.7 %) patients. All 13 patients with abscess pneumonia and abscesses were discharged from the institute with full recovery or improvement (small sanitized destruction cavities up to 2 cm in diameter remained in the lung parenchyma). There were no lethal outcomes.The overall effectiveness of the treatment of this contingent of patients was 97.4 %, and the general mortality rate — 2.6 %.Videothoscopic treatment was effective in 25 (64.1 %) patients with pleural empyema and nonspecific pleurisy, and in 4 (16 %) patients it allowed to stabilize the condition and carry out resection surgery. Conclusions. Purulent-destructive complications of the respiratory system in coronavirus infection have a causal component, and therefore timely exposure to all parts of the pathogenesis can significantly reduce their level. Preference should be given to videothoracoscopic intervention in the complicated course of coronavirus infection. The high level of diagnosis (25.4 %) of concomitant pathology of the chest with the widespread use of radiological methods in the pandemic of coronavirus infection may indicate a low level of preventive medicine in the state.

Cryptogenic organising pneumonia: an unusual cause of pleuritic chest pain

2021 ◽  
Vol 14 (1) ◽  
pp. e238514
Author(s):  
Rebecca Ceci Bonello ◽  
Etienne Ceci Bonello ◽  
Christian Vassallo ◽  
Edward Giles Bellia
Keyword(s):  
Chest Pain ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Clinical Status ◽  
Lower Lobe ◽  
Pleuritic Chest Pain ◽  
Ct Guided ◽  
Atypical Pathogens ◽  
Ct Guided Biopsy ◽  
The Right

A 76-year-old woman presented with a 2-hour history of pleuritic chest pain with no other associated symptoms. Blood investigations revealed raised inflammatory markers and an elevated white cell count. On chest radiograph, an airspace shadow indicative of a consolidation was prominent. This was followed by a CT scan of her thorax which showed a spiculated lesion in the right upper lobe, a lesion in the posterior segment of the left lower lobe and mildly enlarged right hilar lymph nodes. She was started on dual antibiotic therapy; however, the patient’s clinical status and inflammatory markers did not improve. A bronchoscopy was performed which excluded malignancy and atypical pathogens. CT-guided biopsy confirmed the presence of cryptogenic organising pneumonia. Prednisolone 50 mg daily was prescribed with quick resolution of symptoms.

scholarly journals A 75-Year-Old Female with Hemoptysis and Recurrent Respiratory Infections

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Mary S. Baker ◽  
Khalil Diab
Keyword(s):  
Respiratory Infections ◽  
Interesting Case ◽  
Lung Abscess ◽  
Chest Ct ◽  
Lower Lobectomy ◽  
Recurrent Respiratory Infections ◽  
Amoxicillin Clavulanate ◽  
History Of ◽  
One Year ◽  
Multiple Episodes

This paper describes the case of a 75-year-old female who presented with significant hemoptysis over a 7–10 day period. She had a history of a left lower lobectomy 10 years prior for a “lung abscess.” She subsequently had multiple episodes of cough, fevers, and possible pneumonia treated with multiple courses of Amoxicillin and Amoxicillin/Clavulanate. Review of her chest CT upon presentation to the hospital showed a large necrotic lingular infiltrate, which had been progressively increasing in size over at least one year. Bronchoscopy showed a yellowish, soft round body in the superior lingular subsegment. Endobronchial and transbronchial biopsies showedactinomycesspecies. This is a very interesting case of indolent actinomycosis which we suspect had a very slow progressive course secondary to the multiple courses of antibiotics that the patient was treated with.

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