Internal Medicine

0521779407-13 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:15

918 Low-Oxygen-Affinity Hemoglobins Lung Abscess

Specific Diagnostic Tests

■High P50, hemoglobin oxygen dissociation curve shifted to the right

■Some cases may be detected on hemoglobin electrophoresis

differential diagnosis

■Methemoglobinemia

■Cyanosis secondary to cardiac or pulmonary disorders

management

■No therapy.

specific therapy

n/a

follow-up

n/a

complications and prognosis

■No associated morbidity or mortality.

LUNG ABSCESS

STEVEN R. HAYS, MD

history & physical

History & Risk Factors

■May be associated with infections caused by pyogenic bacteria,

mycobacterium, fungi and parasites

■Anaerobic infection most common cause, up to 90% of cases

■Aspiration biggest risk factor, often associated with periodontal dis-

ease

■Predisposing conditions (73% of patients have at least one):

➣Loss of cough reflex: alcoholism, seizure disorder, drug overdose,

general anesthesia, protracted vomiting

➣Neurologic disorders: cerebrovascular disease, myasthenia

gravis, amyotropic lateral sclerosis, other bulbar processes

➣Poor deglutination associated with neurologic disorders or eso-

phageal disease

■May complicate:

➣Primary or metastatic malignancy as postobstructive pneu-

monia; 8–18% of abscesses have associated malignancy

➣Pulmonary infarctions