Lung abscess history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Patient history is important to establish a diagnosis of lung abscess. Common history findings include conditions associated with a risk of gastric content aspiration, a recent history of hospitalization or surgery. Common symptoms include high fever (>101°F [>38.5°C]), productive cough with purulent sputum, and pleuritic chest pain. The presence of a purulent sputum is pathognomic of acute lung abscess. | Patient history is important to establish a diagnosis of lung abscess. Common history findings include conditions associated with a risk of [[gastric content aspiration]], a recent history of hospitalization or surgery. Common symptoms include [[high fever]] (>101°F [>38.5°C]), [[productive cough]] with [[Sputum|purulent sputum]], and pleuritic [[chest pain]]. The presence of a purulent sputum is pathognomic of acute lung abscess. | ||
==History== | ==History== | ||
A detailed and thorough history from the patient is necessary. Following past medical history is evident in patients with lung abscess. | A detailed and thorough history from the patient is necessary. Following past medical history is evident in patients with lung abscess. | ||
*There may be a history of a condition associated with a risk of gastric content aspiration, such as dysphagia associated with neurologic disease (e.g., stroke, bulbar dysfunction) or esophageal disease (stricture, malignancy, and reflux), or poor dentition and gingivitis. | *There may be a history of a condition associated with a risk of [[gastric content aspiration]], such as [[dysphagia]] associated with [[Neurologic diseases|neurologic disease]] (e.g., [[stroke]], [[bulbar dysfunction]]) or [[esophageal disease]] [[Stricture|(stricture]], [[malignancy]], and [[reflux]]), or poor [[dentition]] and [[Gingivitis|gingivitis.]] | ||
*There may also be a recent history of pneumonia, general anesthesia, nasogastric or endotracheal tube insertion, tooth extraction | *There may also be a recent history of [[pneumonia]], [[general anesthesia]], [[Nasogastric intubation|nasogastric]] or [[endotracheal tube]] insertion, tooth extraction , [[dental surgery]] or [[oropharyngeal]] [[surgery]]. | ||
*Risk factors for pulmonary embolism should be investigated in a patient suspected of this diagnosis.<ref name="pmid10084487">{{cite journal |vauthors=Hirshberg B, Sklair-Levi M, Nir-Paz R, Ben-Sira L, Krivoruk V, Kramer MR |title=Factors predicting mortality of patients with lung abscess |journal=Chest |volume=115 |issue=3 |pages=746–50 |year=1999 |pmid=10084487 |doi= |url=}}</ref> | *Risk factors for [[pulmonary embolism]] should be investigated in a patient suspected of this diagnosis.<ref name="pmid10084487">{{cite journal |vauthors=Hirshberg B, Sklair-Levi M, Nir-Paz R, Ben-Sira L, Krivoruk V, Kramer MR |title=Factors predicting mortality of patients with lung abscess |journal=Chest |volume=115 |issue=3 |pages=746–50 |year=1999 |pmid=10084487 |doi= |url=}}</ref> | ||
*Underlying chronic illness predisposing to lung abscess (e.g., COPD, bronchiectasis, diabetes mellitus, scleroderma, esophageal diverticulum, liver and kidney disease) or immunosuppression (e.g., chemotherapy, organ transplantation, corticosteroid therapy, HIV infection) should also be noted. | *Underlying chronic illness predisposing to lung abscess (e.g., [[Chronic obstructive pulmonary disease|COPD]], [[bronchiectasis]], [[diabetes mellitus]], [[scleroderma]], [[esophageal diverticulum]], [[Liver Disease|liver]] and [[kidney disease]]) or [[immunosuppression]] (e.g., [[chemotherapy]], [[organ transplantation]], [[Corticosteroid medications|corticosteroid]] therapy, [[HIV AIDS|HIV infection]]) should also be noted. | ||
==Symptoms== | ==Symptoms== | ||
Presentation of lung abscess depends upon on the duration of symptoms, it can be acute or chronic <br> | Presentation of lung abscess depends upon on the duration of symptoms, it can be acute or chronic <br> | ||
'''Acute presentation''' | '''Acute presentation''' | ||
*High fever (>101°F [>38.5°C]) | *[[High fever]] (>101°F [>38.5°C]) | ||
*Productive cough with purulent sputum, and pleuritic chest pain <ref name="pmid15986068">{{cite journal |vauthors=Chan PC, Huang LM, Wu PS, Chang PY, Yang TT, Lu CY, Lee PI, Chen JM, Lee CY, Chang LY |title=Clinical management and outcome of childhood lung abscess: a 16-year experience |journal=J Microbiol Immunol Infect |volume=38 |issue=3 |pages=183–8 |year=2005 |pmid=15986068 |doi= |url=}}</ref> | *[[Productive cough]] with [[purulent]] [[sputum]], and [[Pleuritic chest pain|pleuritic]] [[chest pain]] <ref name="pmid15986068">{{cite journal |vauthors=Chan PC, Huang LM, Wu PS, Chang PY, Yang TT, Lu CY, Lee PI, Chen JM, Lee CY, Chang LY |title=Clinical management and outcome of childhood lung abscess: a 16-year experience |journal=J Microbiol Immunol Infect |volume=38 |issue=3 |pages=183–8 |year=2005 |pmid=15986068 |doi= |url=}}</ref> | ||
*Large amounts of purulent secretions are expectorated in the second or third week of the disease | *Large amounts of [[purulent]] secretions are expectorated in the second or third week of the disease | ||
*Putrid sputum is present in about 50% of patients (foul-smelling sputum is highly suggestive of an anaerobic infection)<ref>{{cite book | last = Grippi | first = Michael | title = Fishman's pulmonary diseases and disorders | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071807289 }}</ref> | *Putrid sputum is present in about 50% of patients (foul-smelling sputum is highly suggestive of an [[Anaerobic infection|anaerobic]] infection)<ref>{{cite book | last = Grippi | first = Michael | title = Fishman's pulmonary diseases and disorders | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071807289 }}</ref> | ||
'''Chronic presenation''' | '''Chronic presenation''' | ||
Symptoms are present for several weeks or longer before presentation and include | Symptoms are present for several weeks or longer before presentation and include | ||
*Profound weight loss, malaise<ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref> | *Profound [[weight loss]], [[malaise]]<ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref> | ||
*Low-grade fever, night sweats | *[[Low-grade fever]], [[night sweats]] | ||
*Productive cough | *[[Productive cough]] | ||
*These symptoms mimic those of malignancy(hematologic malignancies). | *These symptoms mimic those of [[malignancy]]([[Hematological malignancy|hematologic]] malignancies). | ||
*Massive hemoptysis can be present in chronic lung abscess.<ref name="pmid8346503">{{cite journal |vauthors=Philpott NJ, Woodhead MA, Wilson AG, Millard FJ |title=Lung abscess: a neglected cause of life threatening haemoptysis |journal=Thorax |volume=48 |issue=6 |pages=674–5 |year=1993 |pmid=8346503 |pmc=464615 |doi= |url=}}</ref> | *Massive [[hemoptysis]] can be present in chronic lung abscess.<ref name="pmid8346503">{{cite journal |vauthors=Philpott NJ, Woodhead MA, Wilson AG, Millard FJ |title=Lung abscess: a neglected cause of life threatening haemoptysis |journal=Thorax |volume=48 |issue=6 |pages=674–5 |year=1993 |pmid=8346503 |pmc=464615 |doi= |url=}}</ref> | ||
== Reference == | == Reference == | ||
Revision as of 22:30, 7 February 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Kiran Singh, M.D. [2] ;Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [3]
Overview
Patient history is important to establish a diagnosis of lung abscess. Common history findings include conditions associated with a risk of gastric content aspiration, a recent history of hospitalization or surgery. Common symptoms include high fever (>101°F [>38.5°C]), productive cough with purulent sputum, and pleuritic chest pain. The presence of a purulent sputum is pathognomic of acute lung abscess.
History
A detailed and thorough history from the patient is necessary. Following past medical history is evident in patients with lung abscess.
- There may be a history of a condition associated with a risk of gastric content aspiration, such as dysphagia associated with neurologic disease (e.g., stroke, bulbar dysfunction) or esophageal disease (stricture, malignancy, and reflux), or poor dentition and gingivitis.
- There may also be a recent history of pneumonia, general anesthesia, nasogastric or endotracheal tube insertion, tooth extraction , dental surgery or oropharyngeal surgery.
- Risk factors for pulmonary embolism should be investigated in a patient suspected of this diagnosis.[1]
- Underlying chronic illness predisposing to lung abscess (e.g., COPD, bronchiectasis, diabetes mellitus, scleroderma, esophageal diverticulum, liver and kidney disease) or immunosuppression (e.g., chemotherapy, organ transplantation, corticosteroid therapy, HIV infection) should also be noted.
Symptoms
Presentation of lung abscess depends upon on the duration of symptoms, it can be acute or chronic
Acute presentation
- High fever (>101°F [>38.5°C])
- Productive cough with purulent sputum, and pleuritic chest pain [2]
- Large amounts of purulent secretions are expectorated in the second or third week of the disease
- Putrid sputum is present in about 50% of patients (foul-smelling sputum is highly suggestive of an anaerobic infection)[3]
Chronic presenation Symptoms are present for several weeks or longer before presentation and include
- Profound weight loss, malaise[4]
- Low-grade fever, night sweats
- Productive cough
- These symptoms mimic those of malignancy(hematologic malignancies).
- Massive hemoptysis can be present in chronic lung abscess.[5]
Reference
- ↑ Hirshberg B, Sklair-Levi M, Nir-Paz R, Ben-Sira L, Krivoruk V, Kramer MR (1999). "Factors predicting mortality of patients with lung abscess". Chest. 115 (3): 746–50. PMID 10084487.
- ↑ Chan PC, Huang LM, Wu PS, Chang PY, Yang TT, Lu CY, Lee PI, Chen JM, Lee CY, Chang LY (2005). "Clinical management and outcome of childhood lung abscess: a 16-year experience". J Microbiol Immunol Infect. 38 (3): 183–8. PMID 15986068.
- ↑ Grippi, Michael (2015). Fishman's pulmonary diseases and disorders. New York: McGraw-Hill Education. ISBN 978-0071807289.
- ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
- ↑ Philpott NJ, Woodhead MA, Wilson AG, Millard FJ (1993). "Lung abscess: a neglected cause of life threatening haemoptysis". Thorax. 48 (6): 674–5. PMC 464615. PMID 8346503.