Diagnosis
Clinical findings can be unreliable and are often non-existent.
Haematology reveals:
- leucocytosis
- raised ESR
Sputum culture:
- send for Gram stain
- culture for aerobic and anaerobic organisms
- determine antibiotic sensitivity
- examine for acid fast bacilli
Chest radiography:
- may reveal one or more circular lesions of almost any size which may cavitate and show fluid levels
Chest ultrasound:
- can identify a fluid collection
- occasionally, aspiration of the abscess is possible
Fibre-optic bronchoscopy:
- permits sampling for bacteriology and for histological diagnosis of any lesions, e.g. neoplasms or foreign bodies
Reference
- Walters J, Foley N, Molyneux M. Continuing education in anaesthesia, critical care and pain: pus in the thorax: management of empyema and lung abscess. 2011 Dec 1;11(6):229-33.
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