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Norhidayah
DEFINISI
Cavitary lung lesions produced by infectious
agents
They may be consequences of aspiration
(most commonly) or pneumonia or they
may be secondary to bronchial obstruction,
bronchiectasis, bacterial endocarditis or
spread of infection from elsewhere in the
lung
ETIOLOGI
Anaerobes are most frequent cause; most lung abscesses are polymicrobial in etiology
Peptostreptococcus
Bacteroides
Fusobacterium
Also
Staphylococcus
Streptococcus pyogenes
Klebsiella
Haemophilus influenzae
Actinomyces species
And, rarely
Aspergillus
Cryptococcus
Histoplasma
Blastomyces
Coccidioides
Mycobacterium
Predisposisi
Most abscesses are caused by mouth
anaerobes in patients with pre-existing
periodontal disease
Alcoholics (most commonly), those with
seizure disorders leading to aspiration and
those with poor dentition are at a higher
risk
Patofisiologi
Secara hematogen:
akibat septikemia atau fenomena septik embolik,
sekunder dari fokus infeksi dari bagian tubuh lain,
spt tricuspid valve endocarditis.
Abses yg terbentuk multipel.
Penyebab tersering stafilokokus.
Penanganannya lebih sulit.
Ukuran abses bervariasi dr bbrpa mm sampai
>5 cm.
Manifestasi klinis
Typically take 7-14 days from pneumonia to
abscess formation, depending on agent
Fever
Cough
Foul-smelling sputum production
Hemoptysis
Night sweats
Anorexia and weight loss
DD
Cavitary bronchogenic carcinoma
TB
Multiple cavities point toward a necrotizing
pneumonia more than lung abscess
Multiple cavitating masses point towards
septic emboli
Gambaran radiologi
Terapi
Antibiotics for 4-6 weeks or until the chest
radiograph shows resolution
Percutaneous catheter drainage
Surgery, either a lobectomy or
pneumonectomy, may be used for patients
who fail to respond to medical therapy
Komplikasi
Empyema
Bronchopleural fistula
Fibrosis of pleura
Prognosis
With proper antibiotic treatment, over 90%
are cured
Those who are immunocompromised or
have a bronchial obstruction have a high
mortality rate
TERIMA KASIH