The Experts below are selected from a list of 261 Experts worldwide ranked by ideXlab platform
Neil A. Ettinger - One of the best experts on this subject based on the ideXlab platform.
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Nephrobronchial Fistula and Lung Abscess Resulting From Nephrolithiasis and Pyelonephritis
Chest, 1995Co-Authors: Jeana D. O'brien, Neil A. EttingerAbstract:There are multiple etiologies reported as causes of Lung Abscess; however, this differential rarely includes intra-abdominal abnormalities other than extension of a hepatic process. We describe a patient who was found to have a Lung Abscess and empyema resulting from the development of a nephrobronchial fistula secondary to nephrolithiasis and pyelonephritis. The patient had no urinary symptoms or known abdominopelvic infection and the etiology of Lung Abscess was only incidentally discovered after chest CT revealed extension of pleural fluid below the diaphragm.
Pan-chyr Yang - One of the best experts on this subject based on the ideXlab platform.
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changing bacteriology of adult community acquired Lung Abscess in taiwan klebsiella pneumoniae versus anaerobes
Clinical Infectious Diseases, 2005Co-Authors: Jiunling Wang, Pan-chyr Yang, Kuanyu Chen, Chitai Fang, Poren Hsueh, Shanchwen ChangAbstract:Background. Most literature regarding Lung Abscess focuses on anaerobic bacterial Lung Abscess, and aerobic gram-negative bacillary infection is less frequently discussed. This study was conducted to investigate the bacteriology of community-acquired Lung Abscess and to improve the empirical therapeutic strategy for adults with community-acquired Lung Abscess. Methods. We reviewed and analyzed data on 90 consecutive adult cases of bacteriologically confirmed community-acquired Lung Abscess treated during 1995‐2003 at a tertiary university hospital in Taiwan. Results. We found that a high proportion (21%) of cases of Lung Abscess were due to Klebsiella pneumoniae infection, which differs from the findings of previous studies. Lung Abscess due to K. pneumoniae was associated with underlying diabetes mellitus (odds ratio [OR], 4.3; 95% confidence interval [CI], 1.0‐18.4; ) and P p .039 negatively correlated with a time from onset of symptoms to diagnosis of 130 days (OR, 0.2; 95% CI, 0.1‐0.7; ). A higher percentage of patients with K. pneumoniae Lung Abscess had concomitant bacteremia (OR, P p .008 9.4; 95% CI, 1.1‐81.9; ), delayed defervesence (OR, 9.2; 95% CI, 1.8‐47.8; ), and multiple cavities P p .032 P p .004 noted on radiographs (OR, 11.0; 95% CI, 1.3‐94.9; ), compared with patients with anaerobic bacterial P p .015 Lung Abscess. The rate of nonsusceptibility to clindamycin and penicillin among anaerobes and Streptococcus milleri group isolates increased. Conclusion. K. pneumoniae has become a more common cause of Lung Abscess than before, and a high proportion of anaerobes and S. milleri strains have become resistant to penicillin and clindamycin. A b-lactam/ b-lactamase inhibitor or second- or third-generation cephalosporin with clindamycin or metronidazole is suggested as empirical antibiotic therapy for community-acquired Lung Abscess.
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empyema thoracis and Lung Abscess caused by viridans streptococci
American Journal of Respiratory and Critical Care Medicine, 1997Co-Authors: Jihshuin Jerng, Pan-chyr Yang, Li-na Lee, Poren Hsueh, Leejene Teng, Kwentay LuhAbstract:We retrospectively studied the bacteriology and clinical features of empyema thoracis and Lung Abscess caused by viridans streptococci in 72 patients seen from January 1984 to September 1996. A total of 76 strains of viridans streptococci were isolated, of which the most common isolates were Streptococcus constellatus (21 strains), S. intermedius (17), and S. sanguis (10). Species belonging to the S. milleri group accounted for the majority (68%) of isolates. In 38 (53%) patients these organisms were recognized as the sole pathogens. Of the 72 patients, 53 had empyema, 14 had Lung Abscesses, and five had both empyema and Lung Abscess. Forty-six (64%) patients had underlying diseases. Of these, malignancies were the most common (17 patients), followed by diabetes mellitus (12 patients) and central nervous system diseases (10 patients). Of the 48 patients who underwent chest-tube drainage, 27 (56%) received further treatments, including intrapleural streptokinase (18 cases), surgery (9), and both intrapleural streptokinase and surgery (3). Two (14%) of the patients with Lung Abscess alone underwent surgical treatment. Although all viridans streptococcal isolates were susceptible to penicillin, the patients in the study had a high mortality (21%). Univariate and multivariate analysis of data for patients with empyema alone (n = 53) showed a significantly increased risk of death in those with underlying malignancy (OR = 16.0, p = 0.023) and those with non-S. milleri-group isolates (OR = 3.72, p = 0.030). These data imply a strong clinical significance of viridans streptococci in the pathogenesis of empyema and Lung Abscess, as well as the need for species identification of viridans streptococci in patients with pleuropulmonary diseases.
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Differentiation of Lung Abscess and empyema by ultrasonography.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1991Co-Authors: Pan-chyr Yang, Li-na LeeAbstract:To assess the value of chest ultrasonography in the differentiation between a Lung Abscess and empyema, 50 patients, including 24 cases of Lung Abscess and 26 cases of empyema, were studied. The ultrasonographic characteristics of a Lung Abscess included an irregular wall width, a blurred outer margin, an oval or round shape, an acute chest wall angle and a negative pleural separation. The ultrasonographic characteristics of empyema were an uniform wall width, a sharp outer margin, a lenticular shape, an obtuse chest wall angle and a positive pleural separation. A new ultrasonographic scoring system was proposed; a positive finding for each of the features: sharp outer margin, lenticular shape, obtuse chest wall angle and positive pleural separation was assigned a score of 1, while a negative finding was assigned a score of zero. The total scores for the four features were then assessed. Ninety-six percent of the empyema cases scored 2 or more, while 96% of the Lung Abscess cases scored 1 or zero. The efficacy of differential diagnosis was 96%. We conclude that chest ultrasonography is a useful tool in the differentiation between Lung Abscess and empyema and that ultrasonography alone is sufficient to make a correct diagnosis in most cases.
Li-na Lee - One of the best experts on this subject based on the ideXlab platform.
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empyema thoracis and Lung Abscess caused by viridans streptococci
American Journal of Respiratory and Critical Care Medicine, 1997Co-Authors: Jihshuin Jerng, Pan-chyr Yang, Li-na Lee, Poren Hsueh, Leejene Teng, Kwentay LuhAbstract:We retrospectively studied the bacteriology and clinical features of empyema thoracis and Lung Abscess caused by viridans streptococci in 72 patients seen from January 1984 to September 1996. A total of 76 strains of viridans streptococci were isolated, of which the most common isolates were Streptococcus constellatus (21 strains), S. intermedius (17), and S. sanguis (10). Species belonging to the S. milleri group accounted for the majority (68%) of isolates. In 38 (53%) patients these organisms were recognized as the sole pathogens. Of the 72 patients, 53 had empyema, 14 had Lung Abscesses, and five had both empyema and Lung Abscess. Forty-six (64%) patients had underlying diseases. Of these, malignancies were the most common (17 patients), followed by diabetes mellitus (12 patients) and central nervous system diseases (10 patients). Of the 48 patients who underwent chest-tube drainage, 27 (56%) received further treatments, including intrapleural streptokinase (18 cases), surgery (9), and both intrapleural streptokinase and surgery (3). Two (14%) of the patients with Lung Abscess alone underwent surgical treatment. Although all viridans streptococcal isolates were susceptible to penicillin, the patients in the study had a high mortality (21%). Univariate and multivariate analysis of data for patients with empyema alone (n = 53) showed a significantly increased risk of death in those with underlying malignancy (OR = 16.0, p = 0.023) and those with non-S. milleri-group isolates (OR = 3.72, p = 0.030). These data imply a strong clinical significance of viridans streptococci in the pathogenesis of empyema and Lung Abscess, as well as the need for species identification of viridans streptococci in patients with pleuropulmonary diseases.
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Differentiation of Lung Abscess and empyema by ultrasonography.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1991Co-Authors: Pan-chyr Yang, Li-na LeeAbstract:To assess the value of chest ultrasonography in the differentiation between a Lung Abscess and empyema, 50 patients, including 24 cases of Lung Abscess and 26 cases of empyema, were studied. The ultrasonographic characteristics of a Lung Abscess included an irregular wall width, a blurred outer margin, an oval or round shape, an acute chest wall angle and a negative pleural separation. The ultrasonographic characteristics of empyema were an uniform wall width, a sharp outer margin, a lenticular shape, an obtuse chest wall angle and a positive pleural separation. A new ultrasonographic scoring system was proposed; a positive finding for each of the features: sharp outer margin, lenticular shape, obtuse chest wall angle and positive pleural separation was assigned a score of 1, while a negative finding was assigned a score of zero. The total scores for the four features were then assessed. Ninety-six percent of the empyema cases scored 2 or more, while 96% of the Lung Abscess cases scored 1 or zero. The efficacy of differential diagnosis was 96%. We conclude that chest ultrasonography is a useful tool in the differentiation between Lung Abscess and empyema and that ultrasonography alone is sufficient to make a correct diagnosis in most cases.
Hyeon Yu - One of the best experts on this subject based on the ideXlab platform.
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management of pleural effusion empyema and Lung Abscess
Seminars in Interventional Radiology, 2011Co-Authors: Hyeon YuAbstract:Pleural effusion is an accumulation of fluid in the pleural space that is classified as transudate or exudate according to its composition and underlying pathophysiology. Empyema is defined by purulent fluid collection in the pleural space, which is most commonly caused by pneumonia. A Lung Abscess, on the other hand, is a parenchymal necrosis with confined cavitation that results from a pulmonary infection. Pleural effusion, empyema, and Lung Abscess are commonly encountered clinical problems that increase mortality. These conditions have traditionally been managed by antibiotics or surgical placement of a large drainage tube. However, as the efficacy of minimally invasive interventional procedures has been well established, image-guided small percutaneous drainage tubes have been considered as the mainstay of treatment for patients with pleural fluid collections or a Lung Abscess. In this article, the technical aspects of image-guided interventions, indications, expected benefits, and complications are discussed and the published literature is reviewed.
Jeana D. O'brien - One of the best experts on this subject based on the ideXlab platform.
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Nephrobronchial Fistula and Lung Abscess Resulting From Nephrolithiasis and Pyelonephritis
Chest, 1995Co-Authors: Jeana D. O'brien, Neil A. EttingerAbstract:There are multiple etiologies reported as causes of Lung Abscess; however, this differential rarely includes intra-abdominal abnormalities other than extension of a hepatic process. We describe a patient who was found to have a Lung Abscess and empyema resulting from the development of a nephrobronchial fistula secondary to nephrolithiasis and pyelonephritis. The patient had no urinary symptoms or known abdominopelvic infection and the etiology of Lung Abscess was only incidentally discovered after chest CT revealed extension of pleural fluid below the diaphragm.
