The value of a CT‐guided fine needle aspirate in infants with lung abscess

Levison, Jonathan A.; Asperen, Peter Van; Wong, Conroy; Harvey, John G.; Halliday, Robert

doi:10.1111/j.1440-1754.2004.00433.x

Cited by 12 publications

(3 citation statements)

References 18 publications

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“…The visualization of mixed flora in (gram) cultures of the secretions strongly indicates the presence of anaerobic microorganisms, and this is extremely useful for making a quick working diagnosis. The definite identification of these bacteria, however, requires the culture of the material collected (with protection) under anaerobic conditions, (13)(14)(15) which, in practice, is rarely necessary for the correct implementation of the treatment. It must be emphasized, however, that the routine sputum cultures carried out under anaerobic conditions do not show anaerobic bacteria, revealing only the growth of accompanying aerobic microorganisms, such as non-hemolytic streptococcus, pneumococcus or some gram-negative cocci.…”

Section: Introductionmentioning

confidence: 99%

Abscesso pulmonar de aspiração: análise de 252 casos consecutivos estudados de 1968 a 2004

et al. 2006

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Objective: To relate the experience of the staff at a health care facility specializing in the management of patients with aspiration lung abscess. Methods: Diagnostic aspects and therapeutic results of 252 consecutive cases of lung abscess seen in patients hospitalized between 1968 and 2004. Results: Of the 252 patients, 209 were male, and 43 were female.The mean age was 41.4 years, and 70.2% were alcoholic. Cough, expectoration, fever and overall poor health were seen over 97% of patients. Chest pain was reported by 64%, 30.2% presented digital clubbing, 82.5% had dental disease, 78.6% reported having lost consciousness at least once, and 67.5% presented foul smelling sputum. In 85.3% of the patients, the lung lesions were located either in the posterior segments of the upper lobe or in the superior segments of the lower lobe, and 96.8% were unilateral. Concomitant pleural empyema was seen in 24 (9.5%) of the patients. Mixed flora was identified in the bronchopulmonary or pleural secretions of 182 patients (72.2%). All patients were initially treated with antibiotics (mainly penicillin or clindamycin), and postural drainage was performed in 98.4% of cases. Surgical procedures were performed in 52 (20.6%) of the patients (drainage of empyema in 24, pulmonary resection in 22 and drainage of the abscess in 6). Cure was obtained in 242 patients (96.0%), and 10 (4.0%) died. Conclusion: Lung abscess occurred predominantly in male adults presenting dental disease and having a history of loss of consciousness (especially as a result of alcohol abuse). Most of the patients were treated clinically with antibiotics and postural drainage, although some surgical procedure was required in one-fifth of the study sample.

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Section: Introductionmentioning

confidence: 99%

Abscesso pulmonar de aspiração: análise de 252 casos consecutivos estudados de 1968 a 2004

et al. 2006

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“…Concomitant viral-bacterial infection can be detected in one-third of children with uncomplicated pneumonia [1]. Multibacterial etiology of pulmonary abscess is common [2,5], but the role of viruses in pathogenesis is not known because abscess samples are not usually examined for the presence of viruses. Our case demonstrates the interplay between RSV and two bacterial species (E. coli and S. pneumoniae).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary abscess of viral-bacterial etiology in a neonate

et al. 2007

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Abbreviations MRI Magnetic resonance imaging RSV Respiratory syncytial virusWe report the case of an infant with a polymicrobial pulmonary abscess visualized using magnetic resonance imaging. Respiratory syncytial virus, Escherichia coli, and Streptococcus pneumoniae were detected directly from abscess fluid, demonstrating the interaction between viruses and bacteria in the development of complicated pneumonia. Case reportA 14-day-old female infant was admitted to a local hospital because of dyspnoea and fever. She was born at term with a birth weight of 3,110 g and an Apgar score of 10. Two days before admission, she developed a cough and nasal discharge. Chest radiographs revealed interstitial infiltrates, and the concentration of serum C-reactive protein was high (on admission 141 mg/l, 2 days later 401 mg/l). Bronchiolitis was diagnosed but because of suspected sepsis, treatment was initiated with intravenous cefuroxime and supplemental oxygen. Blood, cerebrospinal fluid, and urine bacterial cultures were negative. She remained febrile despite expanded treatment with cloxacillin, gentamicin, and cefotaxime. After 7 days, she was referred to our hospital because of pulmonary infection unresponsive to treatment.On admission to our hospital, the girl was irritable and had low-grade fever. She had no dyspnoea, and her respiratory rate (50/min), breathing sounds, and arterial oxygen saturation (98% by pulse oximetry) were normal. Chest radiography showed a central parenchymal lung infiltrate and pleural fluid collection on the right side. Pleural drainage yielded only a minimal amount of fluid with growth of Escherichia coli. Nasopharyngeal aspirate and nasal swab samples were positive for respiratory syncytial virus (RSV) by PCR, and pneumococcal antigen was detected in the urine (Binax NOW; Binax, Scarborough, ME). The patient was treated with cefuroxime and erythromycin. Within the next week, the fever resolved and the C-reactive protein level decreased from 245 mg/l to 45 mg/l. Because of radiological persistence of a pleural shadow, a contrast medium-enhanced MRI of the chest was performed 9 days after referral to our hospital. The examination was performed without sedation while the infant was sleeping after feeding. The MRI showed an abscess in the right lower lobe, consolidation in the right middle and lower lobes, and pleural thickening with fluid on the right side (Fig. 1). The abscess wall and the pleura were loaded with contrast medium. A percutaneous needle puncture of the abscess yielded 7 ml pus that was positive for E. coli by culture, Streptococcus pneumoniae by antigen Eur J Pediatr (

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“…However, with the advent of interventional radiology, computed tomography guided drainage and pigtail catheter insertion are used in non-responders. [5][6][7] If patients deteriorate despite antibiotics and drainage, thoracotomy with marsupialisation of the abscess cavity (cutting a slit into the cyst and suturing the edges of the slit to form a continuous surface from the exterior to the interior) is the next step. Pulmonary resection remains debatable and is limited to immunocompromised children.…”

Section: Long Answermentioning

confidence: 99%