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abses paru

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abses paru

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									Abses paru adalah suatu kavitas dalam jaringan paru yang berisi material purulent berisikan sel
radang     akibat     proses    nekrotik    parenkim    paru   oleh    proses   terinfeksi    .
Bila diameter kavitas < 2 cm dan jumlahnya banyak (multiple small abscesses) dinamakan
“necrotising pneumonia”. Abses besar atau abses kecil mempunyai manifestasi klinik berbeda
namun mempunyai predisposisi yang sama dan prinsip diferensial diagnose sama pula. Abses
timbul karena aspirasi benda terinfeksi, penurunan mekanisme pertahanan tubuh atau virulensi
kuman yang tinggi. Pada umumnya kasus Abses paru ini berhubungan dengan karies gigi,
epilepsi tak terkontrol, kerusakan paru sebelumnya dan penyalahgunaan alkohol.




Dasar Kelainan : Nekrosis jaringan paru yang berisi pus karena penyumbatan bronkus.
I.DIAGNOSIS
A.Keluhan Pokok

      Terdapat riwayat aspirasi
      Demam sampai 3 minggu di sertai menggigil
      Batuk produktif, berbau busuk, purulent, kuning kehijauan atau hemoptisis massif
      Dispnu
      Nyeri dada
      Merasa lemah (malese)
      Berat badan merosot

B.Tanda Penting

      Higiene mulut buruk
      Tampak sianosis
      Clubbing finger/toes (jari tabuh; jari berbentuk pemukul tambur)
      Redup pada daerah abses
      Tanda-tanda lain seperti pneumoni
      Takikardi
      Takipnu
C.Pemeriksaan                                   Laboratorium                                    -
D.Pemeriksaan Khusus

      Diagnosis dengan foto dada, tampak “air-fluid level” .
      CT Scan
      Bronkoskopi
      Aspirasi jarum transtorakal

II.KOMPLIKASI
1.Hemoptisis
2.Pneumotoraks                                atau                             piopneumotoraks
3.Metastasis                                                                              abses
4.Kerusakan                      paru                       yang                      permanen
III.PENATALAKSANAAN
A.Terapi                                                                                  Umum
1.Istirahat

      “Postural drainage” (posisinya sedemikian rupa sehingga letak abses lebih dari saluran
       napas sehingga pus dapat mengalir keluar).
      Drainase dapat juga di lakukan dengan bronkoskopi untuk menyedot sekresi bronkus
       yang kental. Disamping itu juga menepuk-nepuk bagian yang kena abses.

2.Diet
Bergizi                                                                                   tinggi
3.Medikamentosa
Obat pertama :

      Antibiotik yang sesuai
      Ampisilin 1-2 juta unit/4-6 jam
      Klindamisisn 600 mg IV/8 jam, kemudian dilanjutkan dengan per oral.

Obat alternative :

      Dapat juga di berikan bronkolidator.

4.Operasi

      Untuk abses besar
      Bila abses terletak di sebelah distal dari karsinoma bronkus atau corpus alienum
       dilakukan lobektomi.

B.Terapi                                      Komplikasi                                        -
IV.PROGNOSIS

      Dengan antimikroba yang sesuai prognosis baik.
Abses paru didefinisikan sebagai nekrosis jaringan paru dan pembentukan rongga yang berisi
puing-puing nekrotik atau cairan disebabkan oleh infeksi mikroba. The formation of multiple
small (< 2 cm) abscesses is occasionally referred to as necrotizing pneumonia or lung gangrene.
Pembentukan abses multipel kecil (<2 cm) kadang-kadang disebut sebagai nekrosis atau
gangrene paru pneumonia. Both lung abscess and necrotizing pneumonia are manifestations of a
similar pathologic process. Kedua abses paru dan pneumonia nekrosis adalah manifestasi dari
proses patologis yang serupa. Failure to recognize and treat lung abscess is associated with poor
clinical outcome. Kegagalan untuk mengenali dan mengobati abses paru dikaitkan dengan hasil
klinis yang buruk.

In the 1920s, approximately one third of patients with lung abscess died; Dr David Smith
postulated that aspiration of oral bacteria was the mechanism of infection. Pada tahun 1920,
sekitar sepertiga pasien dengan abses paru yang meninggal; Dr David Smith mendalilkan bahwa
aspirasi bakteri oral mekanisme infeksi. He observed that the bacteria found in the walls of the
lung abscesses at autopsy resembled the bacteria noted in the gingival crevice. Dia mengamati
bahwa bakteri yang ditemukan di dinding abses paru-paru di otopsi menyerupai bakteri dicatat
dalam celah gingiva. A typical lung abscess could be reproduced in animal models via an
intratracheal inoculum containing, not 1, but 4 microbes, thought to be Fusobacterium
nucleatum, Peptostreptococcus species, a fastidious gram-negative anaerobe, and, possibly,
Prevotella melaninogenicus . Abses paru-paru yang khas bisa direproduksi pada model hewan
melalui inokulum intratrakeal mengandung,, bukan 1 tapi 4 mikroba, dianggap Fusobacterium
nucleatum, spesies Peptostreptococcus, sebuah anaerob gram negatif cerewet, dan, mungkin,
Prevotella melaninogenicus.

Lung abscess was a devastating disease in the preantibiotic era, when one third of the patients
died, another one third recovered, and the remainder developed debilitating illnesses such as
recurrent abscesses, chronic empyema, bronchiectasis, or other consequences of chronic
pyogenic infections. Abses paru adalah penyakit yang menghancurkan di era preantibiotic, ketika
salah satu sepertiga dari pasien meninggal, sepertiga lainnya satu sembuh, dan sisanya
dikembangkan melemahkan penyakit seperti abses berulang, empiema kronis, bronkiektasis, atau
konsekuensi lain dari infeksi piogenik kronis. In the early postantibiotic period, sulfonamides did
not improve the outcome of patients with lung abscess until the penicillins and tetracyclines were
available. Pada periode awal postantibiotic, sulfonamida tidak meningkatkan hasil pasien dengan
abses paru sampai penisilin dan tetrasiklin yang tersedia. Although resectional surgery was often
considered a treatment option in the past, the role of surgery has greatly diminished over time
because most patients with uncomplicated lung abscess eventually respond to prolonged
antibiotic therapy. Meskipun operasi resectional sering dianggap sebagai pilihan pengobatan di
masa lalu, peran operasi telah sangat berkurang seiring waktu karena kebanyakan pasien dengan
abses paru tanpa komplikasi akhirnya menanggapi terapi antibiotik jangka panjang.

Lung abscesses can be classified based on the duration and the likely etiology. Abses paru-paru
dapat diklasifikasikan berdasarkan durasi dan kemungkinan etiologi. Acute abscesses are less
than 4-6 weeks old, whereas chronic abscesses are of longer duration. Abses akut kurang dari 4-6
minggu, sedangkan abses kronis durasi yang lebih lama. Primary abscess is infectious in origin,
caused by aspiration or pneumonia in the healthy host; secondary abscess is caused by a
preexisting condition (eg, obstruction), spread from an extrapulmonary site, bronchiectasis,
and/or an immunocompromised state. Abses primer menular pada asal, yang disebabkan oleh
aspirasi atau pneumonia di host sehat; abses sekunder disebabkan oleh kondisi yang sudah ada
(misalnya, obstruksi), menyebar dari sebuah situs luar paru, bronkiektasis, dan / atau keadaan
immunocompromised. Lung abscesses can be further characterized by the responsible pathogen,
such as Staphylococcus lung abscess and anaerobic or Aspergillus lung abscess. Abses paru-paru
dapat lebih dicirikan oleh patogen yang bertanggung jawab, seperti abses paru aureus dan abses
paru anaerob atau Aspergillus.




                               A thick-walled lung abscess. Abses paru berdinding tebal.

Paling sering, abses paru muncul sebagai komplikasi dari pneumonia aspirasi akibat bakteri
anaerob mulut. The patients who develop lung abscess are predisposed to aspiration and
commonly have periodontal disease. Para pasien yang mengalami abses paru cenderung untuk
aspirasi dan umumnya memiliki penyakit periodontal. A bacterial inoculum from the gingival
crevice reaches the lower airways, and infection is initiated because the bacteria are not cleared
by the patient's host defense mechanism. Sebuah inokulum bakteri dari celah gingiva mencapai
saluran udara lebih rendah, dan infeksi dimulai karena bakteri tidak dibersihkan oleh mekanisme
pertahanan tuan rumah pasien. This results in aspiration pneumonitis and progression to tissue
necrosis 7-14 days later, resulting in formation of lung abscess. Hal ini menyebabkan
pneumonitis aspirasi dan pengembangan menjadi nekrosis jaringan 7-14 hari kemudian, sehingga
pembentukan abses paru.

Other mechanisms for lung abscess formation include bacteremia or tricuspid valve endocarditis,
causing septic emboli (usually multiple) to the lung. Mekanisme lain untuk pembentukan abses
paru-paru termasuk endokarditis katup trikuspid bakteremia atau, menyebabkan emboli septik
(biasanya beberapa) ke paru-paru. Lemierre syndrome, an acute oropharyngeal infection
followed by septic thrombophlebitis of the internal jugular vein, is a rare cause of lung abscesses.
Lemierre sindrom, infeksi akut orofaringeal diikuti oleh thrombophlebitis septik dari vena
jugularis interna, merupakan penyebab yang jarang dari abses paru-paru. The oral anaerobe F
necrophorum is the most common pathogen. Para anaerob lisan F necrophorum adalah patogen
yang paling umum.

Microbiology Mikrobiologi

Because of the difficulty obtaining material uncontaminated by nonpathogenic bacteria
colonizing the upper airway, lung abscesses rarely have a microbiologic diagnosis. Karena
kesulitan memperoleh bahan terkontaminasi oleh bakteri non-patogen kolonial saluran udara
bagian atas, abses paru-paru jarang memiliki diagnosis mikrobiologis.
Published reports since the beginning of the antibiotic area have established that anaerobic
bacteria are the most significant pathogens in lung abscess. Laporan yang dipublikasikan sejak
awal daerah antibiotik telah menetapkan bahwa bakteri anaerob adalah patogen yang paling
signifikan dalam abses paru. In a study by Bartlett et al in 1974, 46% of patients with lung
abscesses had only anaerobes isolated from sputum cultures, while 43% of patients had a mixture
of anaerobes and aerobes. [1] The most common anaerobes are Peptostreptococcus species,
Bacteroides species, Fusobacterium species, and microaerophilic streptococci. Dalam sebuah
studi oleh Bartlett dkk pada tahun 1974, 46% pasien dengan abses paru-paru hanya anaerob yang
diisolasi dari kultur sputum, sedangkan 43% pasien memiliki campuran anaerob dan aerob. [1]
Yang anaerob yang paling umum adalah spesies Peptostreptococcus, Bacteroides spesies,
spesies Fusobacterium, dan streptokokus mikroaerofilik.

Aerobic bacteria that may infrequently cause lung abscess include Staphylococcus aureus,
Streptococcus pyogenes, Streptococcus pneumoniae (rarely), Klebsiella pneumoniae,
Haemophilus influenzae , Actinomyces species, Nocardia species, and gram-negative bacilli.
Bakteri aerobik yang jarang dapat menyebabkan abses paru-paru termasuk Staphylococcus
aureus, Streptococcus pyogenes, Streptococcus pneumoniae (jarang), Klebsiella pneumoniae,
Haemophilus influenzae, spesies Actinomyces, spesies Nocardia, dan gram-negatif bacilli.

Challenging current expert opinion, a study by Wang et al suggested that the bacteriologic
characteristics of lung abscess have changed. [2] In a series of 90 patients with community-
acquired lung abscess in Taiwan, anaerobes were recovered from just 28 patients (31%); the
predominant bacterium was K pneumoniae , in 30 patients (33%). Menantang pendapat ahli saat
ini, sebuah studi oleh Wang dkk menyarankan bahwa karakteristik bakteriologis abses paru-paru
telah berubah. [2] Dalam serangkaian 90 pasien dengan komunitas-diperoleh abses paru di
Taiwan, anaerob telah pulih dari hanya 28 pasien (31% ); bakteri dominan adalah K pneumoniae,
pada 30 pasien (33%). Another significant finding was that the rate of resistance of anaerobes
and Streptococcus milleri to clindamycin and penicillin increased compared with previous
reports. Temuan lain yang signifikan adalah bahwa tingkat resistensi dari anaerob dan
Streptococcus milleri terhadap klindamisin dan penisilin meningkat dibandingkan dengan
laporan sebelumnya.

Nonbacterial and atypical bacterial pathogens may also cause lung abscesses, usually in the
immunocompromised host. Bakteri patogen nonbakterial dan atipikal juga dapat menyebabkan
abses paru-paru, biasanya di host immunocompromised. These microorganisms include parasites
(eg, Paragonimus and Entamoeba species), fungi (eg, Aspergillus, Cryptococcus, Histoplasma,
Blastomyces, and Coccidioides species), and Mycobacterium species. Mikroorganisme ini
termasuk parasit (misalnya, Paragonimus dan spesies Entamoeba), jamur (misalnya, Aspergillus,
Cryptococcus, Histoplasma, Blastomyces, dan spesies Coccidoide), dan Mycobacterium spesies.

Previous
Next Section: EpidemiologyEpidemiologi

Epidemiology Epidemiologi
Frequency Frekuensi
United States Amerika Serikat

The frequency of lung abscess in the general population is not known. Frekuensi abses paru
dalam populasi umum belum diketahui.

Mortality/Morbidity Mortalitas / Morbiditas

Most patients with primary lung abscess improve with antibiotics, with cure rates documented at
90-95%. Kebanyakan pasien dengan abses paru primer meningkatkan dengan antibiotik, dengan
tingkat kesembuhan 90-95% didokumentasikan di.

Host factors associated with a poor prognosis include advanced age, debilitation, malnutrition,
human immunodeficiency virus infection or other forms of immunosuppression, malignancy, and
duration of symptoms greater than 8 weeks. [3] The mortality rate for patients with underlying
immunocompromised status or bronchial obstruction who develop lung abscess may be as high
as 75%. [4] Tuan faktor yang terkait dengan prognosis yang buruk meliputi usia lanjut,
kekurangan tenaga, kekurangan gizi, infeksi virus human immunodeficiency atau bentuk lain
imunosupresi, keganasan, dan durasi gejala lebih dari 8 minggu. [3] Tingkat kematian pasien
dengan status immunocompromised mendasar atau bronkial obstruksi yang mengembangkan
abses paru dapat setinggi 75%. [4]

Aerobic organisms, frequently hospital acquired, are associated with poor outcomes. Organisme
aerobik, sering didapat di rumah sakit, berhubungan dengan hasil yang buruk. A retrospective
study reported the overall mortality rate of lung abscesses caused by mixed gram-positive and
gram-negative bacteria at approximately 20%. [5] Sebuah studi retrospektif melaporkan tingkat
kematian keseluruhan abses paru-paru yang disebabkan oleh bakteri gram positif dan gram-
negatif dicampur pada sekitar 20%. [5]

Sex Seks

A male predominance for lung abscess is reported in published case series. Sebuah dominasi
laki-laki untuk abses paru-paru dilaporkan dalam seri kasus yang sudah dipublikasikan.

Age Umur

Lung abscesses likely occur more commonly in elderly patients because of the increased
incidence of periodontal disease and the increased prevalence of dysphagia and aspiration. Abses
paru-paru mungkin terjadi lebih umum pada pasien usia lanjut karena peningkatan insiden
penyakit periodontal dan peningkatan prevalensi disfagia dan aspirasi. However, a case series
from an urban center with high prevalence of alcoholism reported a mean age of 41 years. [6]
Namun, serangkaian kasus dari pusat perkotaan dengan prevalensi tinggi alkoholisme
melaporkan usia rata-rata 41 tahun. [6]

Previous
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Contributor Information and Disclosures Kontributor Informasi dan Pengungkapan
Author Penulis

Nader Kamangar, MD, FACP, FCCP, FCCM Associate Professor of Medicine, Division of
Pulmonary, Critical Care and Sleep Medicine, University of California, Los Angeles, David
Geffen School of Medicine, Olive View-UCLA Medical Center; Associate Program Director,
Pulmonary and Critical Care Multi-Campus Fellowship Program, Cedars-Sinai/West Los
Angeles Veterans Affairs/Los Angeles Kaiser Permanente/Olive View-UCLA Medical Center;
Site Director, Pulmonary/Critical Care Fellowship Program, Olive View-UCLA Medical Center
Nader Kamangar, MD, FACP, FCCP, FCCM Associate Professor of Medicine, Divisi paru,
Perawatan Kritis dan Sleep Medicine, University of California, Los Angeles, David Geffen
School of Medicine, Olive View-UCLA Medical Center; Direktur Program Associate, paru dan
Kritis Perawatan Multi-Kampus Fellowship Program, Cedars-Sinai/West Los Angeles Veterans
Affairs / Los Angeles Kaiser Permanente / Olive View-UCLA Medical Center, Direktur Situs,
paru / Perawatan Kritis Fellowship Program, Olive View-UCLA Medical Center
Nader Kamangar, MD, FACP, FCCP, FCCM is a member of the following medical societies:
American Academy of Sleep Medicine , American Association of Bronchology , American
College of Chest Physicians , American College of Physicians , American Lung Association ,
American Medical Association , American Thoracic Society , California Thoracic Society , and
Society of Critical Care Medicine Nader Kamangar, MD, FACP, FCCP, FCCM adalah anggota
dari masyarakat medis berikut: American Academy of Sleep Medicine , Amerika Asosiasi
Bronchology , American College of Chest Physicians , American College of Physicians ,
American Lung Association , American Medical Association , Amerika Masyarakat Thoracic ,
Masyarakat Thoracic California , dan Masyarakat Kedokteran Critical Care
Disclosure: Nothing to disclose. Pengungkapan: Tidak ada yang mengungkapkan.

Coauthor(s) Rekan penulis (s)

Curtis C Sather, MD Fellow, Divison of Pulmonary/Critical Care Medicine, Cedars-Sinai
Medical Center Curtis C Sather, MD Fellow, Divisi Care Medicine paru / Kritis, Cedars-Sinai
Medical Center
Curtis C Sather, MD is a member of the following medical societies: American College of Chest
Physicians , American College of Physicians , American Medical Association , and American
Thoracic Society Curtis C Sather, MD adalah anggota dari masyarakat medis berikut: American
College of Chest Physicians , American College of Physicians , American Medical Association ,
dan American Thoracic Society
Disclosure: Nothing to disclose. Pengungkapan: Tidak ada yang mengungkapkan.

Sat Sharma, MD, FRCPC Professor and Head, Division of Pulmonary Medicine, Department
of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface
General Hospital Sat Sharma, MD, Profesor dan Kepala FRCPC, Divisi Kedokteran paru,
Departemen of Internal Medicine, University of Manitoba, Situs Direktur, Kedokteran Respirasi,
St Bonifasius Rumah Sakit Umum
Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of
Sleep Medicine , American College of Chest Physicians , American College of Physicians-
American Society of Internal Medicine , American Thoracic Society , Canadian Medical
Association , Royal College of Physicians and Surgeons of Canada , Royal Society of Medicine ,
Society of Critical Care Medicine , and World Medical Association Sat Sharma, MD, FRCPC
adalah anggota dari masyarakat medis berikut: American Academy of Sleep Medicine ,
American College of Chest Physicians , American College of Physicians-American Society of
Internal Medicine , American Thoracic Society , Canadian Medical Association , Royal College
of Physicians dan ahli bedah Kanada , Royal Society of Medicine , Masyarakat Kedokteran
Critical Care , dan Asosiasi Medis Dunia
Disclosure: Nothing to disclose. Pengungkapan: Tidak ada yang mengungkapkan.

Specialty Editor Board Khusus Dewan Editor

Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP Professor of Genomics and
Personalized Medicine Research, Internal Medicine, and Pediatrics, Associate Director, Center
for Genomics and Personalized Medicine Research, Director of Research, Section on Pulmonary,
Critical Care, Allergy and Immunologic Diseases, Wake Forest University School of Medicine
Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP Profesor Riset Kedokteran
Genomics dan Personalized, Internal Medicine, dan Pediatrics, Direktur Associate, Pusat
Genomics dan Penelitian Kedokteran Personalized, Direktur Riset, Bagian pada paru, Perawatan
Kritis , Alergi dan Penyakit imunologi, Wake Forest University School of Medicine
Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP is a member of the following
medical societies: American Academy of Allergy Asthma and Immunology , American
Association of Immunologists , American College of Chest Physicians , American College of
Physicians , American Federation for Medical Research , American Thoracic Society , and
Sigma Xi Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP adalah anggota dari
masyarakat medis berikut: American Academy of Allergy Asma dan Imunologi , Amerika
Asosiasi Immunologists , American College of Chest Physicians , American College of
Physicians , Amerika Federasi untuk Penelitian Medis , American Thoracic Society , dan Sigma
Xi
Disclosure: See below for list of all activities None None Pengungkapan: Lihat di bawah untuk
daftar semua Tidak ada Tidak ada kegiatan

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska
Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Francisco
Talavera, PharmD, PhD Ajun Asisten Profesor, University of Nebraska Medical Center
College of Pharmacy, Editor-in-Chief, Medscape Referensi Obat
Disclosure: Medscape Salary Employment Pengungkapan: Medscape Gaji Pekerjaan

Timothy D Rice, MD Associate Professor, Departments of Internal Medicine and Pediatrics and
Adolescent Medicine, St Louis University School of Medicine Timotius D Rice, MD Associate
Profesor, Departemen of Internal Medicine dan Pediatrics and Adolescent Medicine, St Louis
University School of Medicine
Timothy D Rice, MD is a member of the following medical societies: American Academy of
Pediatrics and American College of Physicians Timotius D Beras, MD adalah anggota dari
masyarakat medis berikut: American Academy of Pediatrics dan American College of Physicians
Disclosure: Nothing to disclose. Pengungkapan: Tidak ada yang mengungkapkan.
Chief Editor Pemimpin Redaksi

Zab Mosenifar, MD Director, Division of Pulmonary and Critical Care Medicine, Director,
Women's Guild Pulmonary Disease Institute, Professor and Executive Vice Chair, Department of
Medicine, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen
School of Medicine Zab Mosenifar, MD Direktur, Divisi Kedokteran Paru dan Critical Care,
Direktur, Wanita Persekutuan paru Penyakit Institute, Profesor dan Wakil Ketua Eksekutif,
Departemen Kedokteran, Cedars Sinai Medical Center, Universitas California, Los Angeles,
David Geffen School of Medicine
Zab Mosenifar, MD is a member of the following medical societies: American College of Chest
Physicians , American College of Physicians , American Federation for Medical Research , and
American Thoracic Society Zab Mosenifar, MD adalah anggota dari masyarakat medis berikut:
American College of Chest Physicians , American College of Physicians , Federasi Amerika
untuk Penelitian Medis , dan American Thoracic Society
Disclosure: Nothing to disclose. Pengungkapan: Tidak ada yang mengungkapkan.

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References Referensi

   1. Bartlett JG, Finegold SM. Bartlett JG, Finegold SM. Anaerobic infections of the lung and
      pleural space. Am Rev Respir Dis . Infeksi anaerobik dari paru-paru dan rongga pleura.
      Am Rev Respir Dis. Jul 1974;110(1):56-77. [Medline] . Jul 1974; 110 (1) :56-77.
      [Medline] .
   2. Wang JL, Chen KY, Fang CT, Hsueh PR, Yang PC, Chang SC. JL wang, KY Chen, Fang
      CT, Hsueh PR, Yang PC, Chang SC. Changing bacteriology of adult community-
      acquired lung abscess in Taiwan: Klebsiella pneumoniae versus anaerobes. Clin Infect
      Dis . Bakteriologi Mengubah orang dewasa masyarakat diperoleh abses paru di Taiwan:.
      Klebsiella pneumoniae dibandingkan anaerob Clin Menginfeksi Dis. Apr 1
      2005;40(7):915-22. [Medline] . 1 April 2005; 40 (7) :915-22. [Medline] .
   3. Mwandumba HC, Beeching NJ. Mwandumba HC, Beeching NJ. Pyogenic lung
      infections: factors for predicting clinical outcome of lung abscess and thoracic empyema.
      Curr Opin Pulm Med . Piogenik paru-paru infeksi: faktor untuk memprediksi hasil klinis
      abses paru dan empiema toraks Curr Opin Pulm Med.. May 2000;6(3):234-9. [Medline] .
      Mei 2000; 6 (3) :234-9. [Medline] .
   4. Pohlson EC, McNamara JJ, Char C, Kurata L. Lung abscess: a changing pattern of the
      disease. Am J Surg . Pohlson EC, McNamara JJ, Char C, Kurata L. abses paru-paru:. Pola
      perubahan penyakit Am J Surg. Jul 1985;150(1):97-101. [Medline] . Jul 1985;. 150 (1)
      :97-101 [Medline] .
   5. Hirshberg B, Sklair-Levi M, Nir-Paz R, Ben-Sira L, Krivoruk V, Kramer MR. Hirshberg
      B, Sklair-Levi M, Nir-Paz R, Ben-Sira L, Krivoruk V, Kramer MR. Factors predicting
      mortality of patients with lung abscess. Chest . Faktor yang memprediksi kematian pasien
      dengan abses paru. Chest. Mar 1999;115(3):746-50. [Medline] . Mar 1999; 115 (3) :746-
      50. [Medline] .
   6. Moreira Jda S, Camargo Jde J, Felicetti JC, Goldenfun PR, Moreira AL, Porto Nda S.
      Lung abscess: analysis of 252 consecutive cases diagnosed between 1968 and 2004. J
      Bras Pneumol . Moreira JDA S, Camargo JDE J, Felicetti JC, Goldenfun PR, Moreira
    AL, Porto NDA S. abses paru-paru: analisis 252 kasus didiagnosis berturut-turut antara
    1968 dan 2004 J Bras Pneumol.. Mar-Apr 2006;32(2):136-43. [Medline] . Mar-Apr
    2006; 32 (2) :136-43. [Medline] .
7. Stark DD, Federle MP, Goodman PC, Podrasky AE, Webb WR. Stark DD, Federle MP,
    Goodman PC, Podrasky AE, Webb WR. Differentiating lung abscess and empyema:
    radiography and computed tomography. AJR Am J Roentgenol . Membedakan abses paru
    dan empiema:. Radiografi dan computed tomography AJR Am J Roentgenol. Jul
    1983;141(1):163-7. [Medline] . Jul 1983; 141 (1) :163-7. [Medline] .
8. Williford ME, Godwin JD. Williford ME, Godwin JD. Computed tomography of lung
    abscess and empyema. Radiol Clin North Am . Computed tomography abses paru dan
    empiema Radiol Clin Utara Am.. Sep 1983;21(3):575-83. [Medline] . Sep 1983; 21 (3)
    :575-83. [Medline] .
9. Bouhemad B, Zhang M, Lu Q, Rouby JJ. Bouhemad B, Zhang M, Lu Q, Rouby JJ.
    Clinical review: Bedside lung ultrasound in critical care practice. Crit Care . Tinjauan
    Klinis: Bedside paru-paru USG dalam praktek perawatan kritis Perawatan Crit..
    2007;11(1):205. [Medline] . 2007; 11 (1): 205. [Medline] .
10. Bartlett JG. Bartlett JG. Anaerobic bacterial infections of the lung. Chest . Anaerobik
    bakteri infeksi paru-paru. Chest. Jun 1987;91(6):901-9. [Medline] . Jun 1987; 91 (6)
    :901-9. [Medline] .
11. Sosenko A, Glassroth J. Fiberoptic bronchoscopy in the evaluation of lung abscesses.
    Chest . Sosenko A, bronkoskopi serat optik J. Glassroth dalam evaluasi abses paru-paru.
    Chest. Apr 1985;87(4):489-94. [Medline] . Apr 1985; 87 (4) :489-94. [Medline] .
12. [Guideline] Tice AD, Rehm SJ, Dalovisio JR, et al. [Pedoman] Tice AD, Rehm SJ,
    Dalovisio JR, dkk. Practice guidelines for outpatient parenteral antimicrobial therapy.
    Praktek pedoman untuk terapi rawat jalan antimikroba parenteral. IDSA guidelines. Clin
    Infect Dis . IDSA pedoman. Clin Menginfeksi Dis. Jun 15 2004;38(12):1651-72.
    [Medline] . 15 Juni 2004; 38 (12) :1651-72. [Medline] .
13. Appelbaum PC, Spangler SK, Jacobs MR. Appelbaum PC, Spangler SK, Jacobs MR.
    Beta-lactamase production and susceptibilities to amoxicillin, amoxicillin-clavulanate,
    ticarcillin, ticarcillin-clavulanate, cefoxitin, imipenem, and metronidazole of 320 non-
    Bacteroides fragilis Bacteroides isolates and 129 fusobacteria from 28 US centers.
    Antimicrob Agents Chemother . Beta-laktamase produksi dan kerentanan terhadap
    amoksisilin, amoksisilin-klavulanat, tikarsilin, tikarsilin-klavulanat, Cefoxitin, imipenem,
    dan metronidazol dari 320 non-Bacteroides fragilis dan Bacteroides isolat 129
    fusobacteria dari 28 pusat AS. Antimicrob Chemother Agen. Aug 1990;34(8):1546-50.
    [Medline] . Agustus 1990; 34 (8) :1546-50. [Medline] .
14. Perlino CA. Perlino CA. Metronidazole vs clindamycin treatment of anerobic pulmonary
    infection. Metronidazol vs klindamisin pengobatan infeksi paru anerobic. Failure of
    metronidazole therapy. Arch Intern Med . Kegagalan terapi metronidazol. Intern Med
    Arch. Oct 1981;141(11):1424-7. [Medline] . Oktober 1981; 141 (11) :1424-7. [Medline] .
15. Sanders CV, Hanna BJ, Lewis AC. Sanders CV, Hanna BJ, Lewis AC. Metronidazole in
    the treatment of anaerobic infections. Am Rev Respir Dis . Metronidazol dalam
    pengobatan infeksi anaerobik Am Rev Respir Dis.. Aug 1979;120(2):337-43. [Medline] .
    Agustus 1979; 120 (2) :337-43. [Medline] .
16. Allewelt M, Schuler P, Bolcskei PL, Mauch H, Lode H. Ampicillin + sulbactam vs
    clindamycin +/- cephalosporin for the treatment of aspiration pneumonia and primary
    lung abscess. Clin Microbiol Infect . Allewelt M, Schuler P, Bolcskei PL, Mauch H, Lode
    H. Ampisilin + sulbactam vs klindamisin + / -. Sefalosporin untuk pengobatan
    pneumonia aspirasi dan abses paru primer Clin Microbiol Menginfeksi. Feb
    2004;10(2):163-70. [Medline] . Feb 2004; 10 (2) :163-70. [Medline] .
17. Ott SR, Allewelt M, Lorenz J, Reimnitz P, Lode H. Moxifloxacin vs
    ampicillin/sulbactam in aspiration pneumonia and primary lung abscess. Infection . Ott
    SR, Allewelt M, Lorenz J, Reimnitz P, Lode H. moksifloksasin vs ampisilin / sulbactam
    di pneumonia aspirasi dan abses paru primer. Infeksi. Feb 2008;36(1):23-30. [Medline] .
    Feb 2008; 36 (1) :23-30. [Medline] .
18. Herth F, Ernst A, Becker HD. Herth F, Ernst A, Becker HD. Endoscopic drainage of lung
    abscesses: technique and outcome. Chest . Endoskopi drainase abses paru-paru:. Teknik
    dan hasil Dada. Apr 2005;127(4):1378-81. [Medline] . Apr 2005; 127 (4) :1378-81.
    [Medline] .
19. Bandt PD, Blank N, Castellino RA. Bandt PD, Blank N, Castellino RA. Needle diagnosis
    of pneumonitis. Needle diagnosis pneumonitis. Value in high-risk patients. JAMA . Nilai
    dalam pasien berisiko tinggi. JAMA. Jun 19 1972;220(12):1578-80. [Medline] . 19 Juni
    1972; 220 (12) :1578-80. [Medline] .
20. Bartlett JG. Bartlett JG. HIV infection and surgeons. Curr Probl Surg . Infeksi HIV dan
    ahli bedah. Curr Probl Surg. Apr 1992;29(4):197-280. [Medline] . Apr 1992; 29 (4) :197-
    280. [Medline] .
21. Bartlett JG, Gorbach SL, Tally FP, Finegold SM. Bartlett JG, Gorbach SL, Tally FP,
    Finegold SM. Bacteriology and treatment of primary lung abscess. Am Rev Respir Dis .
    Bakteriologi dan pengobatan abses paru primer. Am Rev Respir Dis. May
    1974;109(5):510-8. [Medline] . Mei 1974; 109 (5) :510-8. [Medline] .
22. Chung G, Goetz MB. Chung G, Goetz MB. Anaerobic Infections of the Lung. Curr Infect
    Dis Rep . Jun 2000;2(3):238-244. [Medline] . . Infeksi anaerobik dari Curr Lung Dis
    Menginfeksi Rep Jun 2000;. 2 (3) :238-244. [Medline] .
23. Finegold SM, George WL, Mulligan ME. Finegold SM, George WL, ME Mulligan.
    Anaerobic infections. Infeksi anaerobik. Part II. Dis Mon . Bagian II. Dis Mon. Nov
    1985;31(11):1-97. [Medline] . Nov 1985; 31 (11) :1-97. [Medline] .
24. Finegold SM, Rolfe RD. Finegold SM, Rolfe RD. Susceptibility testing of anaerobic
    bacteria. Diagn Microbiol Infect Dis . Kerentanan pengujian bakteri anaerob. Diagn
    Microbiol Menginfeksi Dis. Mar 1983;1(1):33-40. [Medline] . Mar 1983; 1 (1) :33-40.
    [Medline] .
25. Howe C, Sampath A, Spotnitz M. The pseudomallei group: a review. J Infect Dis . Howe
    C, Sampath A, Spotnitz M. Kelompok pseudomallei:. Tinjauan J Menginfeksi Dis. Dec
    1971;124(6):598-606. [Medline] . Desember 1971; 124 (6) :598-606. [Medline] .
26. La Scola B, Michel G, Raoult D. Isolation of Legionella pneumophila by centrifugation
    of shell vial cell cultures from multiple liver and lung abscesses. J Clin Microbiol . La
    Scola B, Michel G, Raoult D. Isolasi Legionella pneumophila oleh sentrifugasi kultur sel
    botol shell dari beberapa hati dan abses paru. J Clin Microbiol. Mar 1999;37(3):785-7.
    [Medline] . Mar 1999; 37 (3) :785-7. [Medline] .
27. Mansharamani N, Balachandran D, Delaney D, Zibrak JD, Silvestri RC, Koziel H. Lung
    abscess in adults: clinical comparison of immunocompromised to non-
    immunocompromised patients. Respir Med . Mansharamani N, Balachandran D, Delaney
    D, Zibrak JD, Silvestri RC, Koziel H. abses paru-paru pada orang dewasa: perbandingan
       klinis Respir Med immunocompromised non-immunocompromised pasien.. Mar
       2002;96(3):178-85. [Medline] . Mar 2002; 96 (3) :178-85. [Medline] .
   28. Mansharamani NG, Koziel H. Chronic lung sepsis: lung abscess, bronchiectasis, and
       empyema. Curr Opin Pulm Med . Mansharamani NG, Koziel H. paru kronis sepsis: abses
       paru, bronkiektasis, dan empiema Curr Opin Pulm Med.. May 2003;9(3):181-5.
       [Medline] . Mei 2003; 9 (3) :181-5. [Medline] .
   29. Narushima M, Suzuki H, Kasai T, et al. Narushima M, Suzuki H, Kasai T, et al.
       Pulmonary nocardiosis in a patient treated with corticosteroid therapy. Respirology .
       Nocardiosis paru pada pasien yang diobati dengan terapi kortikosteroid. Respirology. Mar
       2002;7(1):87-9. [Medline] . Mar 2002; 7 (1) :87-9. [Medline] .
   30. Senecal JL, St-Antoine P, Beliveau C. Legionella pneumophila lung abscess in a patient
       with systemic lupus erythematosus. Am J Med Sci . Senecal JL, St-Antoine P, Beliveau
       C. Legionella pneumophila abses paru-paru pada pasien dengan lupus eritematosus
       sistemik. Am J Med Sci. May 1987;293(5):309-14. [Medline] . Mei 1987; 293 (5) :309-
       14. [Medline] .
   31. Weissberg D. Percutaneous drainage of lung abscess. J Thorac Cardiovasc Surg .
       Weissberg D. perkutan drainase abses paru. J Thorac Cardiovasc Surg. Feb
       1984;87(2):308-12. [Medline] . Feb 1984; 87 (2) :308-12. [Medline] .




Histology of a lung abscess shows dense inflammatory reaction (low power). Histologi dari
abses paru menunjukkan reaksi inflamasi padat (daya rendah).
A thick-walled lung abscess. Abses paru berdinding tebal.
Pneumococcal pneumonia complicated by lung necrosis and abscess formation. Pneumonia
pneumokokus rumit oleh nekrosis paru-paru dan pembentukan abses.
A lateral chest radiograph shows air-fluid level characteristic of lung abscess. Sebuah rontgen
dada lateral yang menunjukkan udara-cairan karakteristik tingkat abses paru.
A 54-year-old patient developed cough with foul-smelling sputum production. Seorang pasien 54
tahun dikembangkan batuk dengan berbau produksi sputum. A chest radiograph shows lung
abscess in the left lower lobe, superior segment. Sebuah rontgen dada menunjukkan abses paru di
lobus kiri bawah, segmen unggul.
A 42-year-old man developed fever and production of foul-smelling sputum. Seorang pria 42-
tahun dikembangkan demam dan produksi dahak yang berbau busuk. He had a history of heavy
alcohol use, and poor dentition was obvious on physical examination. Dia memiliki riwayat
penggunaan alkohol berat, dan gigi yang buruk jelas pada pemeriksaan fisik. Chest radiograph
shows lung abscess in the posterior segment of the right upper lobe. Rontgen dada menunjukkan
abses paru di segmen posterior dari lobus kanan atas.
A 42-year-old man developed fever and production of foul-smelling sputum. Seorang pria 42-
tahun dikembangkan demam dan produksi dahak yang berbau busuk. He had a history of heavy
alcohol use, and poor dentition was obvious on physical examination. Dia memiliki riwayat
penggunaan alkohol berat, dan gigi yang buruk jelas pada pemeriksaan fisik. Lung abscess in the
posterior segment of the right upper lobe was demonstrated on chest radiograph. Abses paru-paru
di segmen posterior dari lobus kanan atas ditunjukkan pada radiografi dada. CT scan shows a
thin-walled cavity with surrounding consolidation. CT scan menunjukkan rongga berdinding
tipis dengan konsolidasi sekitarnya.
Chest radiograph of a patient who had foul-smelling and bad-tasting sputum, an almost
diagnostic feature of anaerobic lung abscess. Dada radiograf seorang pasien yang telah dahak
yang berbau busuk dan buruk-mencicipi, sebuah fitur yang hampir diagnostik abses paru
anaerobik.
Histology of a lung abscess shows dense inflammatory reaction (high power). Histologi dari
abses paru menunjukkan reaksi inflamasi padat (daya tinggi).
[ CLOSE WINDOW ] [ TUTUP WINDOW ]
[ CLOSE WINDOW ] [ TUTUP WINDOW ]
Read more about Lung Abscess on Medscape

Amerika Serikat

The frequency of lung abscess in the general population is not known. Frekuensi abses paru
dalam populasi umum belum diketahui.

Mortality/Morbidity Mortalitas / Morbiditas

Most patients with primary lung abscess improve with antibiotics, with cure rates documented at
90-95%. Kebanyakan pasien dengan abses paru primer meningkatkan dengan antibiotik, dengan
tingkat kesembuhan 90-95% didokumentasikan di.

Host factors associated with a poor prognosis include advanced age, debilitation, malnutrition,
human immunodeficiency virus infection or other forms of immunosuppression, malignancy, and
duration of symptoms greater than 8 weeks. [3] The mortality rate for patients with underlying
immunocompromised status or bronchial obstruction who develop lung abscess may be as high
as 75%. [4] Tuan faktor yang terkait dengan prognosis yang buruk meliputi usia lanjut,
kekurangan tenaga, kekurangan gizi, infeksi virus human immunodeficiency atau bentuk lain
imunosupresi, keganasan, dan durasi gejala lebih dari 8 minggu. [3] Tingkat kematian pasien
dengan status immunocompromised mendasar atau bronkial obstruksi yang mengembangkan
abses paru dapat setinggi 75%. [4]

Aerobic organisms, frequently hospital acquired, are associated with poor outcomes. Organisme
aerobik, sering didapat di rumah sakit, berhubungan dengan hasil yang buruk. A retrospective
study reported the overall mortality rate of lung abscesses caused by mixed gram-positive and
gram-negative bacteria at approximately 20%. [5] Sebuah studi retrospektif melaporkan tingkat
kematian keseluruhan abses paru-paru yang disebabkan oleh bakteri gram positif dan gram-
negatif dicampur pada sekitar 20%. [5]

Sex Seks

A male predominance for lung abscess is reported in published case series. Sebuah dominasi
laki-laki untuk abses paru-paru dilaporkan dalam seri kasus yang sudah dipublikasikan.

Age Umur
Lung abscesses likely occur more commonly in elderly patients because of the increased
incidence of periodontal disease and the increased prevalence of dysphagia and aspiration. Abses
paru-paru mungkin terjadi lebih umum pada pasien usia lanjut karena peningkatan insiden
penyakit periodontal dan peningkatan prevalensi disfagia dan aspirasi. However, a case series
from an urban center with high prevalence of alcoholism reported a mean age of 41 years. [6]
Namun, serangkaian kasus dari pusat perkotaan dengan prevalensi tinggi alkoholisme
melaporkan usia rata-rata 41 tahun. [6]

								
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