Chronic lung sepsis: lung abscess, bronchiectasis, and empyema.
Chronic lung infections including lung abscess, bronchiectasis, and empyema remain serious medical diseases despite the availability of antimicrobial agents. Recent publications contribute to our understanding of disease pathogenesis and management of these entities. The microbial pathogen of lung abscess may be different comparing immunocompetent with immunocompromised patients, supporting a concept for aggressive diagnostic investigations and targeting of specific potential pathogens. The use of surgery in bronchiectasis may be declining, but surgical intervention remains an important strategy with favorable outcomes, especially in cases of focal bronchiectasis. For empyema, maintaining a high index of clinical suspicion may allow for diagnostic thoracentesis in patients with pleural effusions and allow initiation of appropriate tube thoracotomy drainage and use of fibrinolytics. With appropriate management, morbidity and mortality may be limited and outcomes generally favorable.
Mansharamani
Naresh G
NG
Attending/Consultant Physician, Newport Hospital, Rhode Island, USA. NARESH3@aol.com
Koziel
Henry
H
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001987:Bronchiectasis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods; D004322:Drainage / Q000379:methods; D016724:Empyema, Pleural / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents