Lung abscess differential diagnosis: Difference between revisions
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*Elderly male or female <ref name="pmid4353362">{{cite journal |vauthors=Chaudhuri MR |title=Primary pulmonary cavitating carcinomas |journal=Thorax |volume=28 |issue=3 |pages=354–66 |year=1973 |pmid=4353362 |pmc=470041 |doi= |url=}}</ref> | *Elderly male or female <ref name="pmid4353362">{{cite journal |vauthors=Chaudhuri MR |title=Primary pulmonary cavitating carcinomas |journal=Thorax |volume=28 |issue=3 |pages=354–66 |year=1973 |pmid=4353362 |pmc=470041 |doi= |url=}}</ref> | ||
*Presents with a low-grade fever, absence of leukocytosis, systemic complaints weight loss,fatigue | *Presents with a low-grade fever, absence of leukocytosis, systemic complaints weight loss,fatigue | ||
*Absence of factors that predispose to gastric content aspiration, no response to antibiotics within 10 days | *Absence of factors that predispose to gastric content aspiration, no response to antibiotics within 10 days | ||
*Hemoptysis is commonly associated with bronchogenic carcinoma | *Hemoptysis is commonly associated with bronchogenic carcinoma | ||
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*A coin-shaped lesion with thick wall(>15mm) is seen on X-ray with less ground glass opacities | *A coin-shaped lesion with thick wall(>15mm) is seen on X-ray with less ground glass opacities <ref name="pmid8572761">{{cite journal |vauthors=Mouroux J, Padovani B, Elkaïm D, Richelme H |title=Should cavitated bronchopulmonary cancers be considered a separate entity? |journal=Ann. Thorac. Surg. |volume=61 |issue=2 |pages=530–2 |year=1996 |pmid=8572761 |doi=10.1016/0003-4975(95)00973-6 |url=}}</ref> <ref name="pmid16183941">{{cite journal |vauthors=Onn A, Choe DH, Herbst RS, Correa AM, Munden RF, Truong MT, Vaporciyan AA, Isobe T, Gilcrease MZ, Marom EM |title=Tumor cavitation in stage I non-small cell lung cancer: epidermal growth factor receptor expression and prediction of poor outcome |journal=Radiology |volume=237 |issue=1 |pages=342–7 |year=2005 |pmid=16183941 |doi=10.1148/radiol.2371041650 |url=}}</ref> | ||
*Bronchoalveolar lavage cytology shows malignant cells | *Bronchoalveolar lavage cytology shows malignant cells | ||
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*Tuberculosis | *Pulmonary Tuberculosis | ||
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*Any age group | *Any age group | ||
*Symptoms include productive cough,night sweats ,fever and weight loss | *Symptoms include productive cough,night sweats ,fever and weight loss | ||
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*CXR and CT demonstrates cavities in the upper lobe of the lung | *CXR and CT demonstrates cavities in the upper lobe of the lung | ||
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*Sputum smear positive for acid-fast bacilli and culture in Lowenstein-Jensen media grows | *Sputum smear positive for acid-fast bacilli and culture in Lowenstein-Jensen media grows mycobacteri | ||
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*Any age group | *Any age group | ||
*Acute, fulminant infection with rapid progression | *Acute, fulminant infection with rapid progression | ||
*>100.4F fever, with | *>100.4F fever, with hemodynamica instability | ||
*Life threatening condition | *Life threatening condition | ||
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*CXR demonstrates multiple cavitary lesions | *CXR demonstrates multiple cavitary lesions | ||
*Pleural effusion and empyema are common findings | *Pleural effusion and empyema are common findings | ||
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*CBC is positive for causative organism | *CBC is positive for causative organism | ||
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*Dullness to percussion decreased breath sounds, and reduced vocal resonance on examination | *Dullness to percussion decreased breath sounds, and reduced vocal resonance on examination | ||
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*Empyema appears lenticular in shape and has a thin wall with smooth luminal margins | *Empyema appears lenticular in shape and has a thin wall with smooth luminal margins | ||
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*Thoracocentesis | *Thoracocentesis | ||
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*Renal: hematuria, red cell casts | *Renal: hematuria, red cell casts | ||
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*Pulmonary nodules with cavities and infiltrates are a frequent manifestation on CXR | *Pulmonary nodules with cavities and infiltrates are a frequent manifestation on CXR | ||
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*Elderly females of 40-50 age group | *Elderly females of 40-50 age group | ||
*Manifestation of rheumatoid arthritis | *Manifestation of rheumatoid arthritis | ||
*Presents with other systemic symptoms including symmetric arthritis of the small joints of the hands and feet with morning stiffness are common manifestations. | *Presents with other systemic symptoms including symmetric arthritis of the small joints of the hands and feet with morning stiffness are common manifestations. | ||
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*Pulmonary nodules with cavitation are located in the upper lobe (Caplan syndrome) on Xray. | *Pulmonary nodules with cavitation are located in the upper lobe (Caplan syndrome) on Xray. | ||
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*Positive for both rheumatoid factor and anticyclic citrullinated peptide antibody. | |||
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*Sarcoidosis | *Sarcoidosis | ||
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*More common in African-American females | *More common in African-American females | ||
*Often asymptomatic except for enlarged lymph nodes | *Often asymptomatic except for enlarged lymph nodes<ref name="pmid11734441">{{cite journal |vauthors=Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ, McLennan G, Moller DR, Newman LS, Rabin DL, Rose C, Rybicki B, Weinberger SE, Terrin ML, Knatterud GL, Cherniak R |title=Clinical characteristics of patients in a case control study of sarcoidosis |journal=Am. J. Respir. Crit. Care Med. |volume=164 |issue=10 Pt 1 |pages=1885–9 |year=2001 |pmid=11734441 |doi=10.1164/ajrccm.164.10.2104046 |url=}}</ref> | ||
*Associated with restrictive lung disease (interstitial fibrosis) | *Associated with restrictive lung disease (interstitial fibrosis) | ||
*Erythema nodosum | *Erythema nodosum | ||
*Lupus pernio (skin lesions on face resembling lupus) | *Lupus pernio (skin lesions on face resembling lupus) | ||
*Bell palsy | *Bell palsy | ||
*Epithelioid granulomas containing microscopic Schaumann and asteroid bodies | *Epithelioid granulomas containing microscopic Schaumann and asteroid bodies | ||
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*On CXR bilateral adenopathy and coarse reticular opacities are seen. | *On CXR bilateral adenopathy and coarse reticular opacities are seen. | ||
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*Bronchiolitis obliterans (Cryptogenic organizing pneumonia)<ref name="pmid9724431">{{cite journal |vauthors=Murphy J, Schnyder P, Herold C, Flower C |title=Bronchiolitis obliterans organising pneumonia simulating bronchial carcinoma |journal=Eur Radiol |volume=8 |issue=7 |pages=1165–9 |year=1998 |pmid=9724431 |doi=10.1007/s003300050527 |url=}}</ref><ref name="pmid19561910">{{cite journal |vauthors=Al-Ghanem S, Al-Jahdali H, Bamefleh H, Khan AN |title=Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review |journal=Ann Thorac Med |volume=3 |issue=2 |pages=67–75 |year=2008 |pmid=19561910 |pmc=2700454 |doi=10.4103/1817-1737.39641 |url=}}</ref> | *Bronchiolitis obliterans (Cryptogenic organizing pneumonia)<ref name="pmid9724431">{{cite journal |vauthors=Murphy J, Schnyder P, Herold C, Flower C |title=Bronchiolitis obliterans organising pneumonia simulating bronchial carcinoma |journal=Eur Radiol |volume=8 |issue=7 |pages=1165–9 |year=1998 |pmid=9724431 |doi=10.1007/s003300050527 |url=}}</ref><ref name="pmid19561910">{{cite journal |vauthors=Al-Ghanem S, Al-Jahdali H, Bamefleh H, Khan AN |title=Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review |journal=Ann Thorac Med |volume=3 |issue=2 |pages=67–75 |year=2008 |pmid=19561910 |pmc=2700454 |doi=10.4103/1817-1737.39641 |url=}}</ref> | ||
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*Rare condiiton | *Rare condiiton | ||
*It is a pathological diagnosis and mimics asthma,pneumonia and emphysema | *It is a pathological diagnosis and mimics asthma,pneumonia and emphysema | ||
*It is | *It is caused by drug or toxin exposure, autoimmune diseases,viral infections, or radiation injury. | ||
*Presents with fever, cough, wheezing and shortness of breath over weeks to months,<ref name="pmid2805873">{{cite journal |vauthors=Cordier JF, Loire R, Brune J |title=Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients |journal=Chest |volume=96 |issue=5 |pages=999–1004 |year=1989 |pmid=2805873 |doi= |url=}}</ref> | *Presents with fever, cough, wheezing and shortness of breath over weeks to months,<ref name="pmid2805873">{{cite journal |vauthors=Cordier JF, Loire R, Brune J |title=Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients |journal=Chest |volume=96 |issue=5 |pages=999–1004 |year=1989 |pmid=2805873 |doi= |url=}}</ref> | ||
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*Biopsyof the lung <ref name="pmid19561910">{{cite journal |vauthors=Al-Ghanem S, Al-Jahdali H, Bamefleh H, Khan AN |title=Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review |journal=Ann Thorac Med |volume=3 |issue=2 |pages=67–75 |year=2008 |pmid=19561910 |pmc=2700454 |doi=10.4103/1817-1737.39641 |url=}}</ref> | *Biopsyof the lung <ref name="pmid19561910">{{cite journal |vauthors=Al-Ghanem S, Al-Jahdali H, Bamefleh H, Khan AN |title=Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review |journal=Ann Thorac Med |volume=3 |issue=2 |pages=67–75 |year=2008 |pmid=19561910 |pmc=2700454 |doi=10.4103/1817-1737.39641 |url=}}</ref> | ||
*Pulmonary function tests | *Pulmonary function tests demonstrate low fev1/fvc | ||
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Revision as of 13:55, 7 February 2017
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Lung abscess Microchapters |
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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, tuberculosis, Wegener's granulomatosis, rheumatoid nodules.
Differential diagnosis
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Reference
- ↑ 1.0 1.1 Chaudhuri MR (1973). "Primary pulmonary cavitating carcinomas". Thorax. 28 (3): 354–66. PMC 470041. PMID 4353362.
- ↑ Mouroux J, Padovani B, Elkaïm D, Richelme H (1996). "Should cavitated bronchopulmonary cancers be considered a separate entity?". Ann. Thorac. Surg. 61 (2): 530–2. doi:10.1016/0003-4975(95)00973-6. PMID 8572761.
- ↑ Onn A, Choe DH, Herbst RS, Correa AM, Munden RF, Truong MT, Vaporciyan AA, Isobe T, Gilcrease MZ, Marom EM (2005). "Tumor cavitation in stage I non-small cell lung cancer: epidermal growth factor receptor expression and prediction of poor outcome". Radiology. 237 (1): 342–7. doi:10.1148/radiol.2371041650. PMID 16183941.
- ↑ 4.0 4.1 Langford CA, Hoffman GS (1999). "Rare diseases.3: Wegener's granulomatosis". Thorax. 54 (7): 629–37. PMC 1745525. PMID 10377211.
- ↑ Lee KS, Kim TS, Fujimoto K, Moriya H, Watanabe H, Tateishi U, Ashizawa K, Johkoh T, Kim EA, Kwon OJ (2003). "Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients". Eur Radiol. 13 (1): 43–51. doi:10.1007/s00330-002-1422-2. PMID 12541109.
- ↑ Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ, McLennan G, Moller DR, Newman LS, Rabin DL, Rose C, Rybicki B, Weinberger SE, Terrin ML, Knatterud GL, Cherniak R (2001). "Clinical characteristics of patients in a case control study of sarcoidosis". Am. J. Respir. Crit. Care Med. 164 (10 Pt 1): 1885–9. doi:10.1164/ajrccm.164.10.2104046. PMID 11734441.
- ↑ Brauner MW, Grenier P, Mompoint D, Lenoir S, de Crémoux H (1989). "Pulmonary sarcoidosis: evaluation with high-resolution CT". Radiology. 172 (2): 467–71. doi:10.1148/radiology.172.2.2748828. PMID 2748828.
- ↑ Murphy J, Schnyder P, Herold C, Flower C (1998). "Bronchiolitis obliterans organising pneumonia simulating bronchial carcinoma". Eur Radiol. 8 (7): 1165–9. doi:10.1007/s003300050527. PMID 9724431.
- ↑ 9.0 9.1 Al-Ghanem S, Al-Jahdali H, Bamefleh H, Khan AN (2008). "Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review". Ann Thorac Med. 3 (2): 67–75. doi:10.4103/1817-1737.39641. PMC 2700454. PMID 19561910.
- ↑ Cordier JF, Loire R, Brune J (1989). "Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients". Chest. 96 (5): 999–1004. PMID 2805873.
- ↑ Lee KS, Kullnig P, Hartman TE, Müller NL (1994). "Cryptogenic organizing pneumonia: CT findings in 43 patients". AJR Am J Roentgenol. 162 (3): 543–6. doi:10.2214/ajr.162.3.8109493. PMID 8109493.
- ↑ Suri HS, Yi ES, Nowakowski GS, Vassallo R (2012). "Pulmonary langerhans cell histiocytosis". Orphanet J Rare Dis. 7: 16. doi:10.1186/1750-1172-7-16. PMC 3342091. PMID 22429393.
- ↑ Moore AD, Godwin JD, Müller NL, Naidich DP, Hammar SP, Buschman DL, Takasugi JE, de Carvalho CR (1989). "Pulmonary histiocytosis X: comparison of radiographic and CT findings". Radiology. 172 (1): 249–54. doi:10.1148/radiology.172.1.2787035. PMID 2787035.