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Lung abscess

Última revisión: 20 Aug 2025
Última actualización: 12 Dec 2023

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • positive past medical history
  • fever
  • productive cough
  • cavernous (amphoric) breath sounds
Todos los datos

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
Todos los datos

Factores de riesgo

  • predisposition to aspiration of gastric contents
  • poor dental hygiene and tooth extraction
  • bronchial obstruction
  • immunosuppression
  • chronic illness
  • extrapulmonary sepsis
  • pneumonia
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • CBC
  • chest x-ray
  • sputum Gram stain
  • sputum culture
  • blood culture
  • empyema fluid culture
Todos los datos

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
Todos los datos

Algoritmo de tratamiento

Agudo

low probability of gram-negative or multidrug resistant organism

high probability of gram-negative or multi-drug resistant organism

En curso

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
Ioannis P. Kioumis

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
Georgia G. Pitsiou

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

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

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.
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  • Guías 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 clínica
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