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Lung Abscess - Diagnosis and Management Summary

Lung Abscess Etiology:
 • Necrosis of lung parenchyma by a
• Large volume feeding ... Blood cultures • CXR ... early disease) • CXR ... upright or lat ... #pulmonary #differential
Stage I - Redistribution
In a normal chest film with the patient standing erect, the pulmonary vessels
The pulmonary vascular ... during a period of CHF ... increased width of the vascular ... #Clinical #Radiology ... #CXR #CHF #Cephalization
There is a hydropneumothorax.
Notice the air-fluid level (blue arrow).
The upper lobe is still attached to the
attached to the chest ... small airways leading ... to pulmonary cyst ... #Clinical #Radiology ... #CXR #Pneumothorax
On the left another patient with alveolar edema at admission, which resolved after treatment.
When you scroll
resolved after treatment ... difference in vascular ... #Clinical #Radiology ... #CXR #CHF #Alveolar ... #Pulmonary #Edema
Differentiation Syndrome in APML
Epidemiology:
 • Incidence: common in APL (2-48% depending on the study)
 • Triggers:
Triggers: ATRA treatment ... Cathepsin G release → vascular ... common • Imaging: CXR ... - pulmonary opacities ... sepsis), PE, DAH, CHF
Previous normal chest x-ray (left) and CHF stage II with perihilar haze (right). On the left
Previous normal chest ... diameter of the pulmonary ... #Clinical #Radiology ... #CXR #Lateral # ... CHF #Vascular #Engorgement
Tuberculosis Overview

10 million new M. tuberculosis infections/year
Facultative intracellular rod-shaped bacteria
Multidrug-resistant tuberculosis (MDR-TB) accounts for 4.6% of
emboli • Lung abscess ... involvement - seeding ... and Culture • CXR ... Tuberculosis Treatment ... disease • Check CXR
Tuberculosis Overview

10 million new M. tuberculosis infections/year
Facultative intracellular rod-shaped bacteria
Multidrug-resistant tuberculosis (MDR-TB) accounts for 4.6% of
emboli • Lung abscess ... involvement - seeding ... and Culture • CXR ... Tuberculosis Treatment ... disease • Check CXR
Preoperative Risk Evaluation

Major Pre-Op Questions:
1. Does the patient have any modifiable risk factors that could be
Assess functional ... murmur 3/6) - Pulmonary ... disease b) CHF ... - Peripheral vascular ... - what is the bleeding
There is a hydropneumothorax.
Notice the air-fluid level.
The upper lobe is still attached to the chest wall
attached to the chest ... small airways leading ... to pulmonary cyst ... #Clinical #Radiology ... #CXR #Pneumothorax