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.

Pathophysiology[edit | edit source]

  • 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.

The clinical picture[edit | edit source]

  • 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.

Diagnosis[edit | edit source]

  • 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).

Therapy[edit | edit source]

  • 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.

References[edit | edit source]

Related Articles[edit | edit source]

References[edit | edit source]