Analysis of Lung Parenchymal Sequelae Following Treatment for Lung Abscess

Background: Lung abscess is necrosis of the pulmonary parenchyma caused by microbial infection. At present, clinical outcomes after treatment are good. However, the pulmonary parenchymal changes on the chest computed tomography (CT) after treatment are not well known. We studied the changes of pulmonary parenchyma on plane chest radiography and chest CT in patients with lung abscess following the administration of antibiotics. Methods: We retrospectively reviewed 39 patients who had lung abscess with or without combined pneumonia from January 2006 to July 2010. We studied the therapeutic response in plane chest radiography of them at 1,2, or more than 3 months following treatment. If any chest CT of them during the study period, we reviewed. Results: Mean age of the patients was about 61.3±11.2. Mean duration of antibiotics administration was about 36.7±26.8 days. After 3 months of following plane chest radiography, 10 patients (36%) showed without residual sequelae among 28 patients. Findings from other patients showed decrease in densities (11 patients, 39%), fibrostreaky sequelae (4 patients, 14%) and bullae (3 patients, 10%). After more than 2 months, chest CT was checked only in 7 patients. Among the 7 patients, 4 patients showed no residual lesion, 3 patients showed decreased densities on plane chest radiography. Chest CT revealed fibrostreaky densities in 2 patients, ground glass opacities in 3 patients, bullous formation in 1 patient, and cystic bronchiectasis in 1 patient. Conclusion: After more than 2 months following treatment for lung abscess even though there were no lesions on plane chest radiography, chest CT showed fibrostreaky or ground glass opacity.

keywords: Lung Abscess, complications, Radiography, Thoracic, Tomography, X-Ray Computed, Cicatrix

Reference

1. Bartlett JG. Anaerobic bacterial infections of the lung. Chest 1987;91:901-9.

2. 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.

3. 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.

4. Williford ME, Godwin JD. Computed tomography of lung abscess and empyema. Radiol Clin North Am 1983;21:575-83.

5. Wagley PF, Fisher AM, Block AJ. Primary pulmonary abscess. Trans Am Clin Climatol Assoc 1970;81:51-6.

6. Snow N, Bergin KT, Horrigan TP. Thoracic CT scanning In critically ill patients. Information obtained frequently alters management. Chest 1990;97:1467-70.

7. Jedrychowski W, Krzyzanowski M. The effect of acute broncho-pulmonary infections on the FEV1 change in 13-year follow-up. The Cracow Study. Eur J Epidemiol 1990;6:20-8.

8. Tice AD, Rehm SJ, Dalovisio JR, Bradley JS, Martinelli LP, Graham DR, et al. Practice guidelines for outpatient parenteral antimicrobial therapy. IDSA guidelines. Clin Infect Dis 2004;38:1651-72.

9. Irwin RS, Garrity FL, Erickson AD, Corrao WM, Kaemmerlen JT. Sampling lower respiratory tract secretions in primary lung abscess: a comparison of the accuracy of four methods. Chest 1981;79:559-65.

10.

10. Wang JL, Chen KY, Fang CT, Hsueh PR, Yang PC, Chang SC. Changing bacteriology of adult community- acquired lung abscess in Taiwan: Klebsiella pneumoniae versus anaerobes. Clin Infect Dis 2005;40:915- 22.

11.

11. Wali SO, Shugaeri A, Samman YS, Abdelaziz M. Percutaneous drainage of pyogenic lung abscess. Scand J Infect Dis 2002;34:673-9.

12.

12. Bartlett JG. Anaerobic bacterial infections of the lung and pleural space. Clin Infect Dis 1993;16 Suppl 4: S248-55.

13.

13. Levison ME. Anaerobic pleuropulmonary infection. Curr Opin Infect Dis 2001;14:187-91.

14.

14. Fifer WR, Husebye K, Chedister C, Miller M. Primary lung abscess. Analysis of therapy and results in 55 cases. Arch Intern Med 1961;107:668-80.

15.

15. Rumbaugh IF, Prior JA. Lung abscess: a review of forty- one cases. Ann Intern Med 1961;55:223-34.

16.

16. Prasad US, Tiwary A. Scar cancer of the lung. Indian J Chest Dis Allied Sci 1989;31:125-8.

17.

17. Auerbach O, Garfinkel L, Parks VR. Scar cancer of the lung: increase over a 21 year period. Cancer 1979;43: 636-42.

18.

18. Bobba RK, Holly JS, Loy T, Perry MC. Scar carcinoma of the lung: a historical perspective. Clin Lung Cancer 2011;12:148-54.

19.

19. Ardies CM. Inflammation as cause for scar cancers of the lung. Integr Cancer Ther 2003;2:238-46.

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Article Contents

Vol.71 No.6

Analysis of Lung Parenchymal Sequelae Following Treatment for Lung Abscess

Abstract

Reference

Tuberculosis & Respiratory Diseases