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 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.

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.

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

Streptococcus intermedius: unusual presentation and complication of lung abscess

2021 ◽  
Vol 14 (11) ◽  
pp. e245675
Author(s):  
Nouraldeen Manasrah ◽  
Sushmita Nanja Reddy ◽  
Ali Al Sbihi ◽  
Wasif Hafeez
Keyword(s):  
Young Patients ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Rare Presentation ◽  
Streptococcus Intermedius ◽  
Direct Infiltration ◽  
Vertebral Bodies ◽  
The Right ◽  
Spread Of Infection ◽  
Contiguous Spread

We report a case of a 54-year-old immunocompetent male who had lung abscess secondary to Streptococcus intermedius that led to discitis by contiguous spread of infection. He initially presented with constant chest pain for 6 weeks that radiated to lower back, with no fever, chills or weight loss. He denied smoking cigarettes, alcohol use or any illicit drug. On investigation, a mass was identified on the posterior medial aspect of the right lower lobe with direct infiltration into right side of the T5–T6 vertebral bodies. Histopathology identified organising pneumonia with abscess. Tissue cultures showed S. intermedius, and were negative for other microorganisms. This case highlights a rare presentation of S. intermedius discitis by contiguous spread of infection from posterior right lower lobe lung abscess. S. intermedius usually occurs in older patients with pulmonary infections complicated with pleural effusion or lung abscess, but can present in young patients with no clear symptoms of lung infection, like our patient.

scholarly journals Automated Lobe-Based Airway Labeling

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Suicheng Gu ◽  
Zhimin Wang ◽  
Jill M. Siegfried ◽  
David Wilson ◽  
William L. Bigbee ◽  
...  
Keyword(s):  
Functional Unit ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Chest Ct ◽  
Rule Based ◽  
Centerline Extraction ◽  
Airway Segmentation ◽  
Right Middle Lobe ◽  
Airway Tree ◽  
The Right

Regional quantitative analysis of airway morphological abnormalities is of great interest in lung disease investigation. Considering that pulmonary lobes are relatively independent functional unit, we develop and test a novel and efficient computerized scheme in this study to automatically and robustly classify the airways into different categories in terms of pulmonary lobe. Given an airway tree, which could be obtained using any available airway segmentation scheme, the developed approach consists of four basic steps: (1) airway skeletonization or centerline extraction, (2) individual airway branch identification, (3) initial rule-based airway classification/labeling, and (4) self-correction of labeling errors. In order to assess the performance of this approach, we applied it to a dataset consisting of 300 chest CT examinations in a batch manner and asked an image analyst to subjectively examine the labeled results. Our preliminary experiment showed that the labeling accuracy for the right upper lobe, the right middle lobe, the right lower lobe, the left upper lobe, and the left lower lobe is 100%, 99.3%, 99.3%, 100%, and 100%, respectively. Among these, only two cases are incorrectly labeled due to the failures in airway detection. It takes around 2 minutes to label an airway tree using this algorithm.

scholarly journals Rare clinical manifestation of community-acquired pneumonia

2018 ◽  
Vol 11 (1) ◽  
pp. e225589
Author(s):  
Shay Brikman ◽  
Omri Levi ◽  
Guy Dori
Keyword(s):  
Inflammatory Response ◽  
Physical Examination ◽  
Clinical Manifestation ◽  
Lower Lobe ◽  
Community Acquired Pneumonia ◽  
Chest Ct ◽  
Chest Film ◽  
Unexplained Fever

A 71-year-old patient was admitted due to fever and persistent (>48 hours) hiccups. History and physical examination were not instructive. Lab tests were not specific, showing an inflammatory response. Chest film did not demonstrate opacities. The patient was treated with chlorpromazine with no relief. Fever and hiccups persisted, and therefore neck and chest CT was performed revealing a right lower lobe infiltrate, a finding consistent with pneumonia. Antibiotics were initiated and within 48 hours fever and hiccups resolved and patient recovered. Although hiccups are rarely described as a clinical manifestation of community acquired pneumonia, one should consider this diagnosis in a patient with unexplained fever.

PS02.163: A CASE OF SEPARATION SURGERY WITH DRAINAGE TUBE-LESS (DRESS) ESOPHAGOSTOMY FOR ADVANCED CANCER WITH A RESPIRATORY FISTULA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Yukinori Tanoue ◽  
Shinsuke Takeno ◽  
Fumiaki Kawano ◽  
Kousei Tashiro ◽  
Rouko Hamada ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Cancer ◽  
Aspiration Pneumonia ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Drainage Tube ◽  
Lung Field ◽  
Definitive Chemoradiotherapy ◽  
The Right

Abstract Background Esophagorespiratory fistulas including esophagopulmonary fistulas occur in 5–10% patients with esophageal cancer with invasion to adjacent organs. With an esophagorespiratory fistula, saliva and food flow into the respiratory tract through the fistula and severe pneumonia or lung abscess can develop. Alternatively, whether chemoradiotherapy can be performed for patients with esophagorespiratory fistulas affects the further outcomes of treatment in these patients. An esophageal cancer patient with an esophagopulmonary fistula who underwent separation surgery with drainage tube-less (DRESS) esophagostomy and whose inflammation from the esophagorespiratory fistula could be effectively controlled, which facilitated the prompt administration of definitive chemoradiotherapy, is reported. Methods Case report: A 79-year-old man visited a clinic with a month-long history of dysphagia. Esophageal cancer at the middle thoracic esophagus was detected, and invasion of the left main bronchus and lower lobe of the right lung was seen on contrast-enhanced computed tomography (CT). Three weeks later, urgent CT showed a lung abscess in the lower lobe of the right lung that continued into the adjacent esophageal cancer, infiltrative shadows in the peripheral lung field, and a pleural effusion. Due to the esophagopulmonary fistula, the patient underwent emergency surgery that consisted of esophageal separation surgery and double bilateral esophagostomy on the right and left supraclavicular region and enterostomy (drainage tube-less esophageal separation surgery). Results Antibiotic drug therapy for pneumonia and lung abscess achieved a favorable outcome. Definitive chemoradiotherapy for the esophageal cancer was started from postoperative day 25. Radiotherapy could not be completed because of sepsis due to aspiration pneumonia, though the aspiration pneumonia improved with intensive treatment. At six-month follow-up, the patient had achieved relapse-free survival and is currently symptom-free. Conclusion Separation surgery with a drainage tube-less (DRESS) esophagostomy is the less invasive operative procedure, which allows prompt initiation of chemoradiotherapy. In many cases of esophageal surgeries, an external esophagostomy is made with a drainage tube, and drainage tubes sometimes cause trouble and affect the quality of life of patients after surgery. However, our drainage tube-less (DRESS) esophagostomy might improve patient's quality of life. In addition, evaluation of esophageal cancer by endoscopic examination through the esophagocutaneostomy can be easily performed. Disclosure All authors have declared no conflicts of interest.

scholarly journals Burkholderia cepacia: An unusual cause of pneumonia

2021 ◽  
Vol 6 (4) ◽  
pp. 249-252
Author(s):  
Arjun A S ◽  
Prasanna Kumar T ◽  
Manjunath H K
Keyword(s):  
Burkholderia Cepacia ◽  
Lower Lobe ◽  
Lung Abscess ◽  
High Grade Fever ◽  
Home Setting ◽  
Prescription Practices ◽  
Male Farmer ◽  
History Of ◽  
Chest X Ray ◽  
The Right

Burkholderia Cepacia is a gram negative organism, an uncommon cause of pneumonia. When isolated, it usually represents colonisation. In the presence of immunocompromising conditions, it can cause disease, ranging from mild illness to the highly fatal Cepacia syndrome. The organism is intrinsically resistant to many antibiotics. We report a 57 years old male farmer, who has diabetes mellitus and bronchial asthma, who presented with a acute history of high grade fever, pain abdomen and cough. He was diagnosed with a ruptured liver abscess, with the infection spreading to the right lower lobe. Laparotomy was performed. Pus culture grew Pseudomonas aeruginosa. He improved upon antibiotic therapy, only to return after one month with severe cough, chest X-ray revealing a lung abscess in the right lower lobe. Bronchoalveolar lavage culture grew Burkholderia cepacia, and sensitive antibiotics were initiated, however the patient succumbed to the illness. The implicated source of the organism was the nebulisation solution which he was using regularly. Emphasis should be laid on the need for improved aseptic practices while using medical solutions at either hospital or home setting. An index of suspicion may guide optimal antibiotic prescription practices in susceptible individuals.

Postoperative cavitating infarction following lobectomy: the importance of variant pulmonary anatomy

2020 ◽  
Vol 13 (12) ◽  
pp. e238138
Author(s):  
William John Hunter Brown ◽  
Vidan Masani ◽  
Tim Batchelor ◽  
Jonathan C L Rodrigues
Keyword(s):  
Pulmonary Artery ◽  
Thoracoscopic Surgery ◽  
Vascular Complications ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Preoperative Imaging ◽  
Pulmonary Vasculature ◽  
The Right ◽  
Video Assisted Thoracoscopic Surgery ◽  
Safe Working

A 75-year-old woman was admitted to hospital with haemoptysis, fever and shortness of breath. She had undergone a right video-assisted thoracoscopic surgery upper lobectomy for an apical lung cancer 4 weeks earlier, and had been treated with antibiotics for 1 week prior to admission for a suspected postoperative lung abscess. Review of preoperative imaging found that she possessed a lobar pulmonary artery variant, with postoperative imaging confirming that the right lower lobe segmental pulmonary artery had been divided alongside the upper lobe vessels. The diagnosis of a lung abscess was thus revised to a cavitating pulmonary infarct. There are numerous variations of the pulmonary vasculature, all of which have the potential to cause a range of serious vascular complications if not appreciated preoperatively. Measures to mitigate the risk of complications resulting from vascular anomalies should be considered by both radiologists and surgeons, with effective lines of communication essential to safe working.

scholarly journals Unusual case of a giant lung abscess initially misdiagnosed and treated as an empyema

2019 ◽  
Vol 12 (5) ◽  
pp. e228849
Author(s):  
Joana Sofia Carvalho ◽  
Diogo Paixão Marques ◽  
Inês Oliveira ◽  
Ana Cláudia Vieira
Keyword(s):  
Bronchopleural Fistula ◽  
Final Diagnosis ◽  
Lung Abscess ◽  
Chest Ct ◽  
Appropriate Treatment ◽  
Ultrasound Findings ◽  
History Of ◽  
Respiratory Physiotherapy ◽  
The Right

We report the case of a 66-year-old man with dental infection who presented to our emergency department complaining of a 3-month medical history of chest pain and productive cough, in association with malaise, fever, weight loss and anaemia. His chest radiograph showed a nearly total opacification of the right hemithorax and chest ultrasound findings were suggestive of empyema, subsequently confirmed by a chest CT. The patient started appropriate treatment. A follow-up chest CT performed to rule out bronchopleural fistula revealed a large lung abscess. The patient had the final diagnosis of a giant lung abscess, which was initially thought to be an empyema because of the clinical and radiologic similarities with this entity. The initial misdiagnosis led to prompt percutaneous drainage of the lung abscess in addition to antibiotherapy and respiratory physiotherapy with a good final outcome, which suggests the efficacy of this approach in similar cases.

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