A 63-year-old man with small cell carcinoma of the left mainstem bronchus begins chemotherapy. During the treatment period, he becomes febrile and develops a productive cough. The temperature is 38.7degC (103degF), respirations are 32 per minute and blood pressure is 125/85 mm Hg. A CBC shows leukocytosis (WBC = 18,500/mL). The patient's cough worsens and he begins expectorating large amounts of foul smelling sputum. A chest X-ray shows a distinct cavity with an air/fluid level distal to the tumor area. Which of the following is the most likely diagnosis?
Atelectasis
Bronchiectasis
Ghon complex
Pulmonary abscess
The most common cause of pulmonary abscess is aspiration A cystic abscess contains purulent exudates and is contained by a fibrous wall. Abscess cavities are often paially filled with pus and air, which accounts for the X-ray finding of an "air / fluid level." None of the other choices present as cavitary lesions. * Causes of Lung abscess: 1. ASPIRATION Decrease consciousness* Alcoholics* Hasty intake of food paicle (M/C) 2. SEPTIC EMBOLISM Infective endocarditis 3. POST PNEUMONIA Staph. Aureus Klebsiella 4. OBSTRUCTION NEOPLASM * Clinical features- High fever, productive cough, foul smelling sputum, paroxysms of cough are being brought on bychange of position
Pulmonary Tuberculosis and Lung Abscess