Lung Abscess Case Series and Review of the Literature

Abstract

(1) Background: Lung abscess is a lung infection that leads to the destruction of the lung parenchyma, resulting in a cavity formation and central necrosis filled with purulent fluids. It is an uncommon pediatric problem, and there is a paucity of literature reviews on this subject, especially for the pediatric age group. Lung abscess is commonly divided into those considered primary in previously well children or secondary in those with predisposing co-morbidities. The predominant pathogens isolated from primary lung abscesses are the aerobic organisms, including streptococcal species, Staphylococcus aureus, and Klebsiella pneumoniae, while anaerobic bacteria such as Bacteroides species are predominant in secondary groups. Children usually present with fever, cough, shortness of breath, chest pain, and sputum. While physical examination may reveal diffuse crackles on auscultation, the diagnosis is usually confirmed by chest X-ray. (2) Methods: We report four different cases with lung abscesses from both primary and secondary group with similar presentations and radiological findings, but the approach was different in each according to the underlining cause. (3) Conclusions: Conservative therapies with a prolonged course of antibiotics remain the cornerstone of therapy for both primary and secondary lung abscesses. The underlying cause should be considered when there is a suboptimal response. However, invasive intervention is becoming more popular with better yield, shorter duration of antibiotics and admission, and excellent prognosis.

Intrathoracic Ewing’s sarcoma in an adult masquerading as lung abscess

“…EES lacks distinct clinical manifestations, often leading to diagnostic and therapeutic management delays 16. As in our case, the patient presented with symptoms of localised chest pain, dyspnoea, cough and low-grade fever, commonly observed in other clinical scenarios such as pneumonia or lung abscess.…”

“…As in our case, the patient presented with symptoms of localised chest pain, dyspnoea, cough and low-grade fever, commonly observed in other clinical scenarios such as pneumonia or lung abscess. Accordingly, antibiotics were prescribed, providing temporary relief, and serological–culture tests were done, which came out to be sterile 16…”

Lung abscess: an update on the current knowledge and call for future investigations

“…Since patient characteristics and risk factors for LA, as well as prevalence of microorganisms, differs across clinical settings and countries, there is also a need for larger observational studies that could help identify risk factors for developing LA and improve our clinical understanding of this complex infection. In children, a recent review also concluded that the evidence about LA is sparse [27 ▪ ]. The authors of this review also state that there is unwarranted variation in the clinical management.…”

“…A recent review [27 ▪ ] found that the clinical manifestation of LA in children is comparable to that seen in adults, with variations in symptomatology, site of infection, microorganism, among others.…”

Manifestasi klinis, pemeriksaan penunjang, diagnosis dan tatalaksana abses paru pada anak

“…sedangkan abses paru sekunder dapat disebabkan oleh bakteri anaerob (27%), Pseudomonas aeruginosa, (13%) Staphylococcus aureus (13%), Streptococcus pneumonia (7%), Haemophilus influenza (7%), dan Escherichia coli, atau klebsiella. [6][7][8] Diagnosis dan tatalaksana abses paru pada anak didasarkan pada menifestasi klinis yang terjadi. Diagnosis diperkuat dengan rontgen dada, ultrasonografi, dan computed tomography (CT Scan).…”