ABSTRACT
Lung abscess is a rare entity in pediatric age, but it generates significant morbidity. Even less frequent is the presence of this with spontaneous drainage to the skin, generating an abscess in the chest wall, reason for consultation, of the present clinical case. Subsequently, the presence of lung abscess with extension to the chest wall without pleural involvement was documented by imaging studies, an extremely rare and unusual entity, with only one case described in the world literature within our reach and in an adult patient.
El absceso pulmonar es una entidad infrecuente en la edad pediátrica, pero que genera una morbilidad importante. Aún menos frecuente es la presencia de este con drenaje espontáneo a piel, generando un absceso en pared torácica, motivo de consulta, del presente caso clínico. Posteriormente y por estudios imagenológicos se documentó la presencia de absceso pulmonar con extensión a pared torácica sin afectación pleural, una entidad extremadamente rara e inusual, con un solo caso descrito en la literatura mundial a nuestro alcance y en un paciente adulto.
Subject(s)
Humans , Male , Child, Preschool , Fistula/complications , Fistula/diagnostic imaging , Lung Abscess/complications , Lung Abscess/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Drainage , Thoracic WallABSTRACT
OBJECTIVES: This study was conducted to investigate the risk factors for pulmonary abscess-related empyema by investigating the clinical characteristics and chest computed tomography imaging features of patients with pulmonary abscesses. METHODS: We retrospectively analyzed the chest computed tomography findings and clinical features of 101 cases of pulmonary abscess, including 25 cases with empyema (the experimental group) and 76 cases with no empyema (the control group). The potential risk factors for pulmonary abscess-related empyema were compared between the groups by using univariate and multivariate logistic regression analyses. RESULTS: The incidence of pulmonary abscess-related empyema was 24.8% (25/101). Univariate analysis showed that male gender, diabetes, pleuritic symptoms, white blood cells >10×109/L, albumin level <25 g/L, and positive sputum cultures were potential clinical-related risk factors and that an abscess >5 cm in diameter and transpulmonary fissure abscesses were potential computed tomography imaging-related risk factors for pulmonary abscess-related empyema. Multivariate logistic regression analysis showed that transpulmonary fissure abscesses (odds ratio=9.102, p=0.003), diabetes (odds ratio=9.066, p=0.003), an abscess >5 cm in diameter (odds ratio=8.998, p=0.002), and pleuritic symptoms (odds ratio=5.395, p=0.015) were independent risk factors for pulmonary abscess-related empyema. CONCLUSIONS: Transpulmonary fissure abscesses, diabetes, giant pulmonary abscesses, and pleuritic symptoms increased the risk of empyema among patients with pulmonary abscesses.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Tomography, X-Ray Computed/methods , Empyema, Pleural/diagnostic imaging , Lung Abscess/diagnostic imaging , Pleural Diseases/complications , Sex Factors , Regression Analysis , Risk Factors , Empyema, Pleural/complications , Empyema, Pleural/blood , Diabetes Complications/complications , Serum Albumin, Human/analysis , Leukocyte Count , Lung Abscess/complications , Lung Abscess/bloodABSTRACT
The authors recall the main clinical radiological, bacteriological and therapeutic characteristics of a 100 cases of abcesses in previously unaffected adults lungs observed over a period of 10 years [1968-1977]. They note the young age of a great number of patients, the long evolution preceeding the first consultation illustrated by the frequency of the vomica and the dyspnea. The radiological aspect is typical in 89% of the cases. The bacteriological study, not quite conclusive is in fact not necessary to conduct the treatment. Recovery is achieved in 94% of the cases