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Summary Lung Abscess Bronchiectasis Pleural effusion Notes
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Lung Abscess:Definition: Localized collection of pus. Necrotizing inflammation which results in
destruction of the pulmonary parenchyma.
Aetiology:
Necrotizing infection often with unsuccessful treatment/resolvment
Aspirated contents (gastric, small hazards)
Trauma
Tumor
Embolisation from the RH rare – acute inflammation
Tx: Abscess of any kind will require drainage and antibiotics. Note with
pulmonary abscess, antibiotic penetration is usually poor.
May require further surgical decortication.
Note: Lung abscess vs Empyema: Abscess is a localized collection of pus.
Empyema is collection of pus in a body cavity, in this cases pleural.
Bronchiectasis:
Permanent dilation of bronchioles (wider than blood vessels), bronchiole walls
destroyed, chronic inflammation
Patterns: Tube-like (cylindrical) or sacular
NB Aetiology:
Infections: Necrotising infections (TB, measles, B.Pertussis) or unresolved
childhood infection
Foreign body: Mucus plugging, trauma
Congential: Kartagener’s syndrome(cilia disruption), alpha-1 antitrypsin
(protease) Cystic Fibrosis
Autoimmune: Sjogrens, RA
Immunodeficiency: IgA, requires immunoglobulin replacement
Presentation: Chronic cough and purulent sputum. Dilated bronchioles cannot
spasm, more on the left side (anatomically straighter bronchi for foreign body
lodgement) but usually bilateral, lymphoid follicles present. Dyspnea and
haemoptysis.
Signs: increased resonance, fremitis and
Crackling and wheeze on auscultation. Bronchial breathing
Kartagener’s: Situs inverticus (dextrocardia), infertility, bronchiectasis +
sinusits
Pleural effusion
Aetiology:
Infection
PE (and subsequent infarction to distal vasculature)
Congestive heart failure
hypoalbuminaemia: Reduced osmotic pressure in the bloodstream
Neoplasm: Can cause lymphoedma due to obstruction
Atelectasis: Reduced intrapleural pressure which draws fluid
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