Lungs abscess

Outcome parameters for VAP, HAP, and HCAP are similar to those with CAP. Clinical improvement should occur within 48 to 72 hours of the start of therapy. If a patient is not responding to therapy, then, again, consider infectious and noninfectious reasons. Infectious explanations are the same as for CAP, but noninfectious reasons are not. They include atelectasis, acute respiratory distress syndrome (ARDS), pulmonary embolism or hemorrhage, cancer, empyema, or lung abscess. 

Suggested Alternatives for Differential Diagnosis Blastomycosis, coccidioidomycosis, aspergillosis, pneumonia, respiratory distress syndrome, mediastinal cysts, mycoplasma infections, Pancoast syndrome, sarcoidosis, tuberculosis, lung abscess, lung cancer, lymphoma. 

Lower respiratory tract infections include infectious processes of the lungs and bronchi, pneumonia, bronchitis, bronchiolitis, and lung abscess. 

In a nonfatal incident, a worker in a refinery inhaled methyl mercaptan and was comatose for 9 hours. Although not dyspneic, the individual was cyanotic and experienced convulsions recovery occurred by tbe fourth day. Ten days later tbe worker was treated successfully for a lung abscess. 

It is used for peritonitis, sepsis, meningitis, cholangitis, empyema of the gaU bladder, pneumonia, lung abscesses, pyelonephritis, infections of the bones, joints, skin, soft tissues, abdominal and gynecological infections, and for infected wounds and bums. The main synonym of this drug is rocefm. 

Anaerobes Serious respiratory tract infections such as empyema, anaerobic pneumonitis, and lung abscess serious skin and soft tissue infections septicemia, intra-abdominal infections such as peritonitis and intra-abdominal abscess (typically resulting from anaerobic organisms resident in the normal Gl tract) infections of the female pelvis and genital tract such as endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection. 

Lower respiratory tract infections - Pneumonia, empyema, and lung abscess caused by Bacteroides sp. including the 6. fragilis group. 

The spectrum of respiratory tract infections (RTI) can vary from the common cold to acute or chronic bronchitis to community-acquired pneumonia to nosocomial pneumonia and aspiration pneumonia to ventilator-associated pneumonia to chronic pneumonia (in cystic fibrosis, histoplasmosis, tuberculosis, etc.). Important complications are lung abscess and pleural empyema that will often need drainage and prolonged antimicrobial treatment (>6 weeks). 

X-ray should be performed to exclude empyema or lung abscess. 

If it is decided to treat an upper RTI in general 5-7 days treatment suffices. In lower RTI generally 10-14 days are recommended. Two to three weeks of treatment is advised for Staphylococcus aureus, Legionella pneumophila. Pseudomonas aeruginosa, Pneumocystis jiroveci (formerly carinii) and severe aspiration-pneumonia. Tuberculosis, actinomycosis, nocardiosis, aspergillosis, melioidosis and anaerobic lung abscesses require many months of treatment. 

It is produced by an Actinomyces. Used in the treatment of anaerobic and mixed surgical infections and lung abscess. 

It is valuable in critically ill patients with impaired host defence Pseudomonas or Proteus infections in burns, urinary tract infections, lung abscesses, osteomyelitis, middle ear infection, septicaemia meningitis caused by gram negative bacilli, peritonitis, in skin and soft tissue infections and postoperative infection. 

Codonopsis lanceolata (Sieb. et Zucc.) Trautv. Yang Lu (Bellflower) (whole plant) Apigenin, luteolin, alpha-spinasterol, stigmastenol, oleanolic acid, echinocystic acid, albigenic acid.48 Treat lung abscesses, stimulate milk flow, treat amenorrhea. 

The patient s vital signs provide the most sensitive indicator of response to therapy and normalisation of heart rate, respiratory rate, oxygenation, blood pressure and temperature should be confirmed. Laboratory markers of infection such as CRP and WCC should be monitored to ensure normalisation. Failure to improve may indicate an incorrect diagnosis, a resistant pathogen, poor absorption of antibiotic, immunocompromise or local or distant complications of community-acquired pneumonia such as lung abscess. 

UK studies report mortality rates for adult patients hospitalised with community-acquired pneumonia ranging from 6% to 12%. Mortality increases to over 50% in patients admitted to the intensive care unit. Parapneumonic effusions develop in up to half of patients hospitalised with community-acquired pneumonia, requiring chest tube drainage it may be the cause of persisting pyrexia. Lung abscess is a relatively rare complication of community-acquired pneumonia, and metastatic infection such as meningitis, peritonitis, endocarditis and septic arthritis can occasionally develop. 

A 40-year-old man with cough, shortness of breath, and fever progressed to respiratory failure. He had smoked cocaine for the previous 17 years. His tobacco history was not known. His medical history included recurrent respiratory tract infections. A chest X-ray and CT scan showed findings consistent with bilateral bullous emphysema with a right lung abscess. He was ventilated and given antibiotics but died from respiratory failure secondary to pneumonia. Sputum cultures... 

Johnson, Caroline C., and Sydney M. Finegold. Pyogenic Bacterial Pneumonia, Lung Abscess, and Empyema. In Volume 1 Textbook of Respiratory Medicine. 2nd ed., John F. Murray and Jay A. Nadel, eds. Philadelphia W.B. Saunders Company, 1994. 

Saverymuttu, S.H., Phillips, G., Peters, A.M. and Lavender, J.P. (1985). Indium-III autologous leucocyte scanning in lobar pneumonia and lung abscesses. Thorax 40, 925-930. 

Metronidazole has been shown to be of great value in the management of anaerobic bacterial infections [20,27,75,76]. The role of this drug in the prophylaxis and treatment of various anaerobic bacterial infections, which may develop following appendectomy, elective colonic surgery, colo-rectal surgery and hysterectomy [20,77,78]. Mebendazole is equally useful in cases of endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia and pelvic infections [79]. 

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