Chronic Lung Sepsis: Lung Abscess, Bronchiectasis, and Empyema
Chronic Lung Sepsis: Lung Abscess, Bronchiectasis, and Empyema
Chronic lung infections including lung abscess, bronchiectasis, and empyema remain serious medical diseases despite the availability of antimicrobial agents. Recent publications contribute to our understanding of disease pathogenesis and management of these entities. The microbial pathogen of lung abscess may be different comparing immunocompetent with immunocompromised patients, supporting a concept for aggressive diagnostic investigations and targeting of specific potential pathogens. The use of surgery in bronchiectasis may be declining, but surgical intervention remains an important strategy with favorable outcomes, especially in cases of focal bronchiectasis. For empyema, maintaining a high index of clinical suspicion may allow for diagnostic thoracentesis in patients with pleural effusions and allow initiation of appropriate tube thoracotomy drainage and use of fibrinolytics. With appropriate management, morbidity and mortality may be limited and outcomes generally favorable.
Lung abscess, bronchiectasis, and empyema represent uncommon chronic lung infections and may reflect complications of pneumonia. However, these pulmonary infections remain important clinical entities and can occur in persons with structural lung disease, genetic abnormalities, and disorders of innate or acquired immunity. These chronic pulmonary infections can cause debilitating and life-threatening medical complications. Several published comprehensive review articles related to these topics are available for general readership, whereas this review will focus on recent advances in understanding of pathogenesis and clinical management of these chronic lung infections.
Abstract and Introduction
Abstract
Chronic lung infections including lung abscess, bronchiectasis, and empyema remain serious medical diseases despite the availability of antimicrobial agents. Recent publications contribute to our understanding of disease pathogenesis and management of these entities. The microbial pathogen of lung abscess may be different comparing immunocompetent with immunocompromised patients, supporting a concept for aggressive diagnostic investigations and targeting of specific potential pathogens. The use of surgery in bronchiectasis may be declining, but surgical intervention remains an important strategy with favorable outcomes, especially in cases of focal bronchiectasis. For empyema, maintaining a high index of clinical suspicion may allow for diagnostic thoracentesis in patients with pleural effusions and allow initiation of appropriate tube thoracotomy drainage and use of fibrinolytics. With appropriate management, morbidity and mortality may be limited and outcomes generally favorable.
Introduction
Lung abscess, bronchiectasis, and empyema represent uncommon chronic lung infections and may reflect complications of pneumonia. However, these pulmonary infections remain important clinical entities and can occur in persons with structural lung disease, genetic abnormalities, and disorders of innate or acquired immunity. These chronic pulmonary infections can cause debilitating and life-threatening medical complications. Several published comprehensive review articles related to these topics are available for general readership, whereas this review will focus on recent advances in understanding of pathogenesis and clinical management of these chronic lung infections.
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