Lung abscess differential diagnosis

Abscess Main Page
Lung abscess Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Lung abscess from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Lung abscess differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Lung abscess differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Lung abscess differential diagnosis
CDC on Lung abscess differential diagnosis
Lung abscess differential diagnosis in the news
Blogs on Lung abscess differential diagnosis
Directions to Hospitals Treating Lung abscess
Risk calculators and risk factors for Lung abscess differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Lung abscess must be differentiated from other lesions that present with similar symptoms such as cough, fever with chills and rigor and chest includes malignancy, pulmonary tuberculosis, Wegener's granulomatosis, rheumatoid nodules.

Differential

Disease	Clinical features Signs & symptoms									Radiological Findings	Characterstic feature
	Fever		Cough		Hemoptysis	Dyspnea	Chest pain	Weight loss	Night sweats
	High-grade	Low grade	Productive	Dry
Acute Lung abscess	✔		✔				✔			Air fluid level	Purulent sputum H/o of prior infection or hospitalization Associated with risk factors like aspiration and alcoholism
Malignancy (primary lung cancer)		✔		✔	✔			✔	✔	A coin-shaped lesion with thick wall(>15mm) is seen on CXR with less ground glass opacities [2][3	Chronic smoker Elderly male or female Cough persisting for longer periods BAL positive for malignant cells CT gold standard Biopsy is required for confirmation and differnatiation
Pulmonary Tuberculosis	✔		✔		✔				✔	CXR and CT demonstrates cavities in the upper lobe of the lung	People in endemic at high risk Cough >2 weeks with hemoptysis characterstic Acid fast stain positive for mycobacteria
Necrotizing Pneumonia	✔		✔		✔		✔			Multiple cavitary lesions	Acute life threatening condition Complication of pneumonia or lung abscess Multiple organisms responsible prompt treatment with antibiotics is required CBC positive for causative organism
Pneumonia and empyema	✔		✔		✔	✔	✔			Homogeneous consolidation involving one, or less commonly, multiple lobes	CBC positive for causative agent.
Bronchiectasis			✔		✔					Specific findings include linear lucencies and parallel markings radiating from the hila (tram tracking) dilated bronchi, clustered cysts . general findings include increased pulmonary markings, honeycombing, atelectasis and pleural changes. CT helps is confirms the diagnosis and is considered gold stadard
Wegners granulomatosis			✔		✔	✔				Pulmonary nodules with cavities and infiltrates	Seen mostly in Female age group of 40-55 years Associated with other auto immune diseases Other symptoms such as hematuria is present indicating kidney involvement Traid of Upper , lower respiratory tract and kidney disease Biopsy of involved organ confirms granulomas
Sarcoidosis	✔		✔		✔			✔	✔	Bilateral adenopathy and coarse reticular opacities are seen on CXR	More common in African-american females Associated with other manifestations of restrictive lung disease Biposy of the lung shows epithelioid granulomas containing microscopic schaumann and asteroid bodies.
Rheumatoid nodule						✔		✔		Pulmonary nodules with cavitation are located in the upper lobe are seen on CXR	Seen in patients with rheumatoid arthritis Positive for Rheumatoid factor and Anticyclic citrullinated peptide
Langerhans cell Histiocytosis						✔	✔	✔		Thin-walled cystic cavities on CXR	Exclusively afflicts smokers, with a peak age of onset of between 20 and 40 years. Musculoskeletal and skin is involved Biopsy of the involved organ
Bronchiolitis obliterans			✔		✔	✔	✔			Common appearance on CT is patchy consolidation,often accompanied by ground-glass opacities and nodules.	Mimics asthma, pneumonia and emphysema Risk is increased with occupational exposure of industrial toxins Causes restrictive type of lung disease so FEv1/FVC is >80% Biopsy often confirms the diagnosis

Reference

Template:WikiDoc Sources