Unusual case of a giant lung abscess initially misdiagnosed and treated as an empyema

Carvalho, Joana; Marques, Diogo Paixão; Oliveira, Inês; Vieira, Ana

doi:10.1136/bcr-2018-228849

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…The role of early PCD remains unclear. Current evidence, comprising a single or a few case series, show a high success rate without major complication or mortality in early PCD with concurrent antibiotics (12)(13)(14). Given the paucity of data in this field, we aim to compare the safety and efficacy of early versus delayed drainage in patients with lung abscesses.…”

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confidence: 99%

Early drainage reduces the length of hospital stay in patients with lung abscess

Chiang,

Lin,

Hsu

et al. 2023

Front. Med.

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BackgroundAlthough percutaneous transthoracic catheter drainage (PCD) has been proven effective in lung abscesses, the optimal timing of PCD is still unclear. The study aimed to evaluate the safety and efficacy of early versus delayed drainage in patients with lung abscesses.MethodsThis retrospective study included 103 consecutive patients with liquefied lung abscesses more than 3 cm confirmed by a CT scan received CT-guided PCD over 16 years, from July 2005 to September 2021, in a single institution were reviewed. Early drainage was defined as PCD within one week after a lung abscess was diagnosed. The primary outcome was 90-day mortality. The secondary outcomes included perioperative complications and patients’ length of hospital stay (LoS). Factors associated with 90-day mortality and LoS were also analyzed. The key statistical methods were Chi-square test, Fisher’s exact test, Student t-test, and Pearson correlation.ResultsAmount the 103 patients, there were 64 patients who received early PCD, and 39 patients received delayed PCD. Between the two groups, there were no significant differences in clinical characteristics, 90-day mortality, or perioperative complications. The LoS was significantly shortened in early PCD group (28.6 ± 25.5 vs. 39.3 ± 26.8 (days), p = 0.045). Higher Charlson comorbidity index, secondary lung abscess, and liver cirrhosis were associated with higher mortality (all p < 0.05). Positive sputum culture significantly increased the LoS (coefficient 19.35 (10.19, 28.50), p < 0.001).ConclusionThe 90-day mortality and complications were similar for early PCD and delayed PCD patients, but LoS was significantly shortened in early PCD patient.

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Section: Introductionmentioning

confidence: 99%

Early drainage reduces the length of hospital stay in patients with lung abscess

Chiang,

Lin,

Hsu

et al. 2023

Front. Med.

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Percutaneous transthoracic catheter drainage for lung abscess: a systematic review and meta-analysis

Lee

Hong

Tamburrini³

et al. 2021

Eur Radiol

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PulmonaryAggregatibacter actinomycetemcomitansinfection masquerades as malignancy in a patient with periodontitis

2021

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A 49-year-old man with a 37.5 pack-year smoking history presented with a suspected neoplasm of the right lung following the discovery of a metabolically active mass on positron emission tomography-CT imaging. The patient, who demonstrated poor oral hygiene, had a history of irregular problem-oriented dental visitation. Having excluded malignancy through histologic investigations, Aggregatibacter actinomycetemcomitans—a well-established periodontal pathogen—was subsequently cultured from his pulmonary aspirate. The patient was therefore managed with systemic antimicrobials and adjunctive dental extractions to eliminate the likely source of infection, whereafter the mass resolved without complication. This case corroborates previous reports of extraoral isolation of A. actinomycetemcomitans, which may mimic cancer clinically and radiographically. While a definitive causative link between untreated periodontitis and systemic infection remains to be elucidated, such cases present a compelling argument in favour of promoting oral health to prevent systemic disease.

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Unusual case of a giant lung abscess initially misdiagnosed and treated as an empyema

Cited by 3 publications

References 23 publications

Early drainage reduces the length of hospital stay in patients with lung abscess

Early drainage reduces the length of hospital stay in patients with lung abscess

Percutaneous transthoracic catheter drainage for lung abscess: a systematic review and meta-analysis

PulmonaryAggregatibacter actinomycetemcomitansinfection masquerades as malignancy in a patient with periodontitis

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