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+--- Thread: lung abcess - thiddi (/showthread.php?tid=591156)
lung abcess - thiddi - ArchivalUser - 06-09-2011
A 43-year-old man comes to the emergency
department because of
fever, chills, malaise, cough, and pleuritic chest
pain for 3 days; the
cough is productive of foul-smelling, purulent sputum.
He has
alcoholism. His temperature is 39.2 C (102.6 F),
blood pressure is 110/70 mm
Hg, pulse is 120/min, and respirations are 14/min.
Hemoglobin level is
15 g/dL, and leukocyte count is 25,000/mm3. An ECG
shows normal
findings. An x-ray film of the chest shows a 4-cm
cavity in the superior
segment of the right lower lobe and an air-fluid
level. While awaiting
results of sputum culture, which of the following is
the most appropriate
next step in management?
A
) Observation
B
) Broad-spectrum antibiotic therapy
C
) Isoniazid therapy
D
) Intravenous amphotericin B therapy
E
) Tube thoracostomy
i thin the answer should be E as its lung abcess cavity
0 - ArchivalUser - 06-09-2011
Answer is B. Tube thoracostomy is for drainage of pleural fluid. Surgical thoracotomy and evacuation is definitive for lung abscess this magnitude. Usually, with a small pocket of lung abscess, anerobic coverage alone causes resolution
0 - ArchivalUser - 06-10-2011
bb
we should try antibiotics in lung abcess but in all other abcesses surgical drainage