Internal Medicine

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

Lung Abscess Lung Cancer 921

follow-up

■Continue antibiotic therapy until resolution of abscess: usually 6–8

wks

■Serial CXR q 2–4 wks help document improvement and resolution

complications and prognosis

Complications

■Empyema with bronchopleural fistula

■Rupture into uninvolved segments

■Sepsis

■Massive hemoptysis

■Nonresolution

■Residual cavities and fibrosis should be left alone unless they are the

source of complications such as recurrent pneumonia or hemoptysis

Prognosis

■Generally abscess resolves in 6–8 wks with antibiotics

■Mortality 5–10%

LUNG CANCER

PAUL G. BRUNETTA, MD

history & physical

History

■Cigarette smoking, asbestos, family history, COPD, radiation expo-

sure (miners), prior cancer (oral, laryngeal or lung), age, pulmonary

fibrosis

■Leading cause of cancer death in U.S.

■85% of cases and all subtypes associated with smoking

Signs & Symptoms

■Pleural effusion, focal crackles or wheezes, palpable lymphadenopa-

thy, clubbing, cachexia, pneumonia (postobstructive)

■90% present with cough (new or changed), dyspnea, hemoptysis,

chest pain; less common are weight loss, clubbing, dysphagia

■Paraneoplastic syndromes more associated with small-cell-lung

cancer (SCLC)

➣Superior vena cava (SVC) syndrome, Pancoast syndrome, or

paraneoplastic syndromes and a history of smoking suggest lung

cancer