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The following is a brief synopsis of the discussion on lung abscess that followed the case presentation:
abscess is a localized, advanced suppurative infection that affects one
or several areas of lung parenchyma.
primary: no predisposing factors
secondary: with predisposing factors (see table below under pathogenesis)
incidence since modification of ENT surgical techniques. Once abandoned
seated positioning and uncuffed endotracheal tubes, decreased occurrence
of post-op lung abscesses.
decreased mortality from lung abscess after introduction of antibiotics (penicillin)
mortality rate still remains high: 10 - 38%
abscesses may occur as a result of any of the following :
lung segments are most often affected. Hence, posterior segments of upper
lobes & superior segments of lower lobes.
Xray or CT chest to confirm. Often do not need sophisticated imaging,
but CT chest may show disease prior to Chest Xray. CT also helpful to
distinguish abscess from pyopneumothorax.
low likelihood of malignancy in pediatric population.