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Pulmonary gangrene: a case report
1Department of Chest Medicine, Veterans General Hospital-Taipei, Taipei, Taiwan, R.O.C.
Abstract:
Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. In the English literature, pulmonary gangrene secondary to bacterial infection is uncommon, and fewer to other etiologies. Characteristic roentgen patterns of a mass within a cavity is the hallmark of this disease, which differentiates from a lung abscess. Some authors have emphasized that surgical resection of the infected lobe is the principal option of treatment. In contrast, some have advocated that patients with pulmonary gangrene can be managed with medical therapy. Recently we successfully treated a case of pulmonary gangrene with appropriate antibiotics and percutaneous small bore catheter drainage, even though the complication of bronchopleural fistula was encountered, which led to prolonged hospitalization. The serial roentgenograms and the pictures of computed tomography (CT) will be demonstrated.
Insights
Pulmonary gangrene, a rare lung infection complication, can be treated with antibiotics and catheter drainage. This approach, even with bronchopleural fistula, offers a viable alternative to surgery for this uncommon condition.
Area of Science:
- Pulmonology
- Infectious Diseases
Background:
- Pulmonary gangrene is a rare, severe complication of lung infections, characterized by tissue sloughing.
- It is infrequently documented in English literature, with bacterial causes being uncommon and other etiologies even rarer.
- Distinguishing pulmonary gangrene from lung abscess relies on characteristic radiographic findings of a mass within a cavity.
Observation:
- Surgical resection has been historically considered the primary treatment for pulmonary gangrene.
- Conversely, some medical professionals advocate for non-surgical management options.
- A recent case demonstrated successful treatment using antibiotics and percutaneous small-bore catheter drainage.
Findings:
- The case successfully managed pulmonary gangrene with antibiotics and catheter drainage.
- A bronchopleural fistula complication was encountered, necessitating prolonged hospitalization.
- Radiographic and computed tomography (CT) imaging were utilized to monitor the condition.
Implications:
- Percutaneous catheter drainage combined with antibiotics presents a potential conservative treatment for pulmonary gangrene.
- This approach may be effective even in the presence of complications like bronchopleural fistula.
- Further research into non-operative management strategies for pulmonary gangrene is warranted.