Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- positive past medical history
- fever
- productive cough
- cavernous (amphoric) breath sounds
Otros factores de diagnóstico
- cardiac murmur
- pleuritic chest pain
- constitutional symptoms
- cachexia
- pallor
- gingival disease
- halitosis
- absence of gag reflex
- dyspnea
- hemoptysis
- rigors
- weakness
- arthralgia
- hemorrhagic lesions
- inspiratory crackles
- bronchial breathing
- decreased breath sounds
- unilateral fixed rhonchus
Factores de riesgo
- predisposition to aspiration of gastric contents
- poor dental hygiene and tooth extraction
- bronchial obstruction
- immunosuppression
- chronic illness
- extrapulmonary sepsis
- pneumonia
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- CBC
- chest x-ray
- sputum Gram stain
- sputum culture
- blood culture
- empyema fluid culture
Pruebas diagnósticas que deben considerarse
- CT chest
- bronchoscopy
- quantitative cultures of protected specimen brushings
- quantitative cultures of protected bronchoalveolar lavage samples
- percutaneous needle aspiration and culture
- sputum cytology
- lung ultrasound
- echocardiogram
- rapid enzyme-linked immunosorbent assay (ELISA) for D-dimer
- multidetector CT thorax
- ventilation-perfusion scan
Algoritmo de tratamiento
low probability of gram-negative or multidrug resistant organism
high probability of gram-negative or multi-drug resistant organism
low probability of gram-negative or multidrug resistant organism
high probability of gram-negative or multidrug resistant organism: with or without penicillin/cephalosporin allergy
Colaboradores
Autores
Ioannis P. Kioumis, MD, PhD

Professor of Respiratory Medicine and Infectious Diseases
Aristotle University of Thessaloniki
Respiratory Failure Clinic
General Hospital G. Papanikolaou
Thessaloniki
Greece
Divulgaciones
IPK declares that he has no competing interests.
Georgia G. Pitsiou, MD, PhD

Professor of Respiratory Medicine
Aristotle University of Thessaloniki
Respiratory Failure Clinic
General Hospital G. Papanikolaou
Thessaloniki
Greece
Divulgaciones
GGP declares that she has no competing interests.
Revisores por pares
William G. Cheadle, MD
Professor of Surgery
University of Louisville
Associate Chief of Staff for Research and Development
VAMC Louisville
Louisville
KY
Divulgaciones
WGC declares that he has no competing interests.
Nicholas Maskell, MD
Senior Lecturer and Consultant Physician
North Bristol Lung Centre
Southmead Hospital
Bristol
UK
Divulgaciones
NM declares that he has no competing interests.
Najib Rahman, BM, BCh, MA (Oxon), MRCP (UK)
MRC Training Fellow and Specialist Registrar, Respiratory Medicine
Oxford Centre for Respiratory Medicine
Churchill Hospital
Oxford
UK
Divulgaciones
NR declares that he has no competing interests.
Philip W. Ind, BA (Cantab), MB BChir, MA (Cantab), FRCP
Consultant Physician
Honorary Senior Lecturer
Imperial College Healthcare Trust
Hammersmith Hospital
London
UK
Divulgaciones
PWI declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Walters J, Foley N, Molyneux M. Continuing education in anaesthesia, critical care and pain: pus in the thorax: management of empyema and lung abscess. 2011 Dec 1;11(6):229-33.Texto completo
American College of Radiology. ACR appropriateness criteria: radiologic management of infected fluid collections. 2019 [internet publication].Texto completo
American College of Radiology; Society of Interventional Radiology; Society for Pediatric Radiology. ACR-SIR-SPR practice guideline for specifications and performance of image-guided percutaneous drainage/aspiration of abscesses and fluid collections (PDAFC). 2023 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Neoplasm (primary or metastatic lung cancer, lymphoma)
- Tuberculosis
- Necrotizing pneumonia
Más DiferencialesGuías de práctica clínica
- Practice guideline for specifications and performance of image-guided percutaneous drainage/aspiration of abscesses and fluid collections (PDAFC)
- Appropriateness criteria: radiologic management of infected fluid collections
Más Guías de práctica clínicaInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
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