Abscessive pneumonia

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It occurs most often during sepsis, especially as a complication of staphylococcal pneumonia.

Staphylococcal pneumonia[edit | edit source]

Now rare, more often in infants than in older children,
is severe for the progressive course with a tendency to complications– abscesses and pyopneumotorax,
Staphylococcus aureus, has various toxins and enzymes (hemolysin, leukocidin, staphylokinase, plasma coagulase),
the routes of spread of the infection are bronchogenic or hematogenous.

Inflammation deposits merge, the aureus multiplies rapidly, destroys the surroundings, causes the formation of small abscesses,
rupture of abscesses deposited subpleurally results in pyopneumothorax,
partial obstruction of small bronchi can lead to the formation of pneumococci,
septic thrombi may form in the pulmonary veins.

Sudden high fever, shortness of breath,
may be staphyloderma at the same time,
in infants it occurs peracutally as a septic toxicological form,
physical finding: initially a finding typical of pneumonia, in case of empyema or pyopneumothorax then respiratory weakness,
laboratory tests: marked leukocytosis, neutrophilia, shift to the left, anaemia, high sedimentation and CRP, blood culture is often positive,
heart + lung x-ray: initially small bronchopneumonic lesions, rapidly expanding and gradually merging,
- exudate formation,
- abscesses - form cavities with a wide rim (after emptying the contents into the bronchus, they are filled with air),
complications: only rare with targeted ATB therapy, in younger infants - staphylococcal pericarditis, meningitis, osteomyelitis, metastatic abscesses, sepsis.sepse.

Difficult in the initial stage,
a history of past staphyloderma or mastitis of the mother helps us with dif. dg.,
further: clinical picture, X-ray S + P, cultivation,
differential diagnosis: pneumonia, which may be complicated by empyema (agents: streptococcus, klebsiella, hemophilus).

Antistaphylococcal ATB - oxacillin, vancomycin (3-4 weeks),
Ig or antistaphylococcal serum also helps to manage it,
empyema - drainage of the cavity (max. 7 days),
the prognosis - severe, high mortality - is influenced by the patient's premorbid condition and complications.

Wikiskripta. Abscedující pneumonie [online]. Wikiskripta, ©2014. The last revision 2020-11-13, [cit. 2014-12-01]. <https://www.wikiskripta.eu/index.php?curid=6491>.