Anaerobic infections of the lung

Chung, Geemee; Goetz, Matthew Bidwell

doi:10.1007/s11908-000-0041-9

Cited by 15 publications

(8 citation statements)

References 44 publications

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“…The utility of the incubation of BAL fluid specimens has been reported for the diagnosis of anaerobic lung abscess [ 6 ]. Aggravated SPE develops into anaerobic abscess formation [ 7 ]. Thus, when SPE lesion develops into a microabscess or focal abscess, we can identify the responsible pathogen from BAL fluid collected from the abscessed lesion.…”

Section: Discussionmentioning

confidence: 99%

Periodontitis-associated septic pulmonary embolism caused by Actinomyces species identified by anaerobic culture of bronchoalveolar lavage fluid: a case report

Endo¹,

Mishima

Takeuchi³

et al. 2015

BMC Infect Dis

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BackgroundPeriodontal disease is a less common but important cause of septic pulmonary embolism (SPE). However, the pathogens causing periodontal disease-associated SPE (PD-SPE) have been poorly understood. Actinomyces species are resident microbiota in the oral cavity. Here we report a case of PD-SPE caused by Actinomyces species, which was identified by anaerobic culture of bronchoalveolar lavage fluid (BAL).Case presentationA 64-year-old Asian man, complicated with severe chronic periodontitis, was admitted with chest pain and fever. Chest CT revealed multiple bilateral pulmonary nodules located subpleurally. We diagnosed the case as SPE associated with periodontitis. Although blood cultures were negative for the usual 5-day incubation, anaerobic culture of the BAL fluid sample yielded Actinomyces species. Antibacterial therapy alone did not ameliorate the symptoms; however, additional dental treatment, including tooth extraction, promptly did. The patient was discharged 23 days after admission. The 3-month follow-up revealed no recurrence of the symptoms and complete resolution of the lung lesions.ConclusionThis case demonstrated that Actinomyces species can cause PD-SPE. Additionally, clinicians should consider performing appropriate anaerobic culture of BAL fluid to identify the pathogen of SPE, and to ordering dental treatment, if necessary, in addition to antibiotics for the initial management of PD-SPE.

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Section: Discussionmentioning

confidence: 99%

Periodontitis-associated septic pulmonary embolism caused by Actinomyces species identified by anaerobic culture of bronchoalveolar lavage fluid: a case report

Endo¹,

Mishima

Takeuchi³

et al. 2015

BMC Infect Dis

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“…3 Most primary lung abscesses arise as a complication of aspiration pneumonia and are caused by anaerobes that are normally present in the mouth and gingival crevice. 4 Although the medical literature has reports of lung abscesses caused by unusual species, such as Candida albicans 5 and Legionella pneumophilia 6,7 by far the most common etiologic agents are Peptostreptococcus species, Fusobacterium spp., Prevotella spp., and viridans Streptococci. 8 The patients typically present with indolent symptoms, including cough, fever, sweats, and occasionally hemoptysis.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Resolution of Lung Abscess

Shaheen¹,

Polenakovik²

2006

Clinical Pulmonary Medicine

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A 57-year-old man was hospitalized and treated for community acquired pneumonia. He was found to have radiologic evidence of a lung abscess upon completion of his oral antibiotics. Complete resolution of the abscess in a 3-month-period without any medical or surgical intervention was confirmed thereafter by repeated imaging study. Spontaneous resolution of lung abscess is possible and might be the fate of all uncomplicated lung abscesses if drainage into the tracheobronchial tree takes place early in the course. Host factors may play a role in predicting prognosis and treatment outcome.A 57-year-old man was admitted to the hospital for worsening shortness of breath for 3 days that was associated with fever, rigors, and night sweats for 2 days. He also complained of left-sided pleuritic chest pain aggravated by cough productive of white sputum. His past medical history was significant for psoriasis and a 40 pack-year of tobacco use. Medications included Naprosyn and a topical steroid cream. He had no history of tuberculosis, unusual exposures, or recent travel.On physical examination, the patient was well built and well nourished and appeared in moderate respiratory distress. His blood pressure was 165/90 mm Hg, heart rate 153 beats/min, respiratory rate 32 breaths/min, and temperature 101.8°F. Pulse oximetry showed 94% saturation on ambient air. Chest auscultation revealed markedly decreased breath sounds on the left lung base with egophony. The remainder of the examination was unremarkable except for the presence of scaly silver erythematous lesions on the extensor surfaces, elbows and knees, consistent with psoriasis. Upon admission, the white blood cell count was 22.6 ϫ 10 3 /L, with 76% neutrophils and 9% band forms. Arterial blood gas showed a pH of 7.44, PCO 2 of 40.4 mm Hg, PO 2 of 70 mm Hg, and saturation of 94.2% on ambient air. The results of the other laboratory tests were normal. Chest x-ray revealed consolidation of the left lower lobe with suggestion of collapse secondary to soft tissue density or pleural effusion (Fig. 1).The patient was admitted with a diagnosis of community-acquired pneumonia, and he was started on intravenous ceftriaxone and azithromycin after obtaining sputum and blood samples for cultures and urine sample for Legionella antigen.On the second day of admission, the patient improved symptomatically, became afebrile, and maintained good oxygenation on room air. He continued to improve through the fifth day of hospitalization, at which point he was discharged to home on a 1-week course of oral levofloxacin and bronchodilators. The results of blood and sputum cultures and Legionella urinary antigen were unrevealing. The decision not to proceed with thoracentesis was made after the patient declined the procedure because of his concern about the risks, including pneumothorax.When seen in follow-up 7 days after discharge, the patient showed continuous signs of clinical improvement. A computed tomography (CT) scan of the chest without contrast was obtained 3 weeks after discharge for fu...

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“…Typischerweise leiden betroffene Patienten zugleich an Parodontitis bzw. Gingivitis mit infizierten Zahnfleischtaschen, die mit einer Keimlast bis 10 11 /ml als Reservoir für wiederholte bakterielle Kontaminationen der unteren Atemwege gelten [3]. Da die Aspirationsereignisse meistens im Liegen stattfinden, sind die dorsalen Lungenpartien häufiger von Abszessen betroffen: das rechte posteriore Oberlappensegment, beide apikale Oberlappensegmente und apikale Unterlappensegmente [4].…”

Section: Abszess Durch Aspirationunclassified

Therapie von Lungenabszessen

Marra

Hillejan²,

Ukena

2015

Zentralbl Chir

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A lung abscess is an infectious pulmonary disease characterised by the presence of a pus-filled cavity within the lung parenchyma. The content of an abscess often drains into the airways spontaneously, leading to an air-fluid level visible on chest X-rays and CT scans. Primary lung abscesses occur in patients who are prone to aspiration or in otherwise healthy individuals; secondary lung abscesses typically develop in association with a stenosing lung neoplasm or a systemic disease that compromises immune defences, such as AIDS, or after organ transplantation. The organisms found in abscesses caused by aspiration pneumonia reflect the resident flora of the oropharynx. The most commonly isolated organisms are anaerobic bacteria (Prevotella, Bacteroides, Fusobacterium, Peptostreptococcus) or streptococci; in alcoholics with poor oral hygiene, the spectrum of pathogens includes Staphylococcus aureus, Streptococcus pyogenes and Actinomyces. Chest radiography and computed tomography (CT) are mandatory procedures in the diagnostic algorithm. Standard treatment for a lung abscess consists of systemic antibiotic therapy, which is based on the anticipated or proven bacterial spectrum of the abscess. In most cases, primary abscesses are successfully treated by calculated empiric antibiotic therapy, with an estimated lethality rate of less than 10 %. Secondary abscesses, despite targeted antimicrobial therapy, are associated with a poor prognosis, which depends on the patient's general condition and underlying disease; lethality is as high as 75 %. Negative prognostic factors are old age, severe comorbidities, immunosuppression, bronchial obstruction, and neoplasms. Surgical intervention due to failure of conservative treatment is required in only 10 % of patients, with a success rate of up to 90 % and postoperative mortality rates ranging between 0 and 33 %. Treatment success after endoscopic or percutaneous drainage is achieved in 73 to 100 % of cases, with an acceptable mortality rate (0-9 %).

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Anaerobic infections of the lung

Cited by 15 publications

References 44 publications

Periodontitis-associated septic pulmonary embolism caused by Actinomyces species identified by anaerobic culture of bronchoalveolar lavage fluid: a case report

Periodontitis-associated septic pulmonary embolism caused by Actinomyces species identified by anaerobic culture of bronchoalveolar lavage fluid: a case report

Spontaneous Resolution of Lung Abscess

Therapie von Lungenabszessen

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