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Lung-nontumor

Infections

Abscess

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 30 August 2011, last major update August 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Focal suppurative process characterized by necrosis of lung tissue (eMedicine)

Clinical features
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● Due to sinobronchial infections, dental sepsis, aspiration (due to alcoholism, coma, debilitation), primary bacterial infection (Staphylococcus aureus, Klebsiella pneumonia, Streptococcus pneumonia), anaerobic and aerobic streptococci, fungi; anaerobes from the oral cavity (bacteroides, fusobacterium, peptococcus species are the only isolates in 60% of cases), bronchiectasis, post-transplant, septic emboli, neoplasia induced obstruction, idiopathic
● Aspiration induced abscesses are more common on right side (right sided bronchus is more vertical), usually single
● Air fluid level present if there is communication with air passages
● Symptoms: cough, fever, copious foul-smelling sputum, fever, chest pain, weight loss, clubbing of digits
● 10% of cases are associated with underlying carcinoma
● May extend into pleural cavity and create septic emboli, causing meningitis or brain abscess, serve as nidus for fungal overgrowth (Mucor, aspergillus), may spread elsewhere in lung

Treatment
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● Lobectomy

Gross description
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● Thick, fibrotic walls in chronic abscesses with adjacent active pneumonia

Gross images
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Various images

Micro images
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Early abscess

With bacteria

Chronic abscess

End of Lung-nontumor > Infections > Abscess

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