Tuberc Respir Dis.  2011 Dec;71(6):438-444.

Analysis of Lung Parenchymal Sequelae Following Treatment for Lung Abscess

• Lee JY
• Koo SM
• Park KA
• Seo YR
• Kim SH
• Kim YK
• Kim KU
• Hwang JH
• Uh ST

Abstract

BACKGROUND
Lung abscess is necrosis of the pulmonary parenchyma caused by microbial infection. At present, clinical outcomes after treatment are good. However, the pulmonary parenchymal changes on the chest computed tomography (CT) after treatment are not well known. We studied the changes of pulmonary parenchyma on plane chest radiography and chest CT in patients with lung abscess following the administration of antibiotics.
METHODS
We retrospectively reviewed 39 patients who had lung abscess with or without combined pneumonia from January 2006 to July 2010. We studied the therapeutic response in plane chest radiography of them at 1, 2, or more than 3 months following treatment. If any chest CT of them during the study period, we reviewed.
RESULTS
Mean age of the patients was about 61.3+/-11.2. Mean duration of antibiotics administration was about 36.7+/-26.8 days. After 3 months of following plane chest radiography, 10 patients (36%) showed without residual sequelae among 28 patients. Findings from other patients showed decrease in densities (11 patients, 39%), fibrostreaky sequelae (4 patients, 14%) and bullae (3 patients, 10%). After more than 2 months, chest CT was checked only in 7 patients. Among the 7 patients, 4 patients showed no residual lesion, 3 patients showed decreased densities on plane chest radiography. Chest CT revealed fibrostreaky densities in 2 patients, ground glass opacities in 3 patients, bullous formation in 1 patient, and cystic bronchiectasis in 1 patient.
CONCLUSION
After more than 2 months following treatment for lung abscess even though there were no lesions on plane chest radiography, chest CT showed fibrostreaky or ground glass opacity.

Keyword

Lung Abscess; complications; Radiography, Thoracic; Tomography, X-Ray Computed; Cicatrix

MeSH Terms

Anti-Bacterial Agents
Blister
Bronchiectasis
Cicatrix
Glass
Humans
Lung
Lung Abscess
Necrosis
Pneumonia
Radiography, Thoracic
Retrospective Studies
Thorax
Tomography, X-Ray Computed
Anti-Bacterial Agents

Figure

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  Figure 1 Chest radiography and chest CT during diagnosis and more than 2 months after treatments. (A, C) In a 67-year-old man patchy airspace consolidation in the superior segment of RLL was detected and confirmed lung abscess by chest CT. (B, D) Fifteen months later, the lesion is resolved except for the fibrosteaky density. CT: computed tomography.

• 

  Figure 2 (A, C) In a 64-year-old man with underlying lung cancer in the LUL, segmental air space consoilidation with irregular cavitation is noted in the superior segment of the LLL which is associated with mild adjacent fissural bulging contour. (B, D) Two months later, previous lesion in LLL is improved with a mild residual scar and a pneumatocele. LUL: left upper lobe; LLL: left lower lobe.

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  Figure 3 (A) In a 52-year-old man Segmental air space consolidation with peripheral ground glass attenuation is noted in the superior segment of the LLL and lesser extent in the posterior segment of LLL with mild lung volume expansion. (B) Two months later, there is a decrease in the extent of segmental air space consolidation with peripheral ground glass attenuation in previous area. (C) Irregular shaped low density necrotic areas and multiple cavities were noted within the consolidations. (D) But irregular shaped multiple cavities are increased within the consolidations. Newly appeared cicatricial bronchiolectasis and bronchiectasis is seen. LLL: left lower lobe.

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