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Lung abscess and empyema

H P Wiedemann1, T W Rice

  • 1Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, OH 44195, USA.

Seminars in Thoracic and Cardiovascular Surgery
|April 1, 1995
PubMed
Summary
This summary is machine-generated.

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Lung abscess and empyema remain challenging, with anaerobic bacteria historically being the main cause. Modern treatments focus on antimicrobial therapy and pleural fluid analysis to guide management.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Thoracic Surgery

Background:

  • Lung abscess and empyema are ancient diseases that continue to challenge medical practitioners.
  • Historically, anaerobic bacterial infections were the primary cause, but complex comorbidities and immunosuppression are increasing other infectious etiologies.
  • While most lung abscesses and noninfected parapneumonic effusions respond to antibiotics, complicated effusions require drainage.

Purpose of the Study:

  • To review the contemporary understanding and management of lung abscess and empyema.
  • To highlight the evolving causes of these conditions.
  • To emphasize the diagnostic and therapeutic strategies for complicated parapneumonic effusions.

Main Methods:

  • Review of historical and current medical literature on lung abscess and empyema.

Related Experiment Videos

  • Analysis of diagnostic criteria for complicated parapneumonic effusions, including chemical analysis (pH, glucose, LDH).
  • Discussion of treatment modalities, including antimicrobial therapy, drainage, and surgical intervention.

    • Main Results:

    • Most lung abscesses are treated successfully with antimicrobial therapy, with only 10% requiring drainage or surgery.
    • Complicated parapneumonic effusions, even if not grossly purulent, pose a risk of loculation and require drainage.
    • Chemical analysis of pleural effusions aids in identifying complicated cases that may not be apparent on gross inspection or culture.

    Conclusions:

    • Optimal management of lung abscess and empyema necessitates a multidisciplinary approach involving thoracic surgeons and medical specialists.
    • Early identification and intervention for complicated parapneumonic effusions are crucial to prevent adverse outcomes.
    • Advances in diagnostic tools, such as pleural fluid chemical analysis, improve the management of these thoracic infections.